Table 4. Barriers and strategies in the sustaining the use phase of AI implementation.

Barriers for sustaining the use
• Leadership     • Lack of sustained guidance, common vision among stakeholders Workflow     • Lack of guidance on how to act in a new workflow–non-uniform usage Finance and human resources     • Underinvestment and lack of physical infrastructure to bring benefits of AI. Workflow     • Lack of guidance on how to act in a new workflow–non-uniform usage. Finance and human resources     • Underinvestment and lack of physical infrastructure to bring benefits of AI.
Strategies for sustaining the use
Leadership     • Establishing follow-up procedures for adherence and utilization during the actual use. Change management     • Incentivizing clinicians for using AI (performance-based); Gamification and sense of competition; Continuous monitoring of AI usage enforces change, using old ways unacceptable. Workflow     • Setting performance metrics for monitoring the workflow; Setting a plan for continuous improvements. Finance and human resources     • Fundraising or public-private partnerships to secure funds for sustained use of AI. Training     • Post-implementation training (individual and peer-group), role plays; AI test environment to experiment with the system and to ask questions. Evaluation and monitoring     • Quality improvement methods; Plan-Do-Study-Act methodology; Collecting feedback continuously; Proactively visiting users; Organizing assessment sessions with AI developers. Maintenance     • Information meetings together with AI developers; Super-user meetings; Weekly/monthly follow-ups to check how system works and needs for change; Internal service desk for handling faults and reports; Dedicated contact person from AI developer’s side; Cross-functional governance committee for AI usage promotion, training new users, tracking effectiveness and compliance; reporting, planning financing; External data safety monitoring board to monitor safety and efficacy of AI.