Clinical deployment and validation of a radiology artificial intelligence system for COVID-19

The global COVID-19 pandemic has disrupted patient care delivery in healthcare systems world-wide. For healthcare providers to better allocate their resources and improve the care for patients with severe disease, it is valuable to be able to identify those patients with COVID-19 who are at higher risk for clinical complications. This may help to optimize clinical workflow and more efficiently allocate scarce medical resources. To this end, medical imaging shows great potential and artificial intelligence (AI) algorithms have been developed to assist in diagnosing and risk stratifying COVID-19 patients. However, despite the rapid development of numerous AI models, these models cannot be clinically useful unless they can be deployed in real-world environments in real-time on clinical data. Here, we propose an end-to-end AI hospital-deployment architecture for COVID-19 medical imaging algorithms in hospitals. We have successfully implemented this system at our institution and it has been used in prospective clinical validation of a deep learning algorithm potentially useful for triaging of patients with COVID-19. We demonstrate that many orchestration processes are required before AI inference can be performed on a radiology studies in real-time with the AI model being just one of the components that make up the AI deployment system. We also highlight that failure of any one of these processes can adversely affect the model's performance.