Institutional Practice
Seven Institutional Questions for Consequential Healthcare AI
Trustworthy AI depends on more than a technically capable model or an approved policy. Institutions must connect standards, clinical judgment, cybersecurity, operational authority, evidence, and executive accountability across the full lifecycle of consequential AI. TTIC uses the following questions to make those institutional obligations explicit.
The Questions
What every institution must answer
01What decision is being governed?
Define the consequential decision, affected population, workflow, institutional context, and outcome at stake.
Define permitted purpose, scope, boundaries, prohibited actions, and conditions requiring reauthorization.
03Who may recommend, approve, veto, stop, override, and accept residual risk?
Assign decision rights across clinical, technical, security, privacy, legal, quality, operational, and executive functions.
Define provenance, verification, sufficiency, accountability, exception, outcome, and retention requirements.
05What happens when evidence or system behavior is insufficient?
Specify hold, escalation, fallback, override, incident, and learning pathways before the exception occurs.
Measure safety, security, decision latency, evidence completeness, exceptions, adoption, outcomes, and value through accountable operational objectives.
Preserve institutional decision rights, clinical judgment, production authorization, evidence custody, and outcome accountability regardless of vendor or model.
Boundary
Standards authority, not product endorsement
TTIC is independent and product-neutral in its consortium, standards, and certification activities. Medigram is a commercial implementation of decision-governance infrastructure led by TTIC's Founder & Chair. TTIC authority does not substitute for product evidence, independent evaluation, customer diligence, or institutional authorization.