The health needs of those living in resource-limited settings are a vastly overlooked and understudied area in the intersection of machine learning (ML) and health care. While the use of ML in health care is more recently popularized over the last few years from the advancement of deep learning, low-and-middle income countries (LMICs) have already been undergoing a digital transformation of their own in health care over the last decade, leapfrogging milestones due to the adoption of mobile health (mHealth). With the introduction of new technologies, it is common to start afresh with a top-down approach, and implement these technologies in isolation, leading to lack of use and a waste of resources. In this paper, we outline the necessary considerations both from the perspective of current gaps in research, as well as from the lived experiences of health care professionals in resource-limited settings. We also outline briefly several key components of successful implementation and deployment of technologies within health systems in LMICs, including technical and cultural considerations in the development process relevant to the building of machine learning solutions. We then draw on these experiences to address where key opportunities for impact exist in resource-limited settings, and where AI/ML can provide the most benefit.
Deep learning and other big data technologies have over time become very powerful and accurate. There are algorithms and models developed that have near human accuracy in their task. In health care, the amount of data available is massive and hence, these technologies have a great scope in health care. This paper reviews a few interesting contributions to the field specifically to medical imaging, genomics and patient health records.
In this manuscript, we present an argument that machine learning, a subfield of artificial intelligence, can drive improvement in value-based health care through reducing error in clinical decision making. Much of what has been previously published on machine learning in medicine represent single-use or proof-of-concept cases, as well as broad reviews of the advantages and limitations of machine learning. It is timely to look at the broader strategy for artificial intelligence implementation in medicine and emphasize how machine learning can positively influence value-based care.
The Covid-19 outbreak threatens to saturate healthcare systems in most Western countries. We describe how digital technologies may be used to automatically and remotely monitor patients at home. Patients answer simple self-reported questionnaires and their data is transmitted, in real time, to a Command Centre in the nearest reference hospital. Patient reported data are automatically filtered by algorithms to identify those with early warning signs. Open-source code of all software components required to deploy the remote digital monitoring platform and Command Centres is available.
Industry 4.0 in health care has evolved drastically over the past century. In fact, it is evolving every day, with new tools and strategies being developed by physicians and researchers alike. Health care and technology have been intertwined together with the advancement of cloud computing and big data. This study aims to analyze the impact of industry 4.0 in health care systems. To do so, a systematic literature review was carried out considering peer-reviewed articles extracted from the two popular databases: Scopus and Web of Science (WoS). PRISMA statement 2015 was used to include and excl…
Objectives: The fee-for-service approach to healthcare leads to the management of a patient's conditions in an independent manner, inducing various negative consequences. It is recognized that a bundled care approach to healthcare-one that manages a collection of health conditions together-may enable greater efficacy and cost savings. However, it is not always evident which sets of conditions should be managed in a bundled program. Study Design: Retrospective inference of clusters of health conditions from an electronic medical record (EMR) system. A survey of healthcare experts to ascertain t…
HAPI-FHIR Server Implementation to Enhancing Interoperability among Primary Care Health Information Systems in Sri Lanka: Review of the Technical Use Case
e-Health is a core part of Australias strategy to address rising costs and changing demands for healthcare services. With over $1bn spent and only 6% of Australians registered, the personally controlled electronic health record (PCEHR) suggests user challenges remain. While evidence confirms the benefits from involving users in systems development there is a need for more examples of how to engage effectively in healthcare settings. This research describes the use of an agile development methodology combined with the thinking out loud technique to deliver a solution that exceeded user requirem…
The open data movement constitutes an approach to achieving accountability for government organizations, and is aligned with one of the sustainable development goals outlined by the United Nations. In the area of health care, government agencies at the Federal and State levels have released open health data consisting of de-identified patient outcomes, costs and ratings. We have applied big data analytics to understand patterns and trends in open health data. We envision the use of this data by concerned citizens to understand both national and local trends in health expenditures. We have buil…
For what purposes are crowds being implemented in health care? Which crowdsourcing methods are being used? This work begins to answer these questions by reporting the early results of a systematic literature review of 110 pieces of relevant research. The results of this exploratory research in progress reveals that collective intelligence outcomes are being generated in three broad categories of public health care; health promotion, health research, and health maintenance, using all three known forms of crowdsourcing. Stemming from this fundamental analysis, some potential implications of the …
In recent years, personal health technologies have emerged that allow patients to collect a wide range of health-related data outside the clinic. These patient-generated data (PGD) reflect patients everyday behaviors including physical activity, mood, diet, sleep, and symptoms. However, major players and academics alike, have ignored the case where these patients or normal people are women. Is analyzed the eHealth segment of female fertility planning mobile apps (in US called: period trackers) and its possible extensions to other female health care mobile services. The market potential is very…
Jakarta is a metropolitan city and among the most dense city in Indonesia. Jakarta has 12 major indicators of standardize health care delivery (Standard Pelayanan Minimum or SPM) derivates from Ministry of Health consists of services related to maternal and neonatal health, school-aged population, working-age population, elderly population, some specific conditions (hypertension, diabetes, tuberculosis, HIV), and also mental health. We planned to construct a data warehouse to provide a single integrated data center. In the first phase (2021), we improve the system by giving responsibility to t…
Digital technology is everywhere for the benefit of our daily and professional life. It strongly impacts our life and was crucial to maintain professional and social activities during the COVID19 crisis. Similarly, digital technologies are key within biomedical engineering research topics. Innovations have been generated and introduced over the last 40 years, demonstrating how computing and digital technologies have impacted health care. Although the benefits of digital technology are obvious now, we are at the convergence of several issues which makes us aware about social, societal and envir…
Adopting a good health information system (HIS) is essential for providing high-quality healthcare. With rapid advances in technology in the healthcare industry in recent years, healthcare providers seek effective options to deal with numerous diseases and a growing number of patients, adopting advanced HIS such as for clinical decision support. While the clinical decision support systems (CDSS) can help medical personnel make better decisions, they may bring negative results due to a lack of understanding of the elements that influence GP's adoption of CDSS. This paper focuses on discovering …
We aim to review available literature related to the telemonitoring of maternal health care for a comprehensive understanding of the roles of Medical Cyber-Physical-Systems (MCPS) as cutting edge technology in maternal risk factor management, and for understanding the possible research gap in the domain. In this regard, we search literature through google scholar and PubMed databases for published studies that focus on maternal telemonitoring systems using sensors, Cyber-Physical-System (CPS) and information decision systems for addressing risk factors We extract 1340 articles relevant to mate…
Massachusetts Institute of Technology（麻省理工学院）；Microsoft Research（微软研究院）；Stanford University（斯坦福大学）；Vector Institute（向量研究院）；New York University（纽约大学）；University of Toronto（多伦多大学）
The use of machine learning (ML) in health care raises numerous ethical concerns, especially as models can amplify existing health inequities. Here, we outline ethical considerations for equitable ML in the advancement of health care. Specifically, we frame ethics of ML in health care through the lens of social justice. We describe ongoing efforts and outline challenges in a proposed pipeline of ethical ML in health, ranging from problem selection to post-deployment considerations. We close by summarizing recommendations to address these challenges.
A sound performance of health care organizations depends on vigorous financing system, skilled and well paying personnel, trustworthy information, well sustained health services and reliable technologies they used. The management and organization of health care systems and other health care settings can deeply have an effect on health result, excellence of care, and patient pleasure. Environmental assessment of an organization must considered political, technical and environmental aspects. This research is paying attention on dangerous and unresolved issues resulting from waste. The insufficie…
An Electronic Health Record (EHR) system must enable efficient availability of meaningful, accurate and complete data to assist improved clinical administration through the development, implementation and optimisation of clinical pathways. Therefore data integrity is the driving force in EHR systems and is an essential aspect of service delivery at all levels. However, preserving data integrity in EHR systems has become a major problem because of its consequences in promoting high standards of patient care. In this paper, we review and address the impact of data integrity of the use of EHR sys…
Demand for health care is constantly increasing due to the ongoing demographic change, while at the same time health service providers face difficulties in finding skilled personnel. This creates pressure on health care systems around the world, such that the efficient, nationwide provision of primary health care has become one of society's greatest challenges. Due to the complexity of health care systems, unforeseen future events, and a frequent lack of data, analyzing and optimizing the performance of health care systems means tackling a wicked problem. To support this task for primary care,…
The idea of Artificial Intelligence (AI) has a long history. It turned out, however, that reaching intelligence at human levels is more complicated than originally anticipated. Currently we are experiencing a renewed interest in AI, fueled by an enormous increase in computing power and an even larger increase in data, in combination with improved AI technologies like deep learning. Healthcare is considered the next domain to be revolutionized by Artificial Intelligence. While AI approaches are excellently suited to develop certain algorithms, for biomedical applications there are specific chal…
The distribution of health care payments to insurance plans has substantial consequences for social policy. Risk adjustment formulas predict spending in health insurance markets in order to provide fair benefits and health care coverage for all enrollees, regardless of their health status. Unfortunately, current risk adjustment formulas are known to underpredict spending for specific groups of enrollees leading to undercompensated payments to health insurers. This incentivizes insurers to design their plans such that individuals in undercompensated groups will be less likely to enroll, impacti…
University of Toronto（多伦多大学）；Vector Institute（向量研究所）
Machine learning models in health care are often deployed in settings where it is important to protect patient privacy. In such settings, methods for differentially private (DP) learning provide a general-purpose approach to learn models with privacy guarantees. Modern methods for DP learning ensure privacy through mechanisms that censor information judged as too unique. The resulting privacy-preserving models, therefore, neglect information from the tails of a data distribution, resulting in a loss of accuracy that can disproportionately affect small groups. In this paper, we study the effect…
Stevens Institute of Technology（史蒂文斯理工学院）；Syracuse University（雪城大学）；Texas Tech University（德克萨斯理工大学）
Objective: A patient medical insurance coverage plays an essential role in determining the post-acute care (PAC) discharge disposition. The prior health insurance authorization process postpones the PAC discharge disposition, increases the inpatient length of stay, and effects patient health. Our study implements predictive analytics for the early prediction of the PAC discharge disposition to reduce the deferments caused by prior health insurance authorization, the inpatient length of stay and inpatient stay expenses. Methodology: We conducted a group discussion involving 25 patient care faci…
Technology adoption in healthcare services has resulted in advancing care delivery services and improving the experiences of patients. This paper presents research that aims to find the important requirements for a remote monitoring system for patients with COVID-19. As this pandemic is growing more and more, there is a critical need for such systems. In this paper, the requirements and the value are determined for the proposed system, which integrates a smart bracelet that helps to signal patient vital signs. (376) participants completed the online quantitative survey. According to the study …
Stepwise regression building procedures are commonly used applied statistical tools, despite their well-known drawbacks. While many of their limitations have been widely discussed in the literature, other aspects of the use of individual statistical fit measures, especially in high-dimensional stepwise regression settings, have not. Giving primacy to individual fit, as is done with p-values and $R^2$, when group fit may be the larger concern, can lead to misguided decision making. One of the most consequential uses of stepwise regression is in health care, where these tools allocate hundreds o…
Background: COVID-19 has become a challenge worldwide and properly planning of medical resources is the key to combating COVID-19. In the US Veteran Affairs Health Care System (VA), many of the enrollees are susceptible to COVID-19. Predicting the COVID-19 to allocate medical resources promptly becomes a critical issue. When the VA enrollees have COVID-19 symptoms, it is recommended that their first step should be to call the VA Call Center. For confirmed COVID-19 patients, the median time from the first symptom to hospital admission was seven days. By predicting the number of COVID-19 related…
A Taxonomy of Mental Health and Technology Needs for Alzheimer's and Dementia Caregivers
Siebel School of Computing and Data Science（Siebel计算与数据科学学院）；University of Illinois Urbana-Champaign（伊利诺伊大学厄巴纳-香槟分校）；Department of Psychology（心理学系）；Illinois Neurological Institute（伊利诺伊神经科学研究所）；Department of Human-Centered Computing（以人为中心计算系）；Manning College of Information and Computer Sciences（马歇尔大学信息与计算机科学学院）
Test-Time Learning and Inference-Time Deliberation for Efficiency-First Offline Reinforcement Learning in Care Coordination and Population Health Management
This paper introduces a reliable health care system for diabetic patients based on the Internet of Things technology. A diabetic health care system with a hardware implementation is presented. The proposed work employs Alaris 8100 infusion pump, Keil LPC-1768 board, and IoT-cloud to monitor the diabetic patients. The security of diabetic data over the cloud and the communication channel between health care system components are considered as part of the main contributions of this work. Moreover, an easy way to control and monitor the diabetic insulin pump is implemented. The \mbox{patient\text…
The US federal government spends more than a trillion dollars per year on health care, largely provided by private third parties and reimbursed by the government. A major concern in this system is overbilling, waste and fraud by providers, who face incentives to misreport on their claims in order to receive higher payments. In this paper, we develop novel machine learning tools to identify providers that overbill Medicare, the US federal health insurance program for elderly adults and the disabled. Using large-scale Medicare claims data, we identify patterns consistent with fraud or overbillin…
The Role of Machine Learning in Reducing Healthcare Costs: The Impact of Medication Adherence and Preventive Care on Hospitalization Expenses
The Fu Foundation School of Engineering and Applied Science, Columbia University（哥伦比亚大学傅 Foundation 工程与应用科学学院）；College of Computing, Georgia Institute of Technology（佐治亚理工学院计算学院）
The International Classification of Functioning, Disability, and Health for Children and Youth (ICF-CY) is a scaffold for designating and systematizing data on functioning and disability. It offers a standard semantic and a theoretical foundation for the demarcation and extent of wellbeing and infirmity. The multidimensional layout of ICF-CY comprehends a plethora of information with about 1400 categories making it difficult to analyze. Our research proposes a predictive model that classify self-care problems on Self-Care Activities Dataset based on the ICF- CY. The data used in this study res…
Halmstad University（哈尔姆斯塔德大学）；Halland Hospital, Region Halland（哈兰医院，哈兰地区）
A consequence of the fragmented and siloed healthcare landscape is that patient care (and data) is split along multitude of different facilities and computer systems and enabling interoperability between these systems is hard. The lack interoperability not only hinders continuity of care and burdens providers, but also hinders effective application of Machine Learning (ML) algorithms. Thus, most current ML algorithms, designed to understand patient care and facilitate clinical decision-support, are trained on limited datasets. This approach is analogous to the Newtonian paradigm of Reductionis…
Dissecting Medical Referral Mechanisms in Health Services: Role of Physician Professional Networks
Instituto Superior Técnico, University of Lisbon（里斯本大学高等技术学院）；Nova School of Business and Economics, Universidade Nova de Lisboa（新里斯本大学诺瓦商业与经济学院）；Nova School of Science and Technology, Universidade Nova de Lisboa（新里斯本大学诺瓦科学与技术学院）
DUET（达卡工程技术大学）；EUB（欧洲孟加拉大学）；JNU（贾汉吉尔纳加尔大学）；Daffodil International University（达福迪尔国际大学）；BUP（孟加拉国国父和平大学）
Nearly 30% of the people in the rural areas of Bangladesh are below the poverty level. Moreover, due to the unavailability of modernized healthcare-related technology, nursing and diagnosis facilities are limited for rural people. Therefore, rural people are deprived of proper healthcare. In this perspective, modern technology can be facilitated to mitigate their health problems. ECG sensing tools are interfaced with the human chest, and requisite cardiovascular data is collected through an IoT device. These data are stored in the cloud incorporates with the MQTT and HTTP servers. An innovativ…
