healthcare operations teams

Abstract: AI governance increasingly requires providers and public authorities to reason about multiple AI instantiations, alternative versions, and deployment configurations of multiple AI systems. Yet current regulation remains predominantly single-system-centric, acknowledging such multiplicity only sparsely without treating collections of related AI systems as governance objects. This creates an AI population governance problem: determining which instantiations can be meaningfully considered together and how their changing configurations can be represented and monitored. The first requirement has recently been addressed through trustworthiness-based accounts of AI identity. We address the second by introducing convex AI compositionality: a formal representation of the configurations generated by finite AI system populations that uses convex spaces. The core idea is that convex compositions of the operational states that a population of AI system instantiations may occupy over time are compatible with lifecycle reachability across the population and can preserve the formal identity relations between these systems. Well-known statistical and geometric constructions, such as weighted state distributions and convex hulls, become AI governance tools for distinguishing operational states, population weights, heterogeneity, and AI configuration change across different governance modes while remaining compatible, under stated conditions, with lifecycle reachability and AI identity. We illustrate our AI population governance framework through distributed healthcare deployments and controlled deployment of recruitment AI variants.

Abstract: LLM agents are predominantly benchmarked on short, single-task trajectories, yet real deployments run for hours under contention, surfacing a different class of failures. We use the Clinical Environment Simulator (CES), in which an agent manages an entire emergency-department shift under continuous time and resource pressure, as a testbed: long-horizon execution failures manifest measurably in a single rollout under structured, multi-dimensional grading. On CES, current agents reach the correct diagnosis in most cases yet fail to deliver complete and timely critical actions, revealing an execution gap. We attribute this gap to three long-horizon failure modes, each operationalized as a per-trace counter: instruction-adherence drift, treatment incompleteness, and a severity-equity gap in timeliness. We then introduce Asclepius, an adaptive agent scaffolding with a self-evolving harness that rewrites the operating manual between shifts from trace-level feedback, an externalized clinical skills library for high-stakes regimen knowledge, and three isolated subagents that partition per-turn decisions across the patient queue. On held-out batches never observed during harness evolution, Asclepius improves critical-action correctness by 22% (p = 0.024) over a strong baseline agent framework while preserving diagnostic accuracy, with consistent gains across five LLM judges from three model families; on the full ten-batch set, improvements reach 25% on critical actions and 13% on timeliness. The three failure modes form a coupled bottleneck: decisive reductions appear only when all three components act together.