Event, videoSeptember 30 2020

Disruption and Repair: Integrating AI in Clinical Care

Dina Sarro, William Ratliff, and Madeleine Clare Elish

Databite No. 135

Anthropologist Madeleine Clare Elish speaks with nurse practitioner Dina Sarro and Innovation Program Manager William Ratliff about their experiences integrating AI systems into hospital operations and the critical role nurses play to make the system work. The talk draws on Elish and Elizabeth Anne Watkins’ Data & Society report Repairing Innovation: A Study of Integration AI in Clinical Care Repairing Innovation.

When the Sepsis Watch app was first integrated into hospitals, it disrupted existing systems — such as power dynamics and information flows — that needed to be repaired. Rapid Response Team (RRT) nurses worked to mend these breakages — not physical breakages, but ones of social norms, expectations, and contexts. They applied their knowledge of the team’s schedules, inquired into the well-being of the physicians to understand their moods, and leveraged their clinical expertise (among other activities) to effectively integrate Sepsis Watch into the hospital’s clinical system. This work performed by the RRT nurses, which we refer to as “repair work,” was crucial to integrating Sepsis Watch, demonstrating how essential it is to recognize and value repair work in the integration of future AI systems.

Repair work is essential, and valuing it helps us reframe what’s at stake in “innovation.” Focusing on the role of repair expands our understanding of what constitutes innovation — who does it, what it looks like, and where it happens.

Audience Q&A follows the discussion.

About the Speakers

Madeleine Clare Elish leads the AI on the Ground Initiative at Data & Society, where she and her team investigate the promises and risks of integrating AI technologies into society. Through human-centered and ethnographic research, AI on the Ground sheds light on the consequences of deploying AI systems beyond the research lab, examining who benefits, who is harmed, and who is accountable. The initiative’s work has focused on how organizations grapple with the challenges and opportunities of AI, from changing work practices and responsibilities to new ethics practices and forms of AI governance.

William Ratliff is an Innovation Program Manager at DIHI, leading the sourcing and execution of DIHI’s portfolio of innovation pilot projects. He specializes in strategic design, implementation, and measuring impact for projects like Sepsis Watch. Additionally, he utilizes his data science skill set to identify and progress opportunities to inform clinical decision-making with health system data, for projects like Cardiac Decompensation.

Prior to joining DIHI, Will led various clinical strategy, cost reduction, and electronic health record implementation projects for multi-hospital health systems, as part of his experience working in healthcare consulting. Will earned his undergraduate degrees in Economics and French at Vanderbilt University, and his master’s in business administration from Duke University’s Fuqua School of Business.

Dina Sarro is a cardiology nurse practitioner in Wilmington, NC. Prior to that, she worked as a registered nurse in the cardiac intensive care unit at Duke University Hospital. During her time at Duke, she was the nurse co-lead for the hospital wide Code Blue and Rapid Response Committees.


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“Databites” is a regular speaker series that presents timely conversations about the purpose and power of technology. Speakers bridge our interdisciplinary research with broader public conversations about the societal implications of data and automation.

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