Evidence generation plan for artificial intelligence technologies to help detect fractures on X-rays in urgent care

6 Implementation considerations

Companies should work with providers and central NHS England teams to begin the research. Planning for a prespecified period for the set-up of the technologies is advised. The following considerations around implementing the research process have been identified through working with system partners: 

  • the companies should provide training for staff on using the artificial intelligence (AI)-derived software

  • services should be carefully selected to, when appropriate, maximise data collection for subgroups of interest

  • ideally, a proportion of cases could be saved and sent for peer review as part of the prospective real-world study

  • to assess the potential for automation bias after deployment, companies may want to track the rate of diagnostic disagreement over time

  • all data transfer and processing should adhere to appropriate data protection legislation.

Potential barriers to implementation include: 

  • the availability of research funds for data collection, analysis and reporting 

  • the availability of NHS funding to cover the costs of implementing the technologies in clinical practice 

  • lack of expertise and staff to collect data 

  • burden on healthcare professionals, including the need to have training ahead of implementation, data collection and follow up

  • differences in practice between NHS settings and the level of skills and experience that healthcare professionals have when reviewing X-rays.

ISBN: 978-1-4731-6736-0