Directors do not need to be technologists. They do need eight competencies, each restated for AI and measured against the oversight duty, when AI becomes central to care, products, and operations.

An AI tool that refines a process and one that changes who makes a clinical, coverage, or regulatory decision should not reach the board in the same form. A four-question test helps directors tell them apart.

Boards rarely decide with complete information. The failure is using one method for four kinds of gaps. This guide shows directors how to name each gap, match their questions to it, and record what they decided, from R&D programs to AI approvals.