CANON Named Owner Principle · every AI deployment requires two named persons in the audit trail, a Governance Owner and a Decision Owner, 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 named owner 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 FRAMEWORK The Accountability Gap™ (TAG™) · two seats, one handoff, any regulated sector · clinical AI and financial AI WORKING PAPER №02 The seam · how a bank's automated triage system closed the alerts nobody read · Mo Johnson, MD MBA FRAMEWORK The Accountability Canvas · nine blocks, one Gap Score™, any regulated deployment · clinical AI and financial AI PORTFOLIO GPe Research · adjudication infrastructure for regulated sectors, in clinical AI and financial AI. CANON Named Owner Principle · every AI deployment requires two named persons in the audit trail, a Governance Owner and a Decision Owner, 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 named owner 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 FRAMEWORK The Accountability Gap™ (TAG™) · two seats, one handoff, any regulated sector · clinical AI and financial AI WORKING PAPER №02 The seam · how a bank's automated triage system closed the alerts nobody read · Mo Johnson, MD MBA FRAMEWORK The Accountability Canvas · nine blocks, one Gap Score™, any regulated deployment · clinical AI and financial AI PORTFOLIO GPe Research · adjudication infrastructure for regulated sectors, in clinical AI and financial AI.

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Overridden: what a quarter century of ignored alerts establishes about accountability

A control that fires and a decision that is owned are two different events. Twenty-five years of clinical decision support has measured the first with precision and left the second unrecorded.

Mo Johnson, MD MBA · Sep 8, 2026 · 12 min read

The Accountability Gap™: two seats, one handoff, any regulated sector

The framework that names who owns a decision when AI shapes it. Built in clinical AI, now operating in financial AI, and structurally the same in either room.

Mo Johnson, MD MBA · Jul 26, 2026 · 15 min read

The seam: how a bank's automated triage system closed the alerts nobody read

Community Federal Savings Bank auto closed a very high percentage of its alert volume. The OCC named the bank, not the vendor. The gap was not in the model. It was in the seam between the system and the person who was supposed to review what it closed.

Mo Johnson, MD MBA · Jul 26, 2026 · 10 min read