Health AI without clinician oversight/accountability + redress

Hold AI-generated clinical output as a draft until an accountable clinician reviews and signs it, and record who approved it before it reaches the chart or the patient.

A clinician sign-off step between the model call and every clinical sink: AI-drafted notes, summaries, diagnostic suggestions, triage levels, and treatment plans are stored as drafts (FHIR DocumentReference.docStatus 'preliminary', DiagnosticReport.status 'preliminary', CarePlan.status 'draft') and become final, active, or visible to the patient only through an action by an authorized clinician that records reviewed_by and reviewed_at. Configuration flags that auto-sign or auto-finalize AI-drafted records stay false, and provenance shows the AI as a contributing device and the clinician as verifier. The deployment also names who is accountable for AI-assisted decisions and gives patients a complaint or redress route.

Where it goes: 1 application source code, 2 data models, 9 AI output handling, 3 config and feature flags.

What reviewers look for: on every path from a model response to a patient message, an EHR write, a care plan, or a diagnosis or level-of-care change, a draft or preliminary status that only a clinician action (clinician_sign_off, practitioner_review_and_sign, require_clinician_approval) can promote, with approved_by or reviewed_by recorded; auto_sign / auto_finalize off for AI-created records; a named accountability owner and a redress channel.

note = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
requests.post(f'{FHIR_BASE}/DocumentReference', json=doc_ref(patient_id, note, doc_status='final'))

note = client.chat.completions.create(model=MODEL, messages=msgs).choices[0].message.content
requests.post(f'{FHIR_BASE}/DocumentReference',
              json=doc_ref(patient_id, note, doc_status='preliminary'))   # AI draft

def practitioner_review_and_sign(doc_id, practitioner):   # only path to 'final'
    doc = requests.get(f'{FHIR_BASE}/DocumentReference/{doc_id}').json()
    doc['docStatus'] = 'final'
    doc['authenticator'] = {'reference': f'Practitioner/{practitioner.id}'}
    requests.put(f'{FHIR_BASE}/DocumentReference/{doc_id}', json=doc)
    audit.record(doc_id, reviewed_by=practitioner.id, reviewed_at=utcnow())

Engineering guidance, not legal advice. Each provision below may add its own details (a cadence, a deadline, a required notice element): open it for those.