{"title":"Systematic AI Support for Decision-Making in the Healthcare Sector: Obstacles and Success Factors","authors":"Markus Bertl , Peeter Ross , Dirk Draheim","doi":"10.1016/j.hlpt.2023.100748","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Currently, health care<span> is expert-centric, especially with regard to decision-making. Innovations such as artificial intelligence (AI) or interconnected electronic health records (EHRs) suffer from low adoption rates. In the rare cases of technically successful implementation, they often result in inefficient or error-prone processes.</span></p></div><div><h3>Aim & Methods</h3><p>This paper explores the state of the art in AI-based digital decision support systems (DDSSs). To overcome the low adoption rates, we propose a systematic strategy for bringing DDSS research into clinical practice based on a design science approach. DDSSs can transform health care to be more innovative, patient-centric, accurate and efficient. We contribute by providing a framework for the successful development, evaluation and analysis of systems for AI-based decision-making. This framework is then evaluated using focus group interviews.</p></div><div><h3>Results</h3><p>Centred around our framework, we define a systematic approach for the use of AI in health care. Our systematic AI support approach highlights essential perspectives on DDSSs for systematic development and analysis. The aim is to develop and promote robust and optimal practices for clinical investigation and evaluation of DDSS in order to encourage their adoption rates. The framework contains the following dimensions: disease, data, technology, user groups, validation, decision and maturity.</p></div><div><h3>Conclusion</h3><p>DDSSs focusing on only one framework dimension are generally not successful; therefore, we propose to consider each framework dimension during analysis, design, implementation and evaluation so as to raise the number of DDSSs used in clinical practice.</p></div><div><h3>Public Interest Summary</h3><p>The digital transformation of the healthcare sector creates the potential for the sector to be more accurate, efficient and patient-centric using AI, or so-called digital decision support systems. In this research, we explore why these systems are needed and how they can be successfully implemented in clinical practice. For this, we propose a systematic approach based on our conceptual framework. Against this background, we present our vision for further advancing these technologies. We see our systematic AI support as a primary driver, with the possibility to facilitate the much-needed breakthrough of decision support systems in health care.</p></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"4","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Policy and Technology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2211883723000266","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
引用次数: 4
Abstract
Background
Currently, health care is expert-centric, especially with regard to decision-making. Innovations such as artificial intelligence (AI) or interconnected electronic health records (EHRs) suffer from low adoption rates. In the rare cases of technically successful implementation, they often result in inefficient or error-prone processes.
Aim & Methods
This paper explores the state of the art in AI-based digital decision support systems (DDSSs). To overcome the low adoption rates, we propose a systematic strategy for bringing DDSS research into clinical practice based on a design science approach. DDSSs can transform health care to be more innovative, patient-centric, accurate and efficient. We contribute by providing a framework for the successful development, evaluation and analysis of systems for AI-based decision-making. This framework is then evaluated using focus group interviews.
Results
Centred around our framework, we define a systematic approach for the use of AI in health care. Our systematic AI support approach highlights essential perspectives on DDSSs for systematic development and analysis. The aim is to develop and promote robust and optimal practices for clinical investigation and evaluation of DDSS in order to encourage their adoption rates. The framework contains the following dimensions: disease, data, technology, user groups, validation, decision and maturity.
Conclusion
DDSSs focusing on only one framework dimension are generally not successful; therefore, we propose to consider each framework dimension during analysis, design, implementation and evaluation so as to raise the number of DDSSs used in clinical practice.
Public Interest Summary
The digital transformation of the healthcare sector creates the potential for the sector to be more accurate, efficient and patient-centric using AI, or so-called digital decision support systems. In this research, we explore why these systems are needed and how they can be successfully implemented in clinical practice. For this, we propose a systematic approach based on our conceptual framework. Against this background, we present our vision for further advancing these technologies. We see our systematic AI support as a primary driver, with the possibility to facilitate the much-needed breakthrough of decision support systems in health care.
期刊介绍:
Health Policy and Technology (HPT), is the official journal of the Fellowship of Postgraduate Medicine (FPM), a cross-disciplinary journal, which focuses on past, present and future health policy and the role of technology in clinical and non-clinical national and international health environments.
HPT provides a further excellent way for the FPM to continue to make important national and international contributions to development of policy and practice within medicine and related disciplines. The aim of HPT is to publish relevant, timely and accessible articles and commentaries to support policy-makers, health professionals, health technology providers, patient groups and academia interested in health policy and technology.
Topics covered by HPT will include:
- Health technology, including drug discovery, diagnostics, medicines, devices, therapeutic delivery and eHealth systems
- Cross-national comparisons on health policy using evidence-based approaches
- National studies on health policy to determine the outcomes of technology-driven initiatives
- Cross-border eHealth including health tourism
- The digital divide in mobility, access and affordability of healthcare
- Health technology assessment (HTA) methods and tools for evaluating the effectiveness of clinical and non-clinical health technologies
- Health and eHealth indicators and benchmarks (measure/metrics) for understanding the adoption and diffusion of health technologies
- Health and eHealth models and frameworks to support policy-makers and other stakeholders in decision-making
- Stakeholder engagement with health technologies (clinical and patient/citizen buy-in)
- Regulation and health economics