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The study explores how Taiwan’s electronic health data systems can be used to build algorithms that reduce or eliminate medical errors and to advance precision medicine.

This study is a narrative review of the literature.

The body of medical knowledge has grown far too large for human clinicians to parse. In theory, electronic health records could augment clinical decision-making with electronic clinical decision support systems (CDSSs). However, computer scientists and clinicians have made remarkably little progress in building CDSSs, because health data tend to be siloed across many different systems that are not interoperable and cannot be linked using common identifiers. As a result, medicine in the USA is often practiced inconsistently with poor adherence to the best preventive and clinical practices. Poor information technology infrastructure contributes to medical errors and waste, resulting in suboptimal care and tens of thousands of premature deaths every year. Taiwan’s national health system, in contrast, is underpinned by a coordinated system of electronic data systems but remains underutilized. In this paper, the authors present a theoretical path toward developing artificial intelligence (AI)-driven CDSS systems using Taiwan’s National Health Insurance Research Database. Such a system could in theory not only optimize care and prevent clinical errors but also empower patients to track their progress in achieving their personal health goals.

While research teams have previously built AI systems with limited applications, this study provides a framework for building global AI-based CDSS systems using one of the world’s few unified electronic health data systems.

The primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.

The methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.

The methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.

The study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant.

HealthPathways is an online decision support portal, primarily aimed at General Practitioners (GPs), that provides easy to access and up to date clinical, referral and resource pathways. It is free to access, with the intent of providing the right care, at the right place, at the right time. This case study focuses on the experience and learnings of a HealthPathways program in metropolitan Sydney during the COVID-19 pandemic. It reviews the team's program management responses and looks at key factors that have facilitated the spread and scale of HealthPathways.

Available data and experiences of two HealthPathways program managers were used to recount events and aspects influencing spread and scale.

The key factors for successful spread and scale are a coordinated response, the maturity of the HealthPathways program, having a single source of truth, high level governance, leadership, collaboration, flexible funding and ability to make local changes where required.

There are limited published articles on HealthPathways. The focus of spread and scale of HealthPathways during COVID-19 is unique.

Breast cancer is a global public health dilemma and the most prevalent cancer in the world. Effective treatment plans improve patient survival rates and well-being. The five-year survival rate is often used to develop treatment selection and survival prediction models. However, unlike other types of cancer, breast cancer patients can have long survival rates. Therefore, the authors propose a novel two-level framework to provide clinical decision support for treatment selection contingent on survival prediction.

The first level classifies patients into different survival periods using machine learning algorithms. The second level has two models with different survival rates (five-year and ten-year). Thus, based on the classification results of the first level, the authors employed Bayesian networks (BNs) to infer the effect of treatment on survival in the second level.

The authors validated the proposed approach with electronic health record data from the TriNetX Research Network. For the first level, the authors obtained 85% accuracy in survival classification. For the second level, the authors found that the topology of BNs using Causal Minimum Message Length had the highest accuracy and area under the ROC curve for both models. Notably, treatment selection substantially impacted survival rates, implying the two-level approach better aided clinical decision support on treatment selection.

The authors have developed a reference tool for medical practitioners that supports treatment decisions and patient education to identify patient treatment preferences and to enhance patient healthcare.

The purpose of this study is to examine the state of research into adoption of machine learning systems within the health sector, to identify themes that have been studied and observe the important gaps in the literature that can inform a research agenda going forward.

A systematic literature strategy was utilized to identify and analyze scientific papers between 2012 and 2022. A total of 28 articles were identified and reviewed.

The outcomes reveal that while advances in machine learning have the potential to improve service access and delivery, there have been sporadic growth of literature in this area which is perhaps surprising given the immense potential of machine learning within the health sector. The findings further reveal that themes such as recordkeeping, drugs development and streamlining of treatment have primarily been focused on by the majority of authors in this area.

The search was limited to journal articles published in English, resulting in the exclusion of studies disseminated through alternative channels, such as conferences, and those published in languages other than English. Considering that scholars in developing nations may encounter less difficulty in disseminating their work through alternative channels and that numerous emerging nations employ languages other than English, it is plausible that certain research has been overlooked in the present investigation.

This review provides insights into future research avenues for theory, content and context on adoption of machine learning within the health sector.

The purpose of this paper is to better understand how and why adoption and implementation of healthcare IT innovations occur. The authors examine two IT applications, computerised physician order entry (CPOE) and picture archiving and communication systems (PACS) at the meso and micro levels, within the context of the National Programme for IT in the English National Health Service (NHS).

To analyse these multi-level dynamics, the authors blend Rogers’ diffusion of innovations theory (DoIT) with Webster’s sociological critique of technological innovation in medicine and healthcare systems to illuminate a wider range of interacting factors. Qualitative data collected between 2004 and 2006 uses semi-structured, in-depth interviews with 72 stakeholders across four English NHS hospital trusts.

Overall, PACS was more successfully implemented (fully or partially in three out of four trusts) than CPOE (implemented in one trust only). Factors such as perceived benefit to users and attributes of the application – in particular speed, ease of use, reliability and flexibility and levels of readiness – were highly relevant but their influence was modulated through interaction with complex structural and relational issues.

Results reveal that combining contextual system level theories with DoIT increases understanding of real-life processes underpinning implementation of IT innovations within healthcare. They also highlight important drivers affecting success of implementation, including socio-political factors, the social body of practice and degree of “co-construction” between designers and end-users.

The originality of the study partly rests on its methodological innovativeness and its value on critical insights afforded into understanding complex IT implementation programmes.

This study specifically seeks to investigate the strategic implementation of machine learning (ML) algorithms and techniques in healthcare institutions to enhance innovation management in healthcare settings.

The papers from 2011 to 2021 were considered following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. First, relevant keywords were identified, and screening was performed. Bibliometric analysis was performed. One hundred twenty-three relevant documents that passed the eligibility criteria were finalized.

Overall, the annual scientific production section results reveal that ML in the healthcare sector is growing significantly. Performing bibliometric analysis has helped find unexplored areas; understand the trend of scientific publication; and categorize topics based on emerging, trending and essential. The paper discovers the influential authors, sources, countries and ML and healthcare management keywords.

The study helps understand various applications of ML in healthcare institutions, such as the use of Internet of Things in healthcare, the prediction of disease, finding the seriousness of a case, natural language processing, speech and language-based classification, etc. This analysis would help future researchers and developers target the healthcare sector areas that are likely to grow in the coming future.

The study highlights the potential for ML to enhance medical support within healthcare institutions. It suggests that regression algorithms are particularly promising for this purpose. Hospital management can leverage time series ML algorithms to estimate the number of incoming patients, thus increasing hospital availability and optimizing resource allocation. ML has been instrumental in the development of these systems. By embracing telemedicine and remote monitoring, healthcare management can facilitate the creation of online patient surveillance and monitoring systems, allowing for early medical intervention and ultimately improving the efficiency and effectiveness of medical services.

By offering a comprehensive panorama of ML's integration within healthcare institutions, this study underscores the pivotal role of innovation management in healthcare. The findings contribute to a holistic understanding of ML's applications in healthcare and emphasize their potential to transform and optimize healthcare delivery.

Inscrutable machine learning (ML) models are part of increasingly many information systems. Understanding how these models behave, and what their output is based on, is a challenge for developers let alone non-technical end users.

The authors investigate how AI systems and their decisions ought to be explained for end users through a systematic literature review.

The authors’ synthesis of the literature suggests that AI system communication for end users has five high-level goals: (1) understandability, (2) trustworthiness, (3) transparency, (4) controllability and (5) fairness. The authors identified several design recommendations, such as offering personalized and on-demand explanations and focusing on the explainability of key functionalities instead of aiming to explain the whole system. There exists multiple trade-offs in AI system explanations, and there is no single best solution that fits all cases.

Based on the synthesis, the authors provide a design framework for explaining AI systems to end users. The study contributes to the work on AI governance by suggesting guidelines on how to make AI systems more understandable, fair, trustworthy, controllable and transparent.

This literature review brings together the literature on AI system communication and explainable AI (XAI) for end users. Building on previous academic literature on the topic, it provides synthesized insights, design recommendations and future research agenda.

The purpose of this paper is to examine challenges and potential of big data in heterogeneous business networks and relate these to an implemented logistics solution.

The paper establishes an overview of challenges and opportunities of current significance in the area of big data, specifically in the context of transparency and processes in heterogeneous enterprise networks. Within this context, the paper presents how existing components and purpose-driven research were combined for a solution implemented in a nationwide network for less-than-truckload consignments.

Aside from providing an extended overview of today’s big data situation, the findings have shown that technical means and methods available today can comprise a feasible process transparency solution in a large heterogeneous network where legacy practices, reporting lags and incomplete data exist, yet processes are sensitive to inadequate policy changes.

The means introduced in the paper were found to be of utility value in improving process efficiency, transparency and planning in logistics networks. The particular system design choices in the presented solution allow an incremental introduction or evolution of resource handling practices, incorporating existing fragmentary, unstructured or tacit knowledge of experienced personnel into the theoretically founded overall concept.

The paper extends previous high-level view on the potential of big data, and presents new applied research and development results in a logistics application.

This article aims to understand the role of intermediaries that manage innovation challenges in the healthcare scenario. More specifically, it explores the role of digital platforms in addressing data challenges and fostering data-driven innovation in the health sector.

For exploring the role of platforms, the authors propose a theoretical model based on the platform’s dynamic capabilities, assuming that, because of their set of capabilities, platforms may trigger innovation practices in actor interactions. To corroborate the theoretical framework, the authors present a detailed in-depth case study analysis of Apheris, an innovative data-driven digital platform operating in the healthcare scenario.

The paper finds that the innovative data-driven digital platform can be used to revolutionize established practices in the health sector (a) accelerating research and innovation; (b) overcoming challenges related to healthcare data. The case study demonstrates how data and intellectual property sharing can be privacy-compliant and enable new capabilities.

The paper attempts to fill the gap between the use of the data-driven digital platform and the critical innovation practices in the healthcare industry.