For centuries nursing has been known as a job that requires complex manual operations, that cannot be automated or replaced by any machinery. All the devices and techniques have been invented only to support, but never fully replace, a person with knowledge and expert intuition. With the rise of Artificial Intelligence and continuously increasing digital data flow in healthcare, new tools have arrived to improve patient care and reduce the labour-intensive work conditions of a nurse.
This cross-disciplinary review aims to build a bridge over the gap between computer science and nursing. It outlines and classifies the methods for machine learning and data processing in patient care before and after the operation. It comprises of Process-, Patient-, Operator-, Feedback-, and Technology-centric classifications. The presented classifications are based on the technical aspects of patient case.
Acute kidney injury (AKI) is a common and serious complication after a surgery which is associated with morbidity and mortality. The majority of existing perioperative AKI risk score prediction models are limited in their generalizability and do not fully utilize the physiological intraoperative time-series data. Thus, there is a need for intelligent, accurate, and robust systems, able to leverage information from large-scale data to predict patient's risk of developing postoperative AKI. A retrospective single-center cohort of 2,911 adult patients who underwent surgery at the University of Fl…
Sepsis is an important cause of mortality, especially in intensive care unit (ICU) patients. Developing novel methods to identify early mortality is critical for improving survival outcomes in sepsis patients. Using the MIMIC-III database, we integrated demographic data, physiological measurements and clinical notes. We built and applied several machine learning models to predict the risk of hospital mortality and 30-day mortality in sepsis patients. From the clinical notes, we generated clinically meaningful word representations and embeddings. Supervised learning classifiers and a deep learn…
With the development of the Internet of Things(IoT) and Artificial Intelligence(AI) technologies, human activity recognition has enabled various applications, such as smart homes and assisted living. In this paper, we target a new healthcare application of human activity recognition, early mobility recognition for Intensive Care Unit(ICU) patients. Early mobility is essential for ICU patients who suffer from long-time immobilization. Our system includes accelerometer-based data collection from ICU patients and an AI model to recognize patients' early mobility. To improve the model accuracy and…
Stanford University（斯坦福大学）；Stanford University School of Medicine（斯坦福大学医学院）
Improving the quality of end-of-life care for hospitalized patients is a priority for healthcare organizations. Studies have shown that physicians tend to over-estimate prognoses, which in combination with treatment inertia results in a mismatch between patients wishes and actual care at the end of life. We describe a method to address this problem using Deep Learning and Electronic Health Record (EHR) data, which is currently being piloted, with Institutional Review Board approval, at an academic medical center. The EHR data of admitted patients are automatically evaluated by an algorithm, wh…
In this paper, we report an extensive analysis that we performed in two scenarios where the care relation between doctor and patients are mediated by the relatives of the patients: Pediatric Palliative Care (PPC) and Nursing Homes (NH). When the patients are children or very old adults in the end of life, the provision of care often involve a family caregiver as the main point of contact for the health service. PPC and NH are characterized by emotional complexity, since incurable diseases expose the family caregivers to heavy careload and human distress. In this paper, we discuss our findings …
There is a clear need to involve patients in medical decisions. However, cognitive psychological research has highlighted the cognitive limitations of humans with respect to 1. Probabilistic assessment of the patient state and of potential outcomes of various decisions, 2. Elicitation of the patient utility function, and 3. Integration of the probabilistic knowledge and of patient preferences to determine the optimal strategy. Therefore, without adequate computational support, current shared decision models have severe ethical deficiencies. An informed consent model unfairly transfers the resp…
Electronic Health Records (EHRs) contain a large volume of heterogeneous patient data, which are useful at the point of care and for retrospective research. These data are typically stored in relational databases. Gaining an integrated view of these data for a single patient typically requires complex SQL queries joining multiple tables. In this work, we present a visualization tool that integrates heterogeneous health care data (e.g., clinical notes, laboratory test values, vital signs) into a single timeline. We train risk models offline and dynamically generate and present their predictions…
Massachusetts Institute of Technology（麻省理工学院）；University of Massachusetts（马萨诸塞大学）；Harvard T.H. Chan School of Public Health（哈佛大学陈曾熙公共卫生学院）；Massachusetts General Hospital（麻省总医院）；Tufts University School of Medicine（塔夫茨大学医学院）；Beth Israel Deaconess Medical Center（贝斯以色列女执事医疗中心）；Washington University School of Medicine（华盛顿大学医学院）；Philips Research North America（飞利浦北美研究院）；Harvard University（哈佛大学）；Adobe Research（Adobe研究院）
A crucial step within secondary analysis of electronic health records (EHRs) is to identify the patient cohort under investigation. While EHRs contain medical billing codes that aim to represent the conditions and treatments patients may have, much of the information is only present in the patient notes. Therefore, it is critical to develop robust algorithms to infer patients' conditions and treatments from their written notes. In this paper, we introduce a dataset for patient phenotyping, a task that is defined as the identification of whether a patient has a given medical condition (also ref…
Managing health-care records and information is an imperative necessity. Most patient health records are stored in separate systems and there are still huge paper trails of records that health-care providers must keep to comply with different regulations. This paper proposes an RFID-based system, named SIMOPAC, that integrate RFID technology in health care in order to make patient emergency care as efficient and risk-free as possible, by providing doctors with as much information about a patient as quickly as possible. Every hospital could use SIMOPAC with their existing system in order to pro…
OBJECTIVE: To test the hypothesis that variation in care coordination is related to LOS. DESIGN We applied a spectral co-clustering methodology to simultaneously infer groups of patients and care coordination patterns, in the form of interaction networks of health care professionals, from electronic medical record (EMR) utilization data. The care coordination pattern for each patient group was represented by standard social network characteristics and its relationship with hospital LOS was assessed via a negative binomial regression with a 95% confidence interval. SETTING AND PATIENTS This stu…
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,…
Readmission rates in the hospitals are increasingly being used as a benchmark to determine the quality of healthcare delivery to hospitalized patients. Around three-fourths of all hospital re-admissions can be avoided, saving billions of dollars. Many hospitals have now deployed electronic health record (EHR) systems that can be used to study issues that trigger readmission. However, most of the EHRs are high dimen-sional and sparsely populated, and analyzing such data sets is a Big Data challenge. The effect of some of the well-known dimension reduction techniques is minimized due to presence…
This paper describes the Pressure Ulcers Online Website, which is a first step solution towards a new and innovative platform for helping people to detect, understand and manage pressure ulcers. It outlines the reasons why the project has been developed and provides a central point of contact for pressure ulcer analysis and ongoing research. Using state-of-the-art technologies in convolutional neural networks and transfer learning along with end-to-end web technologies, this platform allows pressure ulcers to be analysed and findings to be reported. As the system evolves through collaborative …
More than ever COVID-19 is putting pressure on health systems all around the world, especially in Brazil. In this study we propose an analytical approach based on statistics and machine learning that uses lab exam data coming from patients to predict whether patients are going to require special care (hospitalisation in regular or special-care units). We also predict the number of days the patients will stay under such care. The two-step procedure developed uses Bayesian Optimisation to select the best model among several candidates leads us to final models that achieve 0.94 area under ROC cur…
In the old age, few people need special care if they are suffering from specific diseases as they can get stroke while they are in normal life routine. Also patients of any age, who are not able to walk, need to be taken care of personally but for this, either they have to be in hospital or someone like nurse should be with them for better care. This is costly in terms of money and man power. A person is needed for 24x7 care of these people. To help in this aspect we purposes a vision based system which will take input from the patient and will provide information to the specified person, who …
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.
Objectives - The authors' aim was to investigate the representations, wishes, and fears of family caregivers (FCs) regarding 14 innovative technologies (IT) for care aiding and burden alleviation, given the severe physical and psychological stress induced by dementia care, and the very slow uptake of these technologies in our society. Methods - A cluster sample survey based on a self-administered questionnaire was carried out on data collected from 270 families of patients with Alzheimer's disease or related disorders, located in the greater Paris area. Multiple Correspondence Analysis was use…
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…
The emergence of an ageing population is a significant public health concern. This has led to an increase in the number of people living with progressive neurodegenerative disorders like dementia. Consequently, the strain this is places on health and social care services means providing 24-hour monitoring is not sustainable. Technological intervention is being considered, however no solution exists to non-intrusively monitor the independent living needs of patients with dementia. As a result many patients hit crisis point before intervention and support is provided. In parallel, patient care r…
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…
After the pandemic of SARS-CoV-2, it has influenced the health care practices around the world. Initial investigations indicate that patients with comorbidities are more fragile to this SARS-CoV-2 infection. They suggested postponing the routine treatment of cancer patients. However, few meta-analyses suggested evidences are not sufficient to hold the claim of the frailty of cancer patients to COVID-19, and they are not in favour of shelving the scheduled procedures. There are recent studies in which medical professionals, according to their competence, are referring to change the routine prac…
Retaining persons living with HIV (PLWH) in medical care is paramount to preventing new transmissions of the virus and allowing PLWH to live normal and healthy lifespans. Maintaining regular appointments with an HIV provider and taking medication daily for a lifetime is exceedingly difficult. 51% of PLWH are non-adherent with their medications and eventually drop out of medical care. Current methods of re-linking individuals to care are reactive (after a patient has dropped-out) and hence not very effective. We describe our system to predict who is most at risk to drop-out-of-care for use by t…
Background: More than half (57%) of pharma clinical research spend is in support of clinical trials. One reason is that Electronic Health Record (EHR) systems and HIPAA privacy rules often limit how broadly patient information can be shared, resulting in laborious human efforts to manually collect, de-identify, and summarize patient information for use in clinical studies. Purpose: Conduct feasibility study for a Rheumatoid Arthritis (RA) clinical trial in an Accountable Care Organization. Measure prevalence of RA and related conditions matching study criteria. Evaluate automation of patient d…
A look at how big data is transforming telemedicine to provide better care by tapping into a larger source of patient information. Telemedicine will have a profound impact on patient care, increase access and quality, and represent an opportunity to keep health care costs down. Data generated by smart devices will enable the real-time monitoring of chronic diseases, allowing optimal dosage of drugs and improve patient outcomes.
Ageing of society and increase of time spent with chronic conditions challenge the traditional long-term care model. Assistive technology and eHealth are seen to play an important role when addressing these challenges. One prominent example are patient self-management systems. These systems not only transform the way patients with chronic conditions interact with the healthcare system, but also change work practices of care providers. This literature review addresses sociotechnical challenges of eHealth technologies with a strong collaborative component. As a result, four themes are identified…
Graphs are very effective tools in visualizing information and are used in many fields including the medical field. In most developing countries primary care, graphs are used to monitor child growth. These measures are therefore often displayed using line graphs, basing it on three indicators (stunting, underweight and wasting) based on the WHO 2006 Child Growth Standard. Most literature on information visualization of electronic health record data focuses on aggregate data visualization tools. This research therefore, was set out to provide such an overview of requirements for computerized gr…
Most recent e-health initiatives perceive customers (patients) as recipients of medical care where they do not have a significant role in the process of health decision making. However, the advancement of Web 2.0 offers patients to have a greater role in the decision making process related to their health as they can be empowered with the ability to access and control information that fits with their personalized needs. However, providing patient empowerment in e-health through Web 2.0 is challenging task because the complexity nature of healthcare business processes. Empowerment closely relat…
Critical care patients experience varying levels of pain during their stay in the intensive care unit, often requiring administration of analgesics and sedation. Such medications generally exacerbate the already sedentary physical activity profiles of critical care patients, contributing to delayed recovery. Thus, it is important not only to minimize pain levels, but also to optimize analgesic strategies in order to maximize mobility and activity of ICU patients. Currently, we lack an understanding of the relation between pain and physical activity on a granular level. In this study, we examin…
