<p>Coordinated access to multi-domain health data can facilitate the development and implementation of artificial intelligence-augmented clinical decision support (AI-CDS). However, scalable institutional frameworks supporting these activities are lacking. We present the PULSE framework, aimed to establish an integrative and ethically governed ecosystem for the patient-guided, patient-contextualized use of multi-domain health data for AI-augmented care. We describe deliverables related to stakeholder engagement and infrastructure development to support routine engagement of patients for consent-guided data abstraction, pre-processing, and cloud migration to support AI-CDS model development and surveillance. Central focus is placed on the routine collection of social determinants of health and patient self-reported health status to contextualize and evaluate models for fair and equitable use. Inaugural feasibility is reported for over 30,000 consecutively engaged patients. The described framework, conceptually developed to support a multi-site cardiovascular institute, is translatable to other disease domains, offering a validated architecture for use by large-scale tertiary care institutions.</p>

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An institutional framework to support ethical fair and equitable artificial intelligence augmented care

  • Steven Dykstra,
  • Matthew MacDonald,
  • Rhys Beaudry,
  • Dina Labib,
  • Melanie King,
  • Yuanchao Feng,
  • Jacqueline Flewitt,
  • Jeff Bakal,
  • Bing Lee,
  • Stafford Dean,
  • Marina Gavrilova,
  • Paul W. M. Fedak,
  • James A. White

摘要

Coordinated access to multi-domain health data can facilitate the development and implementation of artificial intelligence-augmented clinical decision support (AI-CDS). However, scalable institutional frameworks supporting these activities are lacking. We present the PULSE framework, aimed to establish an integrative and ethically governed ecosystem for the patient-guided, patient-contextualized use of multi-domain health data for AI-augmented care. We describe deliverables related to stakeholder engagement and infrastructure development to support routine engagement of patients for consent-guided data abstraction, pre-processing, and cloud migration to support AI-CDS model development and surveillance. Central focus is placed on the routine collection of social determinants of health and patient self-reported health status to contextualize and evaluate models for fair and equitable use. Inaugural feasibility is reported for over 30,000 consecutively engaged patients. The described framework, conceptually developed to support a multi-site cardiovascular institute, is translatable to other disease domains, offering a validated architecture for use by large-scale tertiary care institutions.