"Brilliant AI Doctor" in Rural China: Tensions and Challenges in AI-Powered CDSS Deployment

TL;DR

This study explores the deployment of AI-powered Clinical Decision Support Systems in rural China, highlighting tensions with local contexts and the potential for AI to serve as a collaborative assistant despite challenges.

Contribution

It provides empirical insights into the real-world challenges and perceptions of AI-CDSS in rural healthcare settings in China, informing future design considerations.

Findings

Tensions between AI-CDSS design and rural clinical workflows

Positive clinician attitudes towards AI as a collaborative tool

Technical and usability barriers in deployment

Abstract

Artificial intelligence (AI) technology has been increasingly used in the implementation of advanced Clinical Decision Support Systems (CDSS). Research demonstrated the potential usefulness of AI-powered CDSS (AI-CDSS) in clinical decision making scenarios. However, post-adoption user perception and experience remain understudied, especially in developing countries. Through observations and interviews with 22 clinicians from 6 rural clinics in China, this paper reports the various tensions between the design of an AI-CDSS system ("Brilliant Doctor") and the rural clinical context, such as the misalignment with local context and workflow, the technical limitations and usability barriers, as well as issues related to transparency and trustworthiness of AI-CDSS. Despite these tensions, all participants expressed positive attitudes toward the future of AI-CDSS, especially acting as "a doctor's AI assistant" to realize a Human-AI Collaboration future in clinical settings. Finally we draw on our findings to discuss implications for designing AI-CDSS interventions for rural clinical contexts in developing countries.