Software created from ‘building blocks’ could incorporate artificial intelligence, supporting medical staff with workflow and disease management, study finds

Software created from ‘building blocks’ could incorporate artificial intelligence, supporting medical staff with workflow and disease management, study finds 

New ‘building-block’ approaches to the creation of digital tools which include data and artificial intelligence could play a key role in improving the running of hospital wards and disease management, according to the findings of new research. 

The study, by Dr Robert Free at the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre (BRC), suggests that using a package of digital ‘building-blocks’ to create clinical decision support programs would make it possible to create digital tools that help medical staff prioritise patient care and workloads more effectively.

The study, published in Frontiers in Digital Health outlines how a system of computer software building blocks, developed by the research team, could enable faster more effective disease management protocols for handling local admissions of community acquired pneumonia (CAP). It also explores how this approach could be applied across healthcare more generally.

Their building block system, Embeddable AI and State-based Understandable Logic (EASUL) can use historic data, electronic medical records and include algorithms to develop digital platforms that accommodate different stages of clinical care for patients and allow medical staff to examine this - including likely patient outcomes.

In the study, researchers modelled scenarios using existing patient data and consultations with teams of Specialist Pneumonia Intervention Nurses (SPIN) to test how a program built using EASUL could be used to help clinicians manage those admitted with CAP.  The program was given the data of 52,471 adults admitted between April and June 2022, 630 of whom were diagnosed with CAP. The advice and information generated by the program was compared with the clinical risk assessments given by the SPIN team.

When tallied, EASUL risk assessment matched with the SPIN teams 49.4 % of the time. EASUL never rated any patient as low risk who had been rated as high risk by the clinical team. EASUL also identified 57 cases which, when reviewed by researchers, should have been rated as high risk but only recorded as low or moderate by clinical staff. The paper's authors stressed that the differences were likely due to individual clinical judgement where extensive risk assessment was not considered as clinically appropriate. Due to a lack of available information in the existing patient data it was not possible to include this element in the evaluation.

The researchers behind EASUL also believe another of its potential advantages is its flexible design. It allows for 'on the fly data’, collected as treatment and research is carried out, to be easily included in the system. It has also been designed in a format that can potentially be integrated with existing digital clinical decision support systems.

As a result, EASUL could be adjusted to suit the needs of a variety of clinical settings. It is also designed to automatically adjust its calculation in case of missing data, meaning it could provide robust and relevant informatio to clinical staff in a variety of different situations.

Dr Robert Free, Lecturer in Health Data Science and principal investigator on the study said: “This is a very exciting development. Our proof-of-concept clinical system allowed us to demonstrate how our building block approach could deal with algorithms of varying complexities across the patient’s care. Using EASUL we were able to include both simple risk scores and a pre-existing artificial intelligence model in a real-time data-driven workflow and then present it to clinicians - helping them make decisions about patients.”

Dr Pranabhashis Haldar, a Senior Clinical Lecturer in the NIHR Leicester BRC’s Respiratory Theme, and a contributor to the study, added “The flexible nature of our approach means it can be extended to support different data types, adaptive workflows including advanced artificial intelligence models and potentially mobile apps. Additionally, it could also be used to support patient directed healthcare actions, such as remote monitoring.”

Dr Free concluded: “We believe that EASUL and similar approaches are important steps for making better use of health data from multiple sources and would help to strengthen trust and accountability in complex artificial intelligence enabled clinical decision support. However, we recognise that further research is needed before this can be rolled out into active clinical settings.”

For more information on the study please click here: Frontiers | A data-driven framework for clinical decision support applied to pneumonia management (frontiersin.org)

To find out more about how to get involved in research click here:

The NIHR Leicester BRC is part of the NIHR and hosted by the University Hospitals of Leicester NHS Trust in partnership with the University of Leicester, Loughborough University and the University Hospitals of Northamptonshire NHS Group.

Ends 

For media enquiries and interview requests, please contact:

Joanna Jones, Science Communications Manager, NIHR Leicester BRC  on 07966 678057 or email Joanna.x.jones@uhl-tr.nhs.uk

Notes for editors 

The NIHR Leicester Biomedical Research Centre 

The National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre (BRC) is part of the NIHR and hosted by the University Hospitals of Leicester NHS Trust in partnership with the University of Leicester, Loughborough University and the University Hospitals of Northamptonshire NHS Group. 

The NIHR Leicester BRC undertakes translational clinical research in priority areas of high disease burden and clinical need. These are: 

• Respiratory and infectious diseases 
• Personalised cancer prevention and treatment 
• Lifestyle (including diabetes) 
• Environment and health 
• Data innovation for multiple long term health conditions and ethnic health 
• Cardiovascular disease 

The BRC harnesses the power of experimental science to explore and develop ways to help prevent and treat chronic disease. It brings together 120 highly skilled researchers, 45 academic ‘rising stars’, more than 90 support staff and students and over 450 public contributors. By having scientists working closely with clinicians and the public, the BRC can deliver research that is relevant to both patients and the professionals who treat them. www.leicesterbrc.nihr.ac.uk  

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:
 

• Funding high quality, timely research that benefits the NHS, public health and social care;
• Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
• Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
• Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
• Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
• Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.

 

Leicester’s Research Registry was launch in May 2021 and will share opportunities to get involved in health research taking place in Leicester’s Hospitals, or being run with their research partners, such as the University of Leicester and Loughborough University, in their National Institute for Health Research (NIHR) Biomedical Research Centre, Clinical Research Facility and Patient Recruitment Centre: Leicester.

To sign up to the registry, potential volunteers need to be over 18 years of age, live in the UK, and have a valid email address. You also have the option to select if there are particular areas of health research you are interested in. You will then receive regular updates on all the exciting opportunities to participate in the hospitals’ research.

To sign up, visit www.leicestershospitals.nhs.uk/researchregistry. You can also visit the dedicated Facebook page.