Towards Clinically Useful AI: From Radiology Practices in Global South and North to Visions of AI Support

Despite recent advancements, real-world use of Artificial Intelligence (AI) in radiology remains low, often due to the mismatch between AI offerings and the situated challenges faced by healthcare professionals. To bridge this gap, we conducted a field study at nine medical sites in Denmark and Kenya with two goals: (1) to understand the challenges faced by radiologists during chest X-ray practice; (2) to envision alternative AI futures that align with collaborative clinical work. This study uniquely grounds the AI design insights in the comprehensive characterisation of diagnostic work across multiple geographical and institutional contexts. Building on ideas articulated by interviewed radiologists (N=18), we conceptualised five visions that transcend the traditional notions of AI support. These visions emphasise that the clinical usefulness of AI-based systems depends on their configurability and flexibility across three dimensions: type of clinical site, expertise of medical professionals, and situational and patient contexts. Addressing these dependencies requires expanding the clinical AI design space by envisioning futures rooted in the realities of practice rather than solely following the trajectory of AI development.