Learning Health Systems Machine Intelligence for Clinical Prediction and Healthcare Optimization
DOI:
https://doi.org/10.15662/IJARCST.2023.0602006Keywords:
Learning Health Systems, Real-Time Clinical Feedback Loops, Intelligent Healthcare Decision Support, Predictive Patient Trajectory Analytics, AI-Driven Healthcare Optimization, Data-Driven Clinical Learning, Adaptive Care Delivery Systems, Healthcare Resource Intelligence, Machine Learning in Clinical Practice, Continuous Healthcare ImprovementAbstract
Learning health systems (LHSs) continually and automatically seek ways to improve healthcare delivery and outcomes through a real-time feedback loop. The LHS paradigm encourages the integration of data-driven learning into everyday clinical practice, informing the routine evaluation and refinement of clinical prediction models and optimizing the allocation of resources and workflows. The LHS concept has gained increasing prominence and is now emerging as a mature domain of research and practice.
Three factors have contributed to this evolution. First, the enormous volume of readily available patient data, accumulated through decades of routine clinical practice, has enabled machine learning and artificial intelligence techniques to be successfully applied for predicting patient trajectories, risks, and outcomes at multiple time-scales; indeed, patient trajectories are now being predicted at a more granular scale than ever before. Second, health systems are continually seeking ways to allocate scarce resources more intelligently, both for planning purposes and to meet real-time demand; such work can now be informed by the predictions of patient arrivals at an operational level, as well as by predictions of the expected trajectories of patients within the care delivery process. Third, as the introduction of intelligent decision support systems becomes more common in various aspects of healthcare delivery, research is emerging on how best to integrate such decision support systems with clinical teams for practical impact.
References
[1] Singhal, K., Azizi, S., Tu, T., Mahdavi, S. S., Wei, J., Chung, H. W., Scales, N., Tanwani, A., Cole-Lewis, H., Pfohl, S., Payne, P., Seneviratne, M., Gamble, P., Kelly, C., Scharli, N., Chowdhery, A., Mansfield, P., & others. (2023). Large language models encode clinical knowledge. Nature, 620(7972), 172–180.
[2] Bohr, A., & Memarzadeh, K. (2023). Artificial intelligence in healthcare. Academic Press.
[3] Davuluri, P. N. AI-Augmented Sanctions Screening: Enhancing Accuracy and Latency in Real Time Compliance Systems.
[4] Agrawal, M., Hegselmann, S., Lang, H., Kim, Y., Fröhling, L., Schmitt, M., & others. (2023). Evaluating ChatGPT as a clinical decision support tool. NPJ Digital Medicine, 6(1), 205.
[5] Challen, R., Denny, J., Pitt, M., Gompels, L., Edwards, T., & Tsaneva-Atanasova, K. (2023). Artificial intelligence, bias and clinical safety. BMJ Health & Care Informatics, 30(1), e100640.
[6] Sasi Kumar Kolla, Venkata Akhilesh Ranga Reddy. (2023). Deep Learning Architectures For Multimodal Medical Data Integration. South Eastern European Journal of Public Health, 248–260. https://doi.org/10.70135/seejph.vi.7132
[7] Krittanawong, C., Johnson, K. W., Rosenson, R. S., Wang, Z., Aydar, M., & Baber, U. (2023). Deep learning for cardiovascular medicine: A practical review. European Heart Journal – Digital Health, 4(1), 45–58.
[8] Nori, H., King, N., McKinney, S. M., Carignan, D., & Horvitz, E. (2023). Capabilities of GPT-4 on medical challenge problems. arXiv preprint arXiv:2303.13375.
[9] Valiki, D., & Segireddy, A. R. (2023). Deep Learning Architectures Deployed on Cloud Platforms for Dynamic Financial Risk Evaluation and Market Prediction. American International Journal of Computer Science and Technology, 5(5), 12-24.
[10] Meskó, B., Topol, E. J., & Győrffy, Z. (2023). The future of artificial intelligence in digital health. NPJ Digital Medicine, 6(1), 37.
[11] Lehman, E., Jain, S., Pichotta, K., Goldberg, Y., & Wallace, B. C. (2023). HoloBench: Evaluating large language models in healthcare decision making. Proceedings of the 2023 Conference on Empirical Methods in Natural Language Processing, 11234–11250.
[12] Muehlematter, U. J., Daniore, P., & Vokinger, K. N. (2023). Approval of artificial intelligence and machine learning-based medical devices in healthcare. The Lancet Digital Health, 5(1), e18–e20.
[13] Rasmy, L., Xiang, Y., Xie, Z., Tao, C., & Zhi, D. (2023). Med-BERT: Pretrained contextualized embeddings on large-scale structured electronic health records for disease prediction. NPJ Digital Medicine, 6(1), 86–97.
[14] Mangalampalli, B. M. Generative AI Applications In Healthcare Data Mart Design And Optimization.
[15] Janssen, M., Brous, P., Estevez, E., Barbosa, L. S., & Janowski, T. (2023). Data governance: Organizing data for trustworthy artificial intelligence. Government Information Quarterly, 40(1), 101772.
[16] Divya, V., & Bandi, V. K. (2023). Cloud-Native Model Lifecycle Management for Enterprise AI Systems. International Journal of Scientific Research and Modern Technology, 78.
[17] Abraham, S., Schneider, J., & von Brocke, J. (2023). Data governance for business value creation: A systematic literature review. International Journal of Information Management, 68, 102568.
[18] Rajpurkar, P., Chen, E., Banerjee, O., & Topol, E. J. (2023). AI in health and medicine. Nature Medicine, 29(1), 31–38.
[19] Yandamuri, U. S. (2022). Cloud-Based Data Integration Architectures for Scalable Enterprise Analytics. International Journal of Intelligent Systems and Applications in Engineering, 10, 472-483.
[20] Sendak, M. P., Balu, S., & Schulman, K. A. (2023). Barriers to achieving scalable machine learning in healthcare. NPJ Digital Medicine, 6(1), 54.
[21] Duan, Y., Edwards, J. S., & Dwivedi, Y. K. (2023). Artificial intelligence for decision-making in healthcare and the era of Big Data. International Journal of Information Management, 68, 102675.
[22] Mangala, N. (2022). Implementing Databricks Unity Catalog For Centralized Data Governance In Multi-Business-Unitenterprises. Journal of International Crisis and Risk Communication Research, 101-122.
[23] Shilo, S., Rossman, H., & Segal, E. (2023). Axes of a revolution: Challenges and promises of big data in healthcare. Nature Medicine, 29(1), 8–24.
[24] Shickel, B., Tighe, P. J., Bihorac, A., & Rashidi, P. (2022). Deep EHR: A survey of recent advances in deep learning techniques for electronic health record analysis. IEEE Journal of Biomedical and Health Informatics, 26(2), 533–547.
[25] Topol, E. J. (2023). The convergence of human and artificial intelligence in medicine. Nature Medicine, 29(1), 44–56.
[26] Reddy, V. A. R. (2023). API-First Design As A Strategy For Healthcare System Interoperability. South Eastern European Journal of Public Health, 224–247. https://doi.org/10.70135/seejph.vi.7128
[27] Wahl, B., Cossy-Gantner, A., Germann, S., & Schwalbe, N. R. (2023). Artificial intelligence in healthcare: Governance, ethics and policy considerations. The Lancet Digital Health, 5(2), e85–e92.
[28] Miotto, R., Wang, F., Wang, S., Jiang, X., & Dudley, J. T. (2022). Deep learning for healthcare: Review, opportunities and challenges. Briefings in Bioinformatics, 23(1), bbab432.
[29] Rajesh Mattaparthi. (2023). Deep Learning-Driven Combustion Anomaly Detection in Diesel Powertrains: A Multi-Sensor Fusion Approach for Real-Time ECM Adaptation. International Journal of Intelligent Systems and Applications in Engineering, 11(11s), 1084 –. Retrieved from https://www.ijisae.org/index.php/IJISAE/article/view/8272
[30] Solares, J. R. A., Raimondi, F. E., Zhu, Y., Rahimian, F., Canoy, D., Tran, J., Nazarzadeh, M., & Salimi-Khorshidi, G. (2022). Deep learning for electronic health records: A comparative review of multiple deep neural architectures. Journal of Biomedical Informatics, 129, 104053.
[31] Ahmed, Z., Mohamed, K., Zeeshan, S., & Dong, X. (2023). Artificial intelligence with multi-functional machine learning platform development for better healthcare and precision medicine. Database, 2023, baad021.
[32] Bandi, V. D. V. K. Production-Grade Machine Learning Pipelines For Healthcare Predictive Analytics.
[33] Kaul, V., Enslin, S., & Gross, S. A. (2023). History of artificial intelligence in medicine. Gastrointestinal Endoscopy, 98(2), 245–254.
[34] Tonekaboni, S., Joshi, S., McCradden, M. D., & Goldenberg, A. (2021). What clinicians want: Contextualizing explainable machine learning for clinical end use. Proceedings of Machine Learning Research, 126, 359–380.
[35] Secinaro, S., Calandra, D., Secinaro, A., Muthurangu, V., & Biancone, P. (2023). The role of artificial intelligence in healthcare: A structured literature review. BMC Medical Informatics and Decision Making, 23(1), 15.
[36] Mangalampalli, B. M. Intelligent Data Profiling for Healthcare Data Lakes Using AI-Enhanced Analytics.
[37] Ghassemi, M., Oakden-Rayner, L., & Beam, A. L. (2021). The false hope of current approaches to explainable artificial intelligence in health care. The Lancet Digital Health, 3(11), e745–e750.
[38] Yu, K. H., Kohane, I. S., & Beam, A. L. (2023). Artificial intelligence in healthcare. Nature Biomedical Engineering, 7(3), 215–226.
[39] Beam, A. L., & Kohane, I. S. (2021). Big data and machine learning in health care. JAMA, 325(13), 1317–1318.
[40] Siva Hemanth Kolla, Raghunath Loganathan. (2023). Cloud-Native Deep Learning Architectures For Secure Generative AI Deployment In Enterprise Workflow Platforms. Journal of International Crisis and Risk Communication Research , 603–618. https://doi.org/10.63278/jicrcr.vi.3786
[41] Harrer, S. (2023). Attention is not all you need: The complicated case of ethically using large language models in healthcare and medicine. EBioMedicine, 90, 104512.
[42] Friedman, C. P., Allee, N. J., Delaney, B. C., Flynn, A. J., Silverstein, J. C., Sullivan, K., & Brantley, K. L. (2020). The science of learning health systems: Foundations for a new journal. Learning Health Systems, 4(1), e10203.
[43] Sallam, M. (2023). ChatGPT utility in healthcare education, research, and practice: Systematic review on the promising perspectives and valid concerns. Healthcare, 11(6), 887.
[44] Inala, R. AI-Powered Investment Decision Support Systems: Building Smart Data Products with Embedded Governance Controls.
[45] Goldstein, B. A., Navar, A. M., Carter, R. E., & Moving Beyond Regression Techniques in Cardiovascular Risk Prediction. (2020). Opportunities and challenges in developing risk prediction models with electronic health records data. Circulation: Cardiovascular Quality and Outcomes, 13(11), e006218.
[46] Kung, T. H., Cheatham, M., Medenilla, A., Sillos, C., De Leon, L., Elepaño, C., Madriaga, M., Aggabao, R., Diaz-Candido, G., Maningo, J., & Tseng, V. (2023). Performance of ChatGPT on USMLE: Potential for AI-assisted medical education. PLOS Digital Health, 2(2), e0000198.
[47] Loganathan, R. (2022). Converging Security Architecture and Compliance Management in Enterprise Data Center Ecosystems: A Unified Control Framework. International Journal of Scientific Research and Modern Technology, 1(12), 295-312.
[48] Lee, P., Bubeck, S., & Petro, J. (2023). Benefits, limits, and risks of GPT-4 as an AI chatbot for medicine. New England Journal of Medicine, 388(13), 1233–1239.
[49] Rajkomar, A., Oren, E., Chen, K., Dai, A. M., Hajaj, N., Hardt, M., Liu, P. J., Liu, X., Marcus, J., Sun, M., Sundberg, P., Yee, H., Zhang, K., Duggan, G. E., Flores, G., & Dean, J. (2018). Scalable and accurate deep learning with electronic health records. NPJ Digital Medicine, 1(1), 18.
[50] Rao, A., Kim, J., Kamineni, M., Pang, M., Lie, W., & Dreyer, K. (2023). Evaluating GPT as an adjunct for radiologic decision-making. Radiology, 307(5), e230958.
[51] Mangalampalli, B. M. (2023). AI-Driven Anomaly Detection in Healthcare Claims Data: A Business Intelligence Perspective. Journal of Rare Cardiovascular Diseases.
[52] Yu, K. H., Beam, A. L., & Kohane, I. S. (2018). Artificial intelligence in healthcare. Nature Biomedical Engineering, 2(10), 719–731.
[53] Gottimukkala, V. R. R. (2020). Energy-Efficient Design Patterns for Large-Scale Banking Applications Deployed on AWS Cloud. power, 9(12).
[54] Moor, M., Banerjee, O., Abad, Z. S. H., Krumholz, H. M., Leskovec, J., Topol, E. J., & Rajpurkar, P. (2023). Foundation models for generalist medical artificial intelligence. Nature, 616(7956), 259–265.
[55] Bates, D. W., Saria, S., Ohno-Machado, L., Shah, A., & Escobar, G. (2018). Big data in health care: Using analytics to identify and manage high-risk and high-cost patients. Health Affairs, 33(7), 1123–1131.
[56] Kolla, T. (2023). Predictive ETL Failure Detection in Healthcare Data Pipelines Using Anomaly Detection Algorithms. International Journal of Medical Toxicology & Legal Medicine.
[57] Bandi, V. D. V. K. (2023). MLOps Frameworks for Reliable Model Deployment in Cloud Data Platforms.
[58] Mandel, J. C., Kreda, D. A., Mandl, K. D., Kohane, I. S., & Ramoni, R. B. (2016). SMART on FHIR: A standards-based, interoperable apps platform for electronic health records. Journal of the American Medical Informatics Association, 23(5), 899–908.
[59] Johnson, A. E. W., Pollard, T. J., Shen, L., Lehman, L. H., Feng, M., Ghassemi, M., Moody, B., Szolovits, P., Celi, L. A., & Mark, R. G. (2016). MIMIC-III, a freely accessible critical care database. Scientific Data, 3, 160035.
[60] Mangala, N. (2022). Real-Time Data Quality Monitoring and Gating Frameworks in Cloud-Based Data Pipelines. International Journal of Research and Applied Innovations, 5(6), 8197-8219.
[61] Hripcsak, G., & Albers, D. J. (2015). Next-generation phenotyping of electronic health records. Journal of the American Medical Informatics Association, 22(1), 117–121.
[62] Davuluri, P. N. Integrating Artificial Intelligence into Event-Driven Financial Crime Compliance Platforms.
[63] Jensen, P. B., Jensen, L. J., & Brunak, S. (2012). Mining electronic health records: Towards better research applications and clinical care. Nature Reviews Genetics, 13(6), 395–405.
[64] Murdoch, T. B., & Detsky, A. S. (2013). The inevitable application of big data to health care. JAMA, 309(13), 1351–1352.
[65] Friedman, C. P., Wong, A. K., & Blumenthal, D. (2010). Achieving a nationwide learning health system. Science Translational Medicine, 2(57), 57cm29.
[66] Peddi, R. K. (2021). Optimizing Case Management Workflows in Global Data Center Colocation Services. Universal Journal of Computer Sciences and Communications, 1(1), 1-21.
[67] Hersh, W. (2022). Health informatics: Practical guide (8th ed.). Informatics Education.
[68] Wager, K. A., Lee, F. W., & Glaser, J. P. (2022). Health care information systems: A practical approach for health care management (5th ed.). Jossey-Bass.
[69] McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning.
[70] Shortliffe, E. H., & Cimino, J. J. (2021). Biomedical informatics: Computer applications in health care and biomedicine (5th ed.). Springer.


