This assignment is a simulated case investigation into a fictional ambient AI documentation failure at a pediatric medical center, where an AI listening tool mis-transcribed a patient's penicillin allergy, leading to a contraindicated prescription and an allergic reaction. It walks through the incident timeline, stakeholder impacts, and an ethical analysis grounded in the ANA code of ethics, then presents expert testimony identifying the failure as a sociotechnical breakdown rather than a single clinician's mistake. It closes with a verdict and a governance action plan proposing concrete fixes like mandatory field-level verification, an AI oversight committee, and defined audit escalation thresholds.

Competencies developed:
7.3h – Design system improvement strategies that address internal and external system processes and structures that perpetuate embedded barriers in healthcare systems.
8.1h – Evaluate the unintended consequences of information and communication technologies on care processes, communications, and information flow across care settings.
8.5h – Assess potential ethical and legal issues associated with the use of information and communication technology.
9.1h – Analyze current policies and practices in the context of an ethical framework.

Explanation:
This project investigates a simulated ambient AI documentation failure that led to patient harm, so it centers on the ethics and governance of health technology. Tracing how the AI hallucinated an allergy field and how that error moved downstream to a second provider is a direct case of evaluating the unintended consequences of technology on care processes and information flow (8.1h). The applied ethics section, weighing nonmaleficence, transparency, and accountability against ANA and AMIA codes, shows assessing the ethical and legal issues tied to using this technology (8.5h). The verdict itself, calling out the lack of an audit trigger and unclear ownership of the governance gap, reflects analyzing existing organizational practices against an ethical framework (9.1h). And the governance action plan, with its escalation thresholds, standing AI oversight committee, and vendor accountability requirements, is a strong example of designing system improvement strategies that address the structural gaps that allowed the failure to happen (7.3h).

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