Pathway Forward for Responsible Generative AI Implementation in Healthcare

This thesis explores a pathway forward for responsible generative AI implementation in healthcare. It analyzes existing use cases and gathers stakeholder perspectives to reveal tensions between innovation opportunities and ethical risks of large language models (LLMs). The thesis proposes a practical framework built on objectives of data stewardship, oversight, access equity and transparency to integrate these technologies ethically. It examines assessing alignment, requirements, integration approaches and psychological readiness across health systems. With context-specific governance that can earn stakeholder trust, generative AI will enhance care coordination, outcomes, and clinical knowledge while still upholding patient interests. This thesis provides ideas to promote judicious innovation that increases healthcare access, efficiency and insights while mitigating potential pitfalls. In summary, it charts a framework for leveraging the promise of LLMs to improve medicine, through collaborative policies upholding safety, ethics and human-centric values amidst rapid technological advancement.Plan II Honors Progra

Transforming healthcare: policy discourses of ICT and patient-centred care

Information Technology (IT) is increasingly seen in policy and academic literature as key to the modernization of healthcare provision and to making healthcare patient-centred. However, the concept of Patient-Centred Care (PCC) and the role of IT in the transformation of healthcare are not straightforward. Their meanings need unpacking in order to reveal assumptions behind different visions and their implications for IT-enabled healthcare transformation. To this end, this paper analyses England’s health policy between 1989 and 2013 and reviews literature on PCC and IT. English policy has set out to transform healthcare from organization-centric to patient-centred and has placed IT as central to this process. This policy vision is based on contested conceptualizations of PCC. IT implementation is problematic and this is at least partly due to the underpinning goals and visions of healthcare policy. If this misalignment is not addressed then producing technologically superior systems, or better IT implementation strategies, is unlikely to result in widespread and substantial changes to the way healthcare is delivered and experienced. For IT to support a healthcare service that is truly patient-centred, patients’ needs and wants should be identified and designed into IT-enabled services rather than simply added on afterwards

M-health review: joining up healthcare in a wireless world

In recent years, there has been a huge increase in the use of information and communication technologies (ICT) to deliver health and social care. This trend is bound to continue as providers (whether public or private) strive to deliver better care to more people under conditions of severe budgetary constraint

Software development process of Neotree - a data capture and decision support system to improve newborn healthcare in low-resource settings

The global priority of improving neonatal survival could be tackled through the universal implementation of cost-effective maternal and newborn health interventions. Despite 90% of neonatal deaths occurring in low-resource settings, very few evidence-based digital health interventions exist to assist healthcare professionals in clinical decision-making in these settings. To bridge this gap, Neotree was co-developed through an iterative, user-centered design approach in collaboration with healthcare professionals in the UK, Bangladesh, Malawi, and Zimbabwe. It addresses a broad range of neonatal clinical diagnoses and healthcare indicators as opposed to being limited to specific conditions and follows national and international guidelines for newborn care. This digital health intervention includes a mobile application (app) which is designed to be used by healthcare professionals at the bedside. The app enables real-time data capture and provides education in newborn care and clinical decision support via integrated clinical management algorithms. Comprehensive routine patient data are prospectively collected regarding each newborn, as well as maternal data and blood test results, which are used to inform clinical decision making at the bedside. Data dashboards provide healthcare professionals and hospital management a near real-time overview of patient statistics that can be used for healthcare quality improvement purposes. To enable this workflow, the Neotree web editor allows fine-grained customization of the mobile app. The data pipeline manages data flow from the app to secure databases and then to the dashboard. Implemented in three hospitals in two countries so far, Neotree has captured routine data and supported the care of over 21,000 babies and has been used by over 450 healthcare professionals. All code and documentation are open source, allowing adoption and adaptation by clinicians, researchers, and developers

Research on the Development of Blockchain-based Distributed Intelligent Healthcare Industry -- A Policy Analysis Perspective

As a pivotal innovation in digital infrastructure, blockchain ledger technology catalyzes the development of nascent business paradigms and applications globally. Utilizing Rothwell and Zegveld's taxonomy of twelve innovation policy tools, this study offers a nuanced comparison of domestic blockchain policies, dissecting supply, environment, and demand-driven policy dimensions to distill prevailing strategic orientations towards blockchain healthcare adoption. The findings indicate that blockchain technology has seen rapid growth in the healthcare industry. However, a certain misalignment exists between the corporate and policy layers in terms of supply and demand. While companies focus more on technological applications, existing policies are geared towards regulations and governance. Government emphasis lies on legal supervision through environmental policies, aiming to guide the standardization and regulation of blockchain technology. This maintains a balance between encouraging innovation and market and legal regulatory order, thereby providing a reference for the development of the distributed intelligent healthcare industry in our country.Comment: 6 pages, 4 figure

Artificial intelligence ethics and challenges in healthcare applications: a comprehensive review in the context of the European GDPR mandate

This study examines the ethical issues surrounding the use of Artificial Intelligence (AI) in healthcare, specifically nursing, under the European General Data Protection Regulation (GDPR). The analysis delves into how GDPR applies to healthcare AI projects, encompassing data collection and decision-making stages, to reveal the ethical implications at each step. A comprehensive review of the literature categorizes research investigations into three main categories: Ethical Considerations in AI; Practical Challenges and Solutions in AI Integration; and Legal and Policy Implications in AI. The analysis uncovers a significant research deficit in this field, with a particular focus on data owner rights and AI ethics within GDPR compliance. To address this gap, the study proposes new case studies that emphasize the importance of comprehending data owner rights and establishing ethical norms for AI use in medical applications, especially in nursing. This review makes a valuable contribution to the AI ethics debate and assists nursing and healthcare professionals in developing ethical AI practices. The insights provided help stakeholders navigate the intricate terrain of data protection, ethical considerations, and regulatory compliance in AI-driven healthcare. Lastly, the study introduces a case study of a real AI health-tech project named SENSOMATT, spotlighting GDPR and privacy issues.info:eu-repo/semantics/publishedVersio

Scandals, ethics, and regulatory change in biomedical research

This paper explores how a particular form of regulation––prior ethical review of research––developed over time in a specific context, testing the claims of standard explanations for such change (which center on the role of exogenous shocks in the form of research scandals) against more recent theoretical approaches to institutional changes, which emphasize the role of gradual change. To makes its case, the paper draws on archival and interview material focusing on the research ethics review system in the UK National Health Service. Key insights center on the minimal role scandals play in shaping changes in this regulatory setting and how these depend upon the absence of a single coherent profession (and accompanying social contract) associated with biomedical research

Insight into the Digital Health System of Ukraine (eHealth): Trends, Definitions, Standards, and Legislative Revisions

Purpose. This article aims to provide an in-depth examination of the digital health system of Ukraine, focusing on the emerging trends, precise definitions, established standards, and recent legislative revisions that shape the practice and implementation of eHealth solutions within the country. Background. The digital health landscape in Ukraine has witnessed significant transformations, especially in the wake of the COVID-19 pandemic and subsequent military conflicts. These events have catalyzed the expansion of telemedicine services, leading to innovative approaches in healthcare delivery. The national strategy underscores the necessity for human-centric and accessible telemedicine, reinforced by technological neutrality, and harmonization with global standards. Methods. A review of the current literature, national strategies, and legal documents was conducted, alongside an analysis of data usage and service provision patterns in various Ukrainian regions. Participation in the "Science for Safety and Sustainable Development of Ukraine" competition facilitated project initiatives like the development of a cloud-based platform for patient-centered telerehabilitation for oncology patients. Findings. The utilization of telemedicine has significantly increased in conflict-affected regions, demonstrating the need for, and the effective deployment of, digital health strategies under crisis conditions. Private health facilities and entrepreneurs have been pivotal in the provision of telemedicine services. Legislative efforts have been geared toward framing telemedicine as an integral component of the national eHealth system, ensuring interoperability, and aligning with international standards and the Internet of Medical Things (IoMT). Interpretation. The findings underscore the resilience and adaptability of the Ukrainian healthcare system in the face of adversity. There is a clear trend towards a more integrated, patient-focused, and technologically advanced healthcare model, aligning with international trends and prioritizing public health goals over private profits. This progress, however, is contingent upon continuous development, investment in technological infrastructure, and legislative support to sustain and advance digital health initiatives

Streamlining Hospital Administrative Procedures to Reduce Costs

Americans spent nearly $2.6 trillion, or$8,000 per person for medical and administrative costs in 2010. By 2015, healthcare spending in the United States increased to 5.8% reaching $3.2 trillion or$9,990 per individual. By tackling healthcare administrative costs, it is estimated that healthcare providers could reduce these costs by $20 billion yearly. This case study explored strategies for streamlining hospital administrative procedures to reduce costs. The business process reengineering model formed the conceptual framework for this study. Data were gathered through semistructured face-to-face interviews guided by open-ended questions with a purposeful sample of 4 hospital managers in Atlanta, Georgia. This study identifies important themes regarding cost reduction and hospital administration based on participant interviews. Themes included participants\u27 unfavorable perspectives of the Spell out PPACA (PPACA) legislation, employment of physicians, PPACA reimbursement method, follow-up services, hospital administrative governance, and lack of business education. The themes comprised steps hospital managers could take to streamline administrative procedures to reduce costs. The implications for positive social change included the potential to provide strategies for streamlined processes that could lead to savings passed on to patients from low socio-economic backgrounds through accessibility to affordable healthcare services