# HealthIT.com · Healthcare AI evaluation worksheet

Editorial version: 2026-09-07
Source: https://healthit.com/resources/evaluation-worksheet

Use within your organization's approved process. Do not include patient data.
Completion is a planning aid, not approval, a compliance determination, or a vendor score.

Workflow:
Product/version:
Decision owner:
Evaluation date:
Next review date:

## Define the use case

- [ ] Name the workflow, users, setting, and excluded tasks.
  Evidence / owner / follow-up:

- [ ] Record a baseline and a measurable target outcome.
  Evidence / owner / follow-up:

- [ ] Assign a decision owner and the necessary reviewers.
  Evidence / owner / follow-up:

## Examine the evidence

- [ ] Record product version, source URL, date, and exact supported claim.
  Evidence / owner / follow-up:

- [ ] Review study methods, comparator, conflicts, and limitations.
  Evidence / owner / follow-up:

- [ ] Identify critical unknowns and the evidence needed to close them.
  Evidence / owner / follow-up:

## Plan the implementation

- [ ] Map data flows, subprocessors, access, and retention.
  Evidence / owner / follow-up:

- [ ] Review applicable agreements, regulatory scope, and risk analysis.
  Evidence / owner / follow-up:

- [ ] Confirm the exact EHR integration, maintenance owner, and downtime process.
  Evidence / owner / follow-up:

## Decide how to evaluate

- [ ] Agree pilot measures, review responsibilities, and a stop condition.
  Evidence / owner / follow-up:

- [ ] Include training, correction, integration, and support in total cost.
  Evidence / owner / follow-up:

- [ ] Document the decision, next review date, change controls, and exit plan.
  Evidence / owner / follow-up:

## Decision record

Known:
Unknown:
Proceed / investigate / pause:
Reason:
Conditions before use: