Governed, evidence-based AI is reshaping clinical workflows — from global trends to real-world impact in Middle Eastern health systems, including Burjeel Hospital.
As healthcare systems globally accelerate digital transformation, artificial intelligence (AI) is becoming an essential part of clinical workflows. Yet alongside this progress, a growing challenge has emerged: The use of unapproved or “shadow AI” tools [1] in clinical environments.
While AI has the potential to enhance efficiency, support clinical reasoning, and help clinicians improve patient outcomes, its unregulated use introduces risks around data security, compliance, and clinical reliability. Addressing this balance between innovation and governance is becoming a priority for healthcare leaders worldwide.
A global signal: The rise of shadow AI in clinical practice
Findings from a Wolters Kluwer survey [2] of more than 500 healthcare professionals in the United States highlight the extent of this challenge:
- 40% reported encountering colleagues using unapproved AI tools.
- 17% acknowledged using such tools themselves.
- 23% identified patient safety as their primary concern with unapproved AI tools.
These findings point to a clear paradox: Clinicians are seeking the efficiency of AI, but often lack access to trusted, enterprise-grade solutions integrated into their workflows.
In fact, nearly half of respondents cited workflow efficiency as a key driver, while others pointed to gaps in approved solutions or limited functionality. This reinforces a critical insight: When trusted tools are not available, clinicians will look elsewhere.
From fragmentation to trust: A new approach to clinical ai
This dynamic is not unique to the US — it is increasingly relevant across the world, including affecting use of healthcare AI the Middle East [3].
Historically, some clinicians have relied on multiple external tools to interpret and summarize clinical information — introducing inefficiencies and potential risk. That fragmentation and potential for unwarranted variability in care [4] is only increased by the proliferation of AI tools in clinician workflows. To combat this, health systems and hospitals need to provide a trusted, governed AI capability embedded directly within clinical decision support.
UpToDate® Expert AI has been developed to address this need.
- It provides a faster, conversational way to access expert-authored UpTo-Date® content [5].
- It is designed to support clinical reasoning – not replace it.
- It offers a trusted alternative [6] to general-purpose AI tools, grounded in curated clinical evidence.
Importantly, Expert AI is referential in nature. That means it retrieves and synthesises existing UpToDate content, enabling clinicians to sense-check, explore, and deepen their understanding – within a governed framework.
Real-world impact: Burjeel Holdings pilots UpToDate Expert AI in the UAE
At Burjeel Holdings in the UAE – an early pilot site for UpToDate Expert AI — the impact of integrating trusted AI into clinical workflows is already evident.
“I have been a regular user of UpToDate for over 10 years, and it has consistently supported my clinical decision-making, particularly in complex cases,” says Dr. Halprashanth D. Sathyanarayana, [7] Consultant Neurologist at Burjeel Hospital.
He recalls a challenging case involving a young patient presenting with acute motor weakness: “Using UpToDate, I was able to review key concepts … which provided an important clinical clue.”
This led to a critical diagnostic shift, from an initial suspected Guillain-Barré syndrome to a rare metabolic disorder – Multiple Acyl-CoA Dehydrogenase Deficiency (MADD). The patient ultimately received targeted treatment and made a full recovery.
Dr. Sathyanarayana notes that this particular case highlights how “UpToDate facilitated timely diagnostic reconsideration and guided appropriate management, ultimately improving patient outcomes.”
Building on this foundation, Dr. Sathyanarayana has found his early experience with Expert AI “to be a valuable addition, particularly for quickly addressing clinical queries. I appreciate that the responses are based on curated UpToDate content rather than general web sources, which enhances reliability.”
What makes trusted clinical AI different?
As healthcare organizations evaluate AI adoption, the distinction between general-purpose AI and clinically governed AI becomes critical.
UpToDate Expert AI is built on principles aligned with enterprise healthcare requirements:
- Trusted content only: Grounded in expert-authored, evidence-based UpToDate content.
- Transparency and provenance: Clear sourcing supports clinical confidence.
- Clinical governance: Designed for organisational oversight and responsible use.
- Human in-the-loop: Supports clinicians’ thinking rather than automating decisions.
Balancing innovation with governance
Healthcare systems, particularly across rapidly advancing regions like the Middle East, face increasing pressure to:
- Manage growing patient demand.
- Address workforce constraints.
- Maintain high standards of care.
- Advance national digital health agendas.
AI is a key part of the solution – but only when implemented responsibly [8]. As highlighted in global and regional discussions with healthcare technology stakeholders, organisations must focus on:
- Expanding access to approved, clinically validated AI tools.
- Providing training and clear guidance for clinicians.
- Establishing robust governance frameworks.
- Developing and testing AI outputs that are transparent, explainable, and evidence-based.
As Dr. Sathyanarayana’s experience at Burjeel shows, the value lies not just in speed, but in confidence and clinical relevance.
Learn more about UpToDate Expert AI.
https://www.wolterskluwer.com/en/solutions/uptodate/ai-clinical-decision-support
References:
1.https://www.wolterskluwer.com/en/expert-insights/shadow-ai-transforming-risk-into-responsible-innovation
2. https://www.wolterskluwer.com/en/expert-insights/shadow-ai-providers-are-using-unapproved-tools-to-improve-workflow
3. https://www.wolterskluwer.com/en/expert-insights/launching-uptodate-enterprise-edition-in-emea-new-era-in-clinical-decision-support
4. https://www.wolterskluwer.com/en/expert-insights/reducing-unwarranted-variability-in-care
5. https://www.wolterskluwer.com/en/solutions/uptodate/about/editorial-process
6. https://www.wolterskluwer.com/en/expert-insights/reimagine-trust-for-todays-healthcare-with-uptodate-expert-ai
7. https://www.linkedin.com/in/dr-halprashanth-d-s-8b2870122/
8. https://www.wolterskluwer.com/en/expert-insights/4-pillars-of-trust-in-clinical-genai-solutions
