# A Field Guide to Deploying AI Agents in Clinical Practice

arXiv: https://arxiv.org/abs/2509.26153 · HTML: https://mlsanity.com/paper/2509.26153/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 8 of its 39 references that are in the map.
- First posted on arXiv 30 Sep 2025.

## Placed in

- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 8 of 8)

- [ReAct: Synergizing Reasoning and Acting in Language Models](https://mlsanity.com/paper/2210.03629/) (2022)
- [Lost in the Middle: How Language Models Use Long Contexts](https://mlsanity.com/paper/2307.03172/) (2023)
- [AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments](https://mlsanity.com/paper/2405.07960/) (2024)
- [Medical Hallucinations in Foundation Models and Their Impact on Healthcare](https://mlsanity.com/paper/2503.05777/) (2025)
- [Language Models are Surprisingly Fragile to Drug Names in Biomedical Benchmarks](https://mlsanity.com/paper/2406.12066/) (2024)
- [Cross-Care: Assessing the Healthcare Implications of Pre-training Data on Language Model Bias](https://mlsanity.com/paper/2405.05506/) (2024)
- [Beyond Multiple-Choice Accuracy: Real-World Challenges of Implementing Large Language Models in Healthcare](https://mlsanity.com/paper/2410.18460/) (2024)
- [Scaling Clinician-Grade Feature Generation from Clinical Notes with Multi-Agent Language Models](https://mlsanity.com/paper/2508.01956/) (2025)

## Abstract (arXiv)

Large language models (LLMs) integrated into agent-driven workflows hold immense promise for healthcare, yet a significant gap exists between their potential and practical implementation within clinical settings. To address this, we present a practitioner-oriented field manual for deploying generative agents that use electronic health record (EHR) data. This guide is informed by our experience deploying the "irAE-Agent", an automated system to detect immune-related adverse events from clinical notes at Mass General Brigham, and by structured interviews with 21 clinicians, engineers, and informatics leaders involved in the project. Our analysis reveals a critical misalignment in clinical AI development: less than 20% of our effort was dedicated to prompt engineering and model development, while over 80% was consumed by the sociotechnical work of implementation. We distill this effort into five "heavy lifts": data integration, model validation, ensuring economic value, managing system drift, and governance. By providing actionable solutions for each of these challenges, this field manual shifts the focus from algorithmic development to the essential infrastructure and implementation work required to bridge the "valley of death" and successfully translate generative AI from pilot projects into routine clinical care.