搜索结果：Mayo Clinic proceedings. Digital health

This study proposes a novel, integrative framework for patient-centered data science in the digital health era. We developed a multidimensional model that combines traditional clinical data with patient-reported outcomes, social determinants of health, and multi-omic data to create comprehensive digital patient representations. Our framework employs a multi-agent artificial intelligence approach, utilizing various machine learning techniques including large language models, to analyze complex, longitudinal datasets. The model aims to optimize multiple patient outcomes simultaneously while addressing biases and ensuring generalizability. We demonstrate how this framework can be implemented to create a learning healthcare system that continuously refines strategies for optimal patient care. This approach has the potential to significantly improve the translation of digital health innovations into real-world clinical benefits, addressing current limitations in AI-driven healthcare models.

Mobile health has the potential to revolutionize health care delivery and patient engagement. In this work, we discuss how integrating Artificial Intelligence into digital health applications-focused on supply chain, patient management, and capacity building, among other use cases-can improve the health system and public health performance. We present an Artificial Intelligence and Reinforcement Learning platform that allows the delivery of adaptive interventions whose impact can be optimized through experimentation and real-time monitoring. The system can integrate multiple data sources and digital health applications. The flexibility of this platform to connect to various mobile health applications and digital devices and send personalized recommendations based on past data and predictions can significantly improve the impact of digital tools on health system outcomes. The potential for resource-poor settings, where the impact of this approach on health outcomes could be more decisive, is discussed specifically. This framework is, however, similarly applicable to improving efficiency in health systems where scarcity is not an issue.

Backgrounds: Artificial intelligence (AI) is transforming healthcare, yet translating AI models from theoretical frameworks to real-world clinical applications remains challenging. The Mayo Clinic Platform (MCP) was established to address these challenges by providing a scalable ecosystem that integrates real-world multiple modalities data from multiple institutions, advanced analytical tools, and secure computing environments to support clinical research and AI development. Methods: In this study, we conducted four research projects leveraging MCP's data infrastructure and analytical capabilities to demonstrate its potential in facilitating real-world evidence generation and AI-driven clinical insights. Utilizing MCP's tools and environment, we facilitated efficient cohort identification, data extraction, and subsequent statistical or AI-powered analyses. Results: The results underscore MCP's role in accelerating translational research by offering de-identified, standardized real-world data and facilitating AI model validation across diverse healthcare settings. Compared to Mayo's internal Electronic Health Record (EHR) data, MCP provides broader accessibility, enhanced data stand

Background: As value-based care expands across the U.S. healthcare system, reducing health disparities has become a priority. Social determinants of health (SDoH) indices, like the widely used Area Deprivation Index (ADI), guide efforts to manage patient health and costs. However, the ADI's reliance on housing-related variables (e.g., median home value) may reduce its effectiveness, especially in high-cost regions, by masking inequalities and poor health outcomes. Methods: To overcome these limitations, we developed the balanced ADI (bADI), a new SDoH index that reduces dependence on housing metrics through standardized construction. We evaluated the bADI using data from millions of Medicare Fee-for-Service and Medicare Advantage beneficiaries. Correlation analyses measured its association with clinical outcomes, life expectancy, healthcare use, and cost, and compared results to the ADI. Results: The bADI showed stronger correlations with clinical outcomes and life expectancy than the ADI. It was less influenced by housing costs in expensive regions and more accurately predicted healthcare use and costs. While ADI-based research suggested both the most and least disadvantaged group

Precision health, increasingly supported by digital technologies, is a domain of research that broadens the paradigm of precision medicine, advancing everyday healthcare. This vision goes hand in hand with the groundbreaking advent of artificial intelligence (AI), which is reshaping the way we diagnose, treat, and monitor both clinical subjects and the general population. AI tools powered by machine learning have shown considerable improvements in a variety of healthcare domains. In particular, reinforcement learning (RL) holds great promise for sequential and dynamic problems such as dynamic treatment regimes and just-in-time adaptive interventions in digital health. In this work, we discuss the opportunity offered by AI, more specifically RL, to current trends in healthcare, providing a methodological survey of RL methods in the context of precision and digital health. Focusing on the area of adaptive interventions, we expand the methodological survey with illustrative case studies that used RL in real practice. This invited article has undergone anonymous review and is intended as a book chapter for the volume "Frontiers of Statistics and Data Science" edited by Subhashis Ghosha

Data quality (DQ) and transparency of secondary data are critical factors that delay the adoption of clinical AI models and affect clinician trust in them. Many DQ studies fail to clarify where, along the lifecycle, quality checks occur, leading to uncertainty about provenance and fitness for reuse. This study develops a framework for transparent reporting of DQ assessments across the clinical electronic health record (EHR) data lifecycle. The reporting framework was developed through iterative analysis to identify actors and phases of the clinical data lifecycle. The framework distinguishes between data-generating organizations and data-receiving organizations to allow users to map DQ parameters to stages across the data lifecycle. The framework defines 5 key lifecycle phases and multiple actors. When applied to the real-world dataset, the framework demonstrated applicability in revealing where DQ issues may originate. The framework provides a structured approach for reporting DQ assessments, which can enhance transparency regarding data fitness for reuse, supporting reliable clinical research, AI model development, and internal organisational governance. This work provides practi

User engagement is crucial for the efficacy of digital health and mental health interventions, yet existing design strategies for improving engagement remain heterogeneous, context-specific, and insufficiently grounded in motivational theory. In this paper, we propose a preliminary, theory-grounded design framework that draws on Self-Determination Theory (SDT) and its sub-theory, Organismic Integration Theory (OIT), to guide the design of digital health interventions for sustained user engagement. Informed by existing literature and our own empirical data from surveys (N = 438), interviews (N = 31), and co-design workshops (N = 59) with end users, the framework categorises design strategies across the adoption, interface, and task spheres of the user experience, distinguishing between those that primarily support intrinsic motivation and those that foster autonomous forms of extrinsic motivation. We argue that this distinction is critical: strategies commonly grouped under umbrella terms such as "gamification" in fact operate through different motivational channels and should be designed and evaluated accordingly. By clarifying these motivational pathways, our framework aims to sup

The integration of voice-based AI agents in healthcare presents a transformative opportunity to bridge economic and accessibility gaps in digital health delivery. This paper explores the role of large language model (LLM)-powered voice assistants in enhancing preventive care and continuous patient monitoring, particularly in underserved populations. Drawing insights from the development and pilot study of Agent PULSE (Patient Understanding and Liaison Support Engine) -- a collaborative initiative between IBM Research, Cleveland Clinic Foundation, and Morehouse School of Medicine -- we present an economic model demonstrating how AI agents can provide cost-effective healthcare services where human intervention is economically unfeasible. Our pilot study with 33 inflammatory bowel disease patients revealed that 70\% expressed acceptance of AI-driven monitoring, with 37\% preferring it over traditional modalities. Technical challenges, including real-time conversational AI processing, integration with healthcare systems, and privacy compliance, are analyzed alongside policy considerations surrounding regulation, bias mitigation, and patient autonomy. Our findings suggest that AI-driven

Fast-track procedures play an important role in the context of conditional registration of medical devices, such as listing processes for digital health applications. They offer the potential for earlier patient access to innovative products and involve two registration steps. The applicants can apply first for conditional registration. A successful conditional registration provides a limited funding or approval period and time to prepare the application for permanent registration (the second registration step). For conditional registration, products have to fulfill only a part of the requirements necessary for permanent registration. There is interest in valid and efficient study designs for fast-track procedures. This will be addressed in this paper. A motivating example is the German fast-track registration process of digital health applications (DiGA) for reimbursement by statutory health insurances. The main focus of the paper is the systematic statistical investigation of the utility of adaptive designs in the context of fast-track registration processes like the DiGA fast-track. We demonstrate that, in most cases, such designs are much more efficient than the current standar

This paper highlights the design philosophy and architecture of the Health Guardian, a platform developed by the IBM Digital Health team to accelerate discoveries of new digital biomarkers and development of digital health technologies. The Health Guardian allows for rapid translation of artificial intelligence (AI) research into cloud-based microservices that can be tested with data from clinical cohorts to understand disease and enable early prevention. The platform can be connected to mobile applications, wearables, or Internet of things (IoT) devices to collect health-related data into a secure database. When the analytics are created, the researchers can containerize and deploy their code on the cloud using pre-defined templates, and validate the models using the data collected from one or more sensing devices. The Health Guardian platform currently supports time-series, text, audio, and video inputs with 70+ analytic capabilities and is used for non-commercial scientific research. We provide an example of the Alzheimer's disease (AD) assessment microservice which uses AI methods to extract linguistic features from audio recordings to evaluate an individual's mini-mental state

Growth of the older adult population has led to an increasing interest in technology-supported aged care. However, the area has some challenges such as a lack of caregivers and limitations in understanding the emotional, social, physical, and mental well-being needs of seniors. Furthermore, there is a gap in the understanding between developers and ageing people of their requirements. Digital health can be important in supporting older adults wellbeing, emotional requirements, and social needs. Requirements Engineering (RE) is a major software engineering field, which can help to identify, elicit and prioritize the requirements of stakeholders and ensure that the systems meet standards for performance, reliability, and usability. We carried out a systematic review of the literature on RE for older adult digital health software. This was necessary to show the representatives of the current stage of understanding the needs of older adults in aged care digital health. Using established guidelines outlined by the Kitchenham method, the PRISMA and the PICO guideline, we developed a protocol, followed by the systematic exploration of eight databases. This resulted in 69 primary studies o

Recent advances in digital pathology have demonstrated the effectiveness of foundation models across diverse applications. In this report, we present Atlas, a novel vision foundation model based on the RudolfV approach. Our model was trained on a dataset comprising 1.2 million histopathology whole slide images, collected from two medical institutions: Mayo Clinic and Charité - Universtätsmedizin Berlin. Comprehensive evaluations show that Atlas achieves state-of-the-art performance across twenty-one public benchmark datasets, even though it is neither the largest model by parameter count nor by training dataset size.

Artificial intelligence (AI) has shown great promise in revolutionizing the field of digital health by improving disease diagnosis, treatment, and prevention. This paper describes the Health Guardian platform, a non-commercial, scientific research-based platform developed by the IBM Digital Health team to rapidly translate AI research into cloud-based microservices. The platform can collect health-related data from various digital devices, including wearables and mobile applications. Its flexible architecture supports microservices that accept diverse data types such as text, audio, and video, expanding the range of digital health assessments and enabling holistic health evaluations by capturing voice, facial, and motion bio-signals. These microservices can be deployed to a clinical cohort specified through the Clinical Task Manager (CTM). The CTM then collects multi-modal, clinical data that can iteratively improve the accuracy of AI predictive models, discover new disease mechanisms, or identify novel biomarkers. This paper highlights three microservices with different input data types, including a text-based microservice for depression assessment, a video-based microservice for

This paper discusses and explores the potential and relevance of recent developments in artificial intelligence (AI) and digital twins for health and well-being in low-resource African countries. We use the case of public health emergency response to disease outbreaks and epidemic control. There is potential to take advantage of the increasing availability of data and digitization to develop advanced AI methods for analysis and prediction. Using an AI systems perspective, we review emerging trends in AI systems and digital twins and propose an initial augmented AI system architecture to illustrate how an AI system can work with a 3D digital twin to address public health goals. We highlight scientific knowledge discovery, continual learning, pragmatic interoperability, and interactive explanation and decision-making as essential research challenges for AI systems and digital twins.

Software engineering for digital health applications entails several challenges, including heterogeneous data acquisition, data standardization, software reuse, security, and privacy considerations. We explore these challenges and how our Stanford Spezi ecosystem addresses these challenges by providing a modular and standards-based open-source digital health ecosystem. Spezi enables developers to select and integrate modules according to their needs and facilitates an open-source community to democratize access to building digital health innovations.

The term artificial implies an inherent dichotomy from the natural or organic. However, AI, as we know it, is a product of organic ingenuity: designed, implemented, and iteratively improved by human cognition. The very principles that underpin AI systems, from neural networks to decision-making algorithms, are inspired by the organic intelligence embedded in human neurobiology and evolutionary processes. The path from organic to artificial intelligence in digital health is neither mystical nor merely a matter of parameter count, it is fundamentally about organization and adaption. Thus, the boundaries between artificial and organic are far less distinct than the nomenclature suggests.

This research paper presents a meta-analysis of the multifaceted role of technology in mental health. The pervasive influence of technology on daily lives necessitates a deep understanding of its impact on mental health services. This study synthesizes literature covering Behavioral Intervention Technologies (BITs), digital mental health interventions during COVID-19, young men's attitudes toward mental health technologies, technology-based interventions for university students, and the applicability of mobile health technologies for individuals with serious mental illnesses. BITs are recognized for their potential to provide evidence-based interventions for mental health conditions, especially anxiety disorders. The COVID-19 pandemic acted as a catalyst for the adoption of digital mental health services, underscoring their crucial role in providing accessible and quality care; however, their efficacy needs to be reinforced by workforce training, high-quality evidence, and digital equity. A nuanced understanding of young men's attitudes toward mental health is imperative for devising effective online services. Technology-based interventions for university students are promising, al

Adopting a good health information system (HIS) is essential for providing high-quality healthcare. With rapid advances in technology in the healthcare industry in recent years, healthcare providers seek effective options to deal with numerous diseases and a growing number of patients, adopting advanced HIS such as for clinical decision support. While the clinical decision support systems (CDSS) can help medical personnel make better decisions, they may bring negative results due to a lack of understanding of the elements that influence GP's adoption of CDSS. This paper focuses on discovering obstacles that may contribute to the problems surrounding CDSS adoption. Thirty general practitioners were interviewed from different primary health centers in Saudi Arabia in order to determine the challenges and obstacles in the sector. While the outcome confirms that there are obstacles that affect the aspects, such as time risk, quality of the system used, slow Internet speed, user interface, lack of training, high costs, patient satisfaction, multiple systems used, technical support, computer skills, lack of flexibility, system update, professional skills and knowledge, computer efficienc

Although serious games have been increasingly used for mental health applications, few explicitly address coping with grief as a core mechanic and narrative experience for patients. Existing grief-related digital games often focus on clinical training for medical professionals rather than immersive storytelling and agency in emotional processing for the patient. In response, we designed Road to Acceptance, a VR game that presents grief through first-person narrative and gameplay. As the next phase of evaluation, we propose a workshop-based study with 12 licensed mental health professionals to assess the therapeutic impacts of the game and the alignment with best practices in grief education and interventions. This will inform iterative game design and patient evaluation methods, ensuring that the experience is clinically appropriate. Potential findings can contribute to the design principles of grief-related virtual reality experiences, bridging the gap between interactive media, mental health interventions, and immersive storytelling.