General-purpose generative AI (GenAI) models are being rapidly adopted in healthcare, but they are challenging to assess with traditional evaluation frameworks. These conceptual, methodological, and practical challenges parallel decades of work in evaluating clinician and health system quality and safety. We describe the adaptation of methods from several fields, combined with emerging technical approaches, into a structured, multi-method evaluation framework designed to give well-rounded assessments of GenAI in health at scale. The approach first anchors evaluation to Critical User Journeys (CUJs) to help prioritize out of a large choice space, and maps these to a phased AI system lifecycle (base model development, product development, and post-deployment monitoring), since evaluation at each stage requires different methodological approaches. In this context, the approach then integrates three distinct evaluation methods (closed-question benchmarks, LLM-as-a-judge autoraters, and expert human review) across three core domains: accuracy, safety, and usefulness. Taken together, this approach provides a strategic framework for bridging the gap between benchmarking results and performance in the real world with the goal of supporting decision-making and accountability across development, procurement, and deployment for product teams, health systems, and regulators.

翻译：暂无翻译