Advancing healthcare AI governance through a comprehensive maturity model based on systematic review.

Abstract

Artificial Intelligence (AI) deployment in healthcare is accelerating, yet governance frameworks remain fragmented and often assume extensive resources. Through a systematic review of 35 frameworks for AI implementation in healthcare (published 2019-2024), we identified seven critical domains of healthcare AI governance. While existing frameworks provide valuable guidance, the resource requirements create barriers for smaller healthcare organizations. To address this gap, we organized key findings from the review to create the Healthcare AI Governance Readiness Assessment (HAIRA), a five-level maturity model that provides actionable governance pathways based on organizational resources. HAIRA spans from Level 1 (Initial/Ad Hoc) to Level 5 (Leading), with specific benchmarks across all seven governance domains. This tiered approach enables healthcare organizations to assess their current AI governance capabilities and establish appropriate advancement targets. Our framework addresses a critical need for adaptive governance strategies that ensure that AI implementation delivers tangible benefits to systems of varying resource levels.