Measuring What Matters: Benchmarking Generative, Multimodal, and Agentic AI in Healthcare

TL;DR

This paper emphasizes the need for comprehensive benchmarks to evaluate AI models in healthcare, focusing on reliability, safety, and clinical relevance in real-world settings beyond traditional performance metrics.

Contribution

It proposes a systematic framework for benchmarking generative, multimodal, and agentic AI in healthcare to better assess their practical utility and safety.

Findings

Current benchmarks often overestimate clinical readiness.

Performance drops significantly on real clinical tasks.

Existing benchmarks mainly test knowledge, not reliability.

Abstract

AI models are increasingly deployed in live clinical environments where they must perform reliably across complex, high-stakes workflows that standard training and validation datasets were never designed to capture. Evaluating these systems requires benchmarks: structured combinations of tasks, datasets, and metrics that enable reproducible, comparable measurement of what a model can do. The central challenge in healthcare AI is not performance alone, but the absence of systematic methods to measure reliability, safety, and clinical relevance under real-world conditions. Most existing benchmarks test what a model knows; too few test whether it can perform reliably and without failing across the full complexity of real clinical tasks. Current benchmarks have accumulated through ad hoc dataset construction optimized for narrow task performance: frontier models achieve near-perfect scores on medical licensing examinations, but when evaluated across real clinical tasks, performance degrades sharply, scoring 0.74--0.85 on documentation, 0.61--0.76 on clinical decision support, and only 0.53--0.63 on administrative and workflow tasks \cite{medhelm}. High benchmark scores give a false sense of deployment readiness, and the gap between performance and utility widens precisely as AI systems take on more consequential clinical roles. Without a principled framework for benchmark design, the field cannot determine whether poor clinical performance reflects model limitations or failures in how performance is being measured.