When AI Writes Medical Device Requirements, What Does It Miss?

Nov 2, 2026 | Health Tech

Image Source: Image generated using OpenAI
Independent Contributor
Written by: Shreya Sridhar, Principal Systems Engineer
On behalf of: N/A

Artificial intelligence is making its way into nearly every stage of medical device development, including one of the most foundational activities: defining product requirements. With a well-structured prompt, AI-generated requirements, spanning user needs, software specifications, and even preliminary verification criteria, can be produced in a fraction of the time traditionally required.

For medical device manufacturers, this presents an appealing opportunity to accelerate development. However, generating requirements quickly is not the same as ensuring they are complete.

The challenge is that AI-generated requirements can look technically sound when reviewed individually, while still overlooking critical relationships between system functions, clinical workflows, and safety considerations. These omissions may be difficult to recognize until much later in development, when they become considerably more expensive to address.

The Problem With Requirements That Look Complete

Consider a hypothetical remote cardiac monitoring system that collects electrocardiogram (ECG) data from a wearable sensor, analyzes the recordings for potential cardiac abnormalities, and presents relevant findings to clinicians for review.

An AI tool tasked with generating requirements for this system might produce a reasonable list covering sensor connectivity, data acquisition, signal processing, arrhythmia detection, clinician notifications, and visualization of ECG recordings.

Each requirement could be clear, testable, and technically feasible. But what happens when the wearable sensor temporarily loses connectivity? How should the system respond when poor signal quality affects the reliability of an algorithm’s output? If an abnormality is detected in a recording that later fails quality checks, should the clinician still receive the same alert?

These are not necessarily missing features. They are dependencies and conditions that emerge when individual functions are considered together as part of a clinical workflow.

A requirements document could contain hundreds of well-written statements and still fail to describe how the product should behave in these situations.

This is not a limitation unique to AI. Human engineers can overlook similar dependencies. However, the speed and apparent completeness of AI-generated documentation can create a false sense of confidence, particularly when reviewers are faced with large volumes of technically plausible content.

Reviewing Capabilities Instead of Documents

One way to address this challenge is to change how AI-generated requirements are reviewed.

Rather than evaluating requirements only as individual statements organized by subsystem, development teams can examine them through the lens of complete, end-to-end product capabilities.

A useful approach is vertical slicing, which decomposes a complex product into smaller increments that deliver meaningful functionality across the system [1].

At the product level, a slice might represent the complete capability to acquire ECG data, assess signal quality, identify a potential arrhythmia, communicate the finding, and support clinician review.

At the feature level, that capability can be decomposed into the supporting user interface, data processing, algorithms, application logic, integrations, risk controls, and verification activities.

This decomposition creates an opportunity to review requirements in context. Instead of asking only whether the arrhythmia detection requirements are complete, engineers can examine whether the entire clinical workflow is supported, including its dependencies and potential failure conditions.

For example, reviewing the complete monitoring capability may reveal that signal quality must influence how detected events are classified and communicated to clinicians. That dependency might be overlooked when signal processing, detection algorithms, and notification functions are reviewed independently.

The objective is not simply to organize AI-generated requirements differently. It is to expose interactions that would otherwise remain hidden between engineering disciplines.

Making AI-Assisted Engineering More Reliable

AI can still play a valuable role in this process. Beyond generating initial requirements, it can help identify potential dependencies, propose alternative workflow scenarios, and suggest verification conditions for engineers to evaluate.

However, the review process must remain grounded in clinical intent and system behavior.

For each end-to-end capability, engineers should consider whether the complete user workflow is represented, whether abnormal and failure conditions have been addressed, and whether the resulting requirements can be traced to appropriate risk controls and verification evidence.

Importantly, generating a traceability relationship does not demonstrate that the underlying requirement is correct or that the proposed verification is sufficient. Those judgments still require engineering and clinical expertise.

Speed Is Valuable, but Completeness Matters More

As AI tools become increasingly capable of producing engineering documentation, the bottleneck in medical device development may shift from creating artifacts to reviewing their quality and completeness.

This makes the structure of the review process particularly important. Teams need methods that help them identify missing dependencies, challenge assumptions, and evaluate whether the requirements collectively describe a safe and usable product.

For medical device manufacturers, the opportunity is not merely to write requirements faster. It is to combine AI-assisted generation with disciplined, end-to-end systems thinking.

Ultimately, the most consequential requirement may not be the one AI writes incorrectly. It may be the one nobody realizes is missing.

 

Author Bio

    Shreya Sridhar is a Principal Systems Engineer and Technical Lead at Medtronic, specializing in AI-enabled medical device software, systems engineering, and regulated product development. Her work focuses on integrating system architecture, requirements engineering, risk management, and verification to support the development of safe and reliable healthcare technologies. She has published articles in IEEE Engineering Management Review, INCOSE INSIGHT, Medical Design & Outsourcing, and MedTech Intelligence. She also serves on the Board of Directors of INCOSE New England and is an active contributor to industry conferences and professional engineering initiatives.

    References: [1] Sridhar S. Decomposing Complexity: A Systems Engineering View of Modern Software: Aligning the V-Model with a Slicing-Based Decomposition Strategy. INCOSE INSIGHT. 2026;29(4):34-37. https://doi.org/10.1002/inst.70075
    All content is published for informational purposes only and does not constitute medical, legal, or investment advice. For more information, see our Terms and Conditions

    Articles that may be of interest

    Hygiene Poverty and the Overlooked Toileting Needs of Women

    Hygiene Poverty and the Overlooked Toileting Needs of Women

    If you had to choose between food and toilet paper, what would you choose? A UK report from In Kind Direct and The Hygiene Bank found that 47% of people experiencing hygiene poverty had gone without toilet roll, making it the most common product people went without....

    read more
    What Are You Signing When the AI Wrote the Note?

    What Are You Signing When the AI Wrote the Note?

    Anyone who has finished an emergency shift knows the chart stack. The department is still loud, the next team has the board, and a column of unsigned notes waits on the workstation. You read each one, fix what's wrong, and sign. That signature has always meant...

    read more
    Interoperability Begins Where Data Exchange Ends

    Interoperability Begins Where Data Exchange Ends

    Standards and APIs can move information. True healthcare interoperability requires the governance, trust and workflow design that make the information usable. Healthcare has spent years treating interoperability as a problem of moving data. National exchange has...

    read more

    Articles that may be of interest

    Hygiene Poverty and the Overlooked Toileting Needs of Women

    Hygiene Poverty and the Overlooked Toileting Needs of Women

    If you had to choose between food and toilet paper, what would you choose? A UK report from In Kind Direct and The Hygiene Bank found that 47% of people experiencing hygiene poverty had gone without toilet roll, making it the most common product people went without....

    read more
    What Are You Signing When the AI Wrote the Note?

    What Are You Signing When the AI Wrote the Note?

    Anyone who has finished an emergency shift knows the chart stack. The department is still loud, the next team has the board, and a column of unsigned notes waits on the workstation. You read each one, fix what's wrong, and sign. That signature has always meant...

    read more
    Interoperability Begins Where Data Exchange Ends

    Interoperability Begins Where Data Exchange Ends

    Standards and APIs can move information. True healthcare interoperability requires the governance, trust and workflow design that make the information usable. Healthcare has spent years treating interoperability as a problem of moving data. National exchange has...

    read more