Exploring the Ethical and Practical Considerations of Artificial Intelligence in Real World Healthcare Settings: Stakeholder Focus Group Study (Preprint)

BACKGROUND Artificial intelligence (AI) technologies continue to transform how we research human disease, diagnose and treat patients, and operate hospitals. However, emerging ethical dilemmas surrounding their design, use, and oversight demand both policy attention and empirical research. OBJECTIVE This study aimed to explore current AI development, integration, and use activities and identify emerging ethical priorities across the Texas Medical Center (TMC), the largest medical center in the world. METHODS Three qualitative focus groups were conducted via Zoom between May and June 2025 to gauge the perspectives of N=19 clinicians, developers, administrators, and patient advocates on core aspects of clinical AI in healthcare. RESULTS Experts noted that while AI is currently being used to extend clinical expertise and enhance workflow efficiency, there are significant barriers accessing quality datasets for training, insufficient governance on the use of AI tools in the clinic, and limited patient involvement in AI development decisions. These concerns were heightened for practitioners working in safety net hospitals and in other under-resourced healthcare settings. Clinicians and patient advocates also differed in their views on patient notification about the use of AI at the point of care, justifying future research on this question. CONCLUSIONS Our findings offer a useful case study for how large, academic medical centers currently leverage AI technologies to improve patient care, and where to focus education and training efforts to further build AI literacy among patients, providers and administrators in the future.