Briefing Capability Statement ✉

Health Reclaimed · Appendix A

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What would you do if the system worked?

Before acquiring an artificial intelligence system, an organization should be able to answer a narrower question than whether it is ready. It should be able to answer what it would do if the system worked.

Twenty-two questions, in five conditions. Work through each one and record what you actually know, not what you assume. Where you cannot answer, say so — an unanswered question is the most useful result this assessment produces.

Your answers stay in your browser. Nothing you type into the assessment is transmitted, stored on a server, or visible to SANCIAN — there is no account and no submission. Your email address is sent to SANCIAN once, to unlock the assessment. The answers themselves never leave this device, and clearing your browser data erases them.

How to work through it

Record what you know under each question. If you cannot answer one, mark it — that is the result worth having. At the end you get a single page listing every question you could not answer, grouped by condition, which you can print or save and take into the room where the decision is being made.

The five conditions run in series, not in parallel. A system can perform perfectly and still produce nothing if one condition is missing — the capacity to act on what it finds. Conditions further down the chain may be fully in place and never get reached.

1

Legal standing

  1. Does your organization have the authority to act on what this system would produce? Name the source of that authority.

  2. If the system identifies a risk in a population you do not directly serve, what standing do you have to intervene?

  3. If someone challenges an action taken on the basis of this system's output, who defends it and on what basis?

  4. Are there actions the system might recommend that your organization is not permitted to take?

2

Financial capacity

  1. What is the cost of acting on the output at expected volume, separate from the cost of the system itself?

  2. If the system identifies more cases, more risks, or more need than you currently address, is there capacity to respond, or will the additional findings go unaddressed?

  3. Is monitoring funded as an ongoing operating cost rather than a project expense?

  4. What happens to the system when the funding that acquired it ends?

3

Procedural clarity

  1. Who receives the output? Name a role, not a department.

  2. What is that person required to do with it, and within what period?

  3. What happens if they do nothing? Is that visible to anyone?

  4. How does this output enter existing workflows, and what does it displace? If it is added to a queue that is already full, what falls off?

  5. Who is authorized to override the system, and what record does an override leave?

4

Contractual position

  1. What does your agreement with the supplier require them to disclose about how the system was developed and on what data?

  2. What evidence of the system's operation will exist, who holds it, and can you obtain it without the supplier's cooperation?

  3. If the system's performance degrades, what obligation does the supplier have, and what remedy do you have?

  4. Does your agreement require the supplier to obtain and preserve the information you may need from parties upstream of them?

  5. Who negotiated these terms, and what technical documentation did they review before accepting them?

5

Legitimacy

  1. Do the people this system will make determinations about know it exists?

  2. Was the community consulted before deployment or informed after it?

  3. If someone believes the system was wrong about them, how do they say so, and who is required to respond?

  4. Would you be comfortable explaining this deployment publicly, in detail, to the population it affects?

What you could not answer

This updates as you work. Print it or save it as text — it is the document to bring to the acquisition decision.

Readiness assessment — unanswered questions

No questions marked yet

Any question you cannot answer is a gap, and gaps in the same section compound. A section where most questions are unanswered indicates a condition that is not in place, which means the system will not produce the outcome you are buying it for regardless of how well it performs.

This assessment is deliberately something you complete about your own organization. That has a limit worth naming. Chapter 12 argues that an evaluation performed by a party with an interest in the result is worth less than one performed independently. The same applies here. Use this to find your gaps, not to certify that you have none.

Appendix A, Health Reclaimed: Artificial Intelligence, Public Health, and the Authority to Act
Dr. Sancian Crawford, PhD, DCM, MPH · ISBN 979-8-9979517-0-2
sancian.com/readiness

After the gaps

The other three assessments

Equity in detection and response, the authority map, and the monitoring framework — open to read and cite.

Read Appendices B–D

The book

The argument these questions come from, in full. Paperback, hardcover and Kindle.

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Work through it with us

Where an unanswered question is a live procurement problem, SANCIAN does this work with federal health agencies.

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