CANON Named Owner Principle · every clinical AI deployment requires two named persons in the audit trail — a Governance Owner at Layer 4 and a Decision Owner at the bedside, not one substituting for the other WORKING PAPER №01 The handoff that isn’t · how clinical AI escapes accountability · Mo Johnson, MD MBA EVIDENCE Duke-Margolis 2026 · most US health systems have not named who owns the clinical AI decision when something goes wrong CANON Layer 4 · Clinical AI Governance at the bedside · the layer where the named owner has to live FRAMEWORK Clinical AI Accountability Canvas™ · the diagnostic framework distinguishing Clinical AI Governance from General AI Governance EVIDENCE Stanford MedAgentBench · agentic systems already executing clinical recommendations without a named adjudicator on the chart CANON The Two Inputs · internal data the institution audits · external data the model was trained on, rarely audited at the deployment site CITATION MedicoVigilance™ Issue 6 · The Layer With No Name · 1,627 institutional subscribers CANON The Accountability Gap · the structural failure point where AI stops and the physician starts FRAMEWORK Mind the 9 Blocks™ · the nine institutional blocks that must be in place before clinical AI deployment EVIDENCE npj Digital Medicine · the four-layer governance cascade · most institutions have built the first two layers and left Layer 4 unbuilt PORTFOLIO Tangibley Health Inc. · MedicoVigilance™ Surface 1 · the named-owner architecture deployed in clinical workflow CANON Named Owner Principle · every clinical AI deployment requires two named persons in the audit trail — a Governance Owner at Layer 4 and a Decision Owner at the bedside, not one substituting for the other WORKING PAPER №01 The handoff that isn’t · how clinical AI escapes accountability · Mo Johnson, MD MBA EVIDENCE Duke-Margolis 2026 · most US health systems have not named who owns the clinical AI decision when something goes wrong CANON Layer 4 · Clinical AI Governance at the bedside · the layer where the named owner has to live FRAMEWORK Clinical AI Accountability Canvas™ · the diagnostic framework distinguishing Clinical AI Governance from General AI Governance EVIDENCE Stanford MedAgentBench · agentic systems already executing clinical recommendations without a named adjudicator on the chart CANON The Two Inputs · internal data the institution audits · external data the model was trained on, rarely audited at the deployment site CITATION MedicoVigilance™ Issue 6 · The Layer With No Name · 1,627 institutional subscribers CANON The Accountability Gap · the structural failure point where AI stops and the physician starts FRAMEWORK Mind the 9 Blocks™ · the nine institutional blocks that must be in place before clinical AI deployment EVIDENCE npj Digital Medicine · the four-layer governance cascade · most institutions have built the first two layers and left Layer 4 unbuilt PORTFOLIO Tangibley Health Inc. · MedicoVigilance™ Surface 1 · the named-owner architecture deployed in clinical workflow

GPE RESEARCH PUBLICATIONS

Closing the accountability gap in clinical AI.

The architecture of accountability for the institutions that have to stand behind the decision.

FRAMEWORK BRIEF №01

Mind the 9 Blocks™: a diagnostic canvas for clinical AI accountability

A nine-block canvas and a three-layer Gap Score™ for surfacing, scoring, and closing the clinical AI accountability gap before a recommendation reaches a patient.

Mo Johnson, MD MBA · May 22, 2026 · 24 min read

OUR TEAM'S TRAINING & INSTITUTIONAL PEDIGREE

Brown University
MIT
Columbia Business School
LSE
IE Business School
University of Minnesota

Recent Papers

VIEW ALL
FROM THE PUBLICATION

Working papers and framework briefs on accountability in clinical AI.

ABOUT How to cite RSS feed