Governance, decision rights, and operating reality

"Should we use AI here" is the wrong question.

The useful one is how much authority the output gets.

Four options. Automate, it acts alone. Augment, it does the work and a person owns the result. Assist, it advises and a human decides. Escalate, it hands off when signals are weak or stakes are high.

None of that is about the model's accuracy. Two organizations can buy the identical tool and sit in completely different risk positions, because they put the human in a different place.

A clinician and an analyst describe the same problem in two languages.

The clinician says "I can't get through my messages without working nights." The analyst says "it's a routing rule in the messaging module."

Clinicians describe work by role and setting. Technical teams describe it by platform and module. Neither is wrong. Neither is enough alone.

Most failed projects I've seen didn't fail at the build. They failed in the gap between those two sentences. Closing that gap on purpose is most of what governance actually is.