Patient perspectives about deployment of artificial intelligence decision support tools in a safety-net healthcare system

Objectives To assess patient awareness, trust, perceived benefits, and risks of artificial intelligence (AI) in clinical care within an urban safety-net health system. Materials and Methods We surveyed 313 patients from November 2024 to January 2025 regarding AI awareness, trust in AI-assisted decision-making, and preferences for transparency and oversight. Quantitative analyses assessed associations between AI awareness and perceived benefit; qualitative analysis identified themes influencing trust. Results While 84% were familiar with commercial AI, fewer than half recognized the use of AI in medical decision support. Greater AI awareness was associated with higher perceived benefit (all P < .001). Participants emphasized transparency (92%), clinician oversight (82%), and validation as critical to trust. Discussion This study provides one of the first assessments of patient perspectives on AI within a safety-net healthcare setting. Patients view clinical AI favorably but demand transparency and clinician involvement. Conclusions Patient education and engagement are essential for equitable, trustworthy AI deployment.