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Value-of-Information Diagnostics in Clinical Testing: A Decision-Theoretic Framework for Cost-Constrained Test Selection
In the evolving landscape of clinical diagnostics, where resource limitations increasingly dictate testing protocols, the integration of value-of-information (VoI) principles within decision-theoretic models offers a transformative approach to optimizing test selection. This conceptual manuscript proposes a novel framework that embeds VoI diagnostics into cost-constrained clinical testing environments, enabling healthcare providers to prioritize tests based on their informational yield relative to economic burdens. Drawing from decision theory, the framework articulates a structured methodology for evaluating diagnostic tests not merely by accuracy but by their capacity to reduce uncertainty in clinical decision-making under budgetary constraints. Key components include a layered architecture that incorporates probabilistic assessments of test outcomes, utility functions for health gains, and iterative feedback mechanisms to refine selections dynamically. Theoretical formulas are introduced to interpret risk propagation in test cascades and decision confidence amid cost thresholds. By synthesizing recent literature on VoI in healthcare, this work highlights how such a framework could mitigate over-testing, enhance resource allocation, and align diagnostic strategies with value-based care paradigms. While conceptual in nature, the implications extend to infrastructural designs in AI-supported healthcare systems, fostering more equitable and efficient clinical pathways. Ultimately, this decision-theoretic lens reframes test selection as an optimization problem, balancing informational value against fiscal realities in diagnostic workflows.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 10 January 2025 | Article: 44

Remote Rehabilitation Progress Quantification: A Smartphone Motion Primitive Framework for Interpretable Recovery Tracking
In the evolving landscape of digital health, remote rehabilitation emerges as a pivotal strategy to enhance patient recovery outside traditional clinical settings. This conceptual manuscript introduces a novel framework leveraging smartphone-embedded sensors to quantify rehabilitation progress through motion primitives—fundamental movement units that enable interpretable tracking of recovery trajectories. By decomposing complex rehabilitative exercises into atomic motion elements, the proposed system facilitates granular analysis of patient adherence, functional improvements, and potential deviations in remote environments. Drawing on theoretical principles from biomechanics, signal processing, and human-computer interaction, we outline an architectural design that integrates real-time data capture, primitive extraction, and interpretive visualization without relying on empirical validation or machine learning models. The framework emphasizes interpretability by mapping primitives to clinical recovery milestones, thereby supporting clinicians in remote decision-making. Key conceptual elements include hierarchical primitive decomposition, temporal alignment mechanisms, and feedback loops for progress quantification. Formulas are presented to model decision confidence in primitive-based assessments and resource allocation for remote monitoring. This approach addresses gaps in current remote rehabilitation paradigms by prioritizing accessibility via ubiquitous smartphones, reducing dependency on specialized wearables, and enhancing patient empowerment through transparent recovery insights. Ultimately, the framework posits a scalable infrastructure for interpretable recovery tracking, fostering equitable access to rehabilitation analytics in diverse socioeconomic contexts. While theoretical, it lays the groundwork for future implementations in post-surgical, neurological, and musculoskeletal recovery scenarios.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 10 January 2025 | Article: 45

Multi-Agent Coordination for Operating Room Turnover: A Constraint-Based Optimization Blueprint
Operating room (OR) turnover represents a critical bottleneck in surgical workflows, where delays in transitioning between procedures can cascade into inefficiencies, increased costs, and compromised patient care. This conceptual manuscript introduces a blueprint for multi-agent coordination grounded in constraint-based optimization to streamline OR turnover processes. Drawing from clinical AI architectures and healthcare analytics infrastructures, we propose the constraint-adaptive multi-agent turnover orchestrator (CAMATO). This theoretical framework integrates autonomous agents for real-time task allocation, resource synchronization, and procedural handoffs. CAMATO leverages interoperability frameworks and decision support pipelines to model turnover as a constrained optimization problem, incorporating variables such as staff availability, equipment sterilization cycles, and environmental constraints. The architecture emphasizes governance mechanisms to monitor agent interactions and mitigate coordination failures, ensuring alignment with electronic health record (EHR) intelligence ecosystems. Through interpretive formulas, we conceptualize risk propagation in agent networks, decision confidence under uncertainty, and resource allocation dynamics. This blueprint highlights the potential for enhanced clinical workflow integration without empirical validation, focusing on theoretical implications for scalable, resilient OR management. By synthesizing recent literature on AI-driven healthcare systems, we outline pathways for future architectural refinements in high-stakes clinical environments.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 10 January 2025 | Article: 46

Preventive Care Recommendations via Benefit–Burden Trade-Offs: A Patient-Centered Utility Framework
 In the evolving landscape of artificial intelligence (AI) for healthcare, patient-centered approaches are essential to balance preventive care benefits against potential burdens. This conceptual manuscript introduces a novel framework for generating preventive care recommendations through explicit benefit–burden trade-offs, prioritizing individual patient utilities. Drawing from clinical AI architectures, healthcare analytics infrastructures, and electronic health record (EHR) intelligence ecosystems, we propose the patient utility trade-off architecture (PUTA). This multi-layered system integrates decision support pipelines with AI governance and interoperability frameworks. PUTA employs utility-based modeling to quantify benefits such as improved health outcomes and burdens like treatment side effects or resource demands, facilitating personalized recommendations in preventive settings. Theoretical formulas capture decision confidence and burden propagation, ensuring interpretive insights into system dynamics without empirical validation. We synthesize recent literature on clinical workflow integration and monitoring systems, highlighting how PUTA addresses gaps in patient-centered AI deployment. By emphasizing infrastructural uniqueness, including adaptive feedback topologies, this framework advances equitable preventive care. Implications for governance in diverse clinical environments underscore the need for robust data exchange and ethical monitoring, positioning PUTA as a foundational tool for future AI-driven healthcare systems.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 10 January 2025 | Article: 47

Social Determinants Integration Without Proxy Leakage: A Causal Design Pattern for Equity-Preserving Modeling
The integration of social determinants of health (SDOH) into artificial intelligence (AI) models for healthcare systems presents a critical challenge in preserving equity while avoiding proxy leakage, where sensitive attributes inadvertently influence predictions through correlated variables. This conceptual manuscript proposes a novel causal design pattern that enables the seamless incorporation of SDOH data into clinical AI architectures without compromising fairness. By leveraging causal inference principles, the pattern mitigates leakage pathways in decision support pipelines, ensuring that equity-preserving modeling aligns with governance frameworks in electronic health record (EHR) intelligence ecosystems. We outline a unique architectural framework, the causal equity orchestrator (CEO), which features layered causal nodes, feedback loops for drift detection, and interpretive formulas for risk propagation and decision confidence. Drawing on a synthesis of recent literature from clinical AI system architectures and healthcare analytics infrastructures, this work emphasizes theoretical implications for interoperability in diverse clinical workflows. The design promotes robust, bias-resistant integration, fostering equitable outcomes in population health analytics without empirical validation. Ultimately, this pattern offers a blueprint for AI developers and health informatics specialists to construct systems that uphold ethical standards in SDOH-driven modeling, addressing disparities in underserved communities through principled causal mechanisms.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 10 January 2025 | Article: 48

Wearable Calibration Transfer Across Device Generations: A Generalization Framework for Clinical Sensing
The rapid evolution of wearable sensor hardware across successive device generations introduces systematic signal drift that undermines the reliability of clinical-grade physiological sensing in real-world healthcare ecosystems. This conceptual systems research article proposes a novel architectural solution to the persistent challenge of calibration transfer without empirical retraining or device-specific fine-tuning. We introduce the cross-generation calibration orchestration and transfer infrastructure (CG-COTI) — a theoretical multi-layer generalization framework specifically engineered for clinical sensing. CG-COTI establishes a device-agnostic calibration lattice that propagates standardized physiological representations across hardware generations through orchestrated metadata-driven mapping, federated drift governance, and closed-loop intelligence layers. Three interpretive conceptual formulations are advanced: a risk-propagation index capturing cumulative sensor drift in multi-generational deployments, a decision-confidence decay function under uncalibrated generational shifts, and a governance-load equilibrium equation balancing monitoring burden with clinical safety. Positioned within existing EHR intelligence ecosystems and decision-support pipelines, CG-COTI offers a scalable architectural blueprint for seamless interoperability, regulatory-compliant deployment, and sustained analytical fidelity. By anchoring calibration transfer within clinical governance and workflow integration models, the framework eliminates the need for repeated device-specific recalibration while preserving signal integrity essential for continuous patient monitoring, early deterioration detection, and precision therapeutics. This purely conceptual architecture advances the theoretical foundations of wearable-enabled healthcare systems, providing a reusable infrastructural scaffold for next-generation clinical sensing deployments across heterogeneous device fleets.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 10 July 2025 | Article: 49

Demand-Shock Detection for Hospital Supply Chains: A Resilience Analytics Blueprint for Critical Consumables
Hospital supply chains face unprecedented vulnerabilities from demand shocks, such as pandemics or natural disasters, which disrupt the availability of critical consumables like personal protective equipment and medications. This conceptual manuscript proposes a resilience analytics blueprint leveraging artificial intelligence (AI) to detect and mitigate these shocks in healthcare systems. Drawing on clinical AI architectures, healthcare analytics infrastructures, and electronic health record (EHR) intelligence ecosystems, we introduce the demand-shock adaptive resilience network (DSARN), a novel framework for proactive monitoring and orchestration. DSARN integrates decision support pipelines with AI governance mechanisms to enable real-time anomaly detection without empirical data or model training. Key components include layered interoperability frameworks for data exchange across hospital nodes and workflow integration models that prioritize critical consumables. Conceptual formulas illustrate risk propagation through supply networks and governance load on monitoring systems. By synthesizing recent literature on AI deployment in healthcare, this blueprint emphasizes theoretical infrastructures for enhancing supply chain resilience, addressing interoperability challenges, and ensuring ethical governance. The architecture fosters adaptive feedback topologies to anticipate disruptions, offering a pathway for hospitals to build robust analytics ecosystems. Ultimately, DSARN provides a theoretical foundation for transforming reactive supply management into predictive resilience, safeguarding patient care amid volatility.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 10 July 2025 | Article: 50

Alarm Fatigue Mitigation Under Safety Constraints: A Context-Aware Suppression Design Framework
Alarm fatigue in healthcare settings poses significant risks to patient safety, arising from excessive, non-actionable alerts that desensitize clinicians. This conceptual manuscript introduces a novel framework for mitigating alarm fatigue through context-aware suppression mechanisms, while rigorously adhering to safety constraints. Drawing on theoretical principles from systems engineering, human factors, and artificial intelligence, we propose the safety-integrated context-aware suppression topology (SICAST), a multi-layered architecture designed to dynamically filter alarms based on real-time contextual data such as patient physiology, environmental factors, and clinician workload. The framework incorporates feedback loops for continuous adaptation, ensuring suppression decisions prioritize risk minimization without compromising vigilance. Key components include a context aggregation layer, a suppression decision engine governed by safety thresholds, and an audit trail for governance. Interpretive formulas model risk propagation under suppression and decision confidence amid constraints. By synthesizing recent literature, we highlight how SICAST addresses gaps in existing approaches, such as static thresholding and a lack of contextual integration. This work advances conceptual designs for AI-driven healthcare systems, emphasizing infrastructural resilience and ethical deployment. Implications for system orchestration in critical care underscore the need for balanced alarm management to enhance patient outcomes and reduce clinician burden.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 10 July 2025 | Article: 51

Home Monitoring Adherence Verification Using Passive Signals: A Robust Missingness-Informed Detection Framework
The rapid evolution of artificial intelligence in healthcare has spotlighted the need for reliable home monitoring systems to verify patient adherence to prescribed regimens. This conceptual manuscript introduces a novel framework for adherence verification leveraging passive signals—such as ambient sensors, wearables, and environmental data—while robustly addressing data missingness. Traditional approaches often falter in real-world deployments due to intermittent signal capture, leading to inaccurate assessments and compromised clinical decisions. We propose the missingness-resilient adherence orchestration network (MRAON), an architectural construct that integrates multi-modal passive signals through layered processing, incorporating missingness-informed imputation strategies and adaptive detection mechanisms. The framework emphasizes theoretical infrastructure for signal fusion, risk propagation modeling, and governance of decision confidence under uncertainty. By synthesizing recent literature on passive monitoring and missing data handling, we delineate how MRAON enhances verification robustness without relying on empirical evaluations. Key conceptual formulas capture dynamics like decision confidence as a function of missingness severity and monitoring burden influenced by resource allocation. This work advances theoretical discourse in AI-driven healthcare analytics, offering a blueprint for scalable, ethical home monitoring systems that prioritize patient autonomy and data integrity. Ultimately, MRAON paves the way for future integrations in chronic disease management, reducing healthcare burdens through intelligent, passive adherence detection.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 10 July 2025 | Article: 52

Maternal Risk Stratification from Prenatal Care Trajectories: A Continuity-Aware Modeling Framework for Preventable Harm
Maternal healthcare faces escalating challenges in identifying preventable harms during pregnancy, where fragmented prenatal care trajectories often obscure emerging risks. This conceptual manuscript introduces a novel continuity-aware modeling framework designed to stratify maternal risks by integrating longitudinal care trajectories into a cohesive analytical architecture. Drawing on theoretical principles from systems engineering and healthcare informatics, the framework emphasizes the orchestration of prenatal data streams to enhance risk detection without relying on empirical datasets or performance metrics. Key components include modular layers for trajectory mapping, continuity assessment, and harm anticipation, supported by interpretive formulas that model risk propagation and decision confidence. By prioritizing infrastructural resilience and governance integration, this approach theorizes improved alignment between clinical workflows and preventive strategies, potentially mitigating disparities in maternal outcomes. The discussion synthesizes literature on machine learning applications in perinatal risk prediction and midwifery continuity models, highlighting architectural innovations for sustainable deployment in diverse healthcare environments. Ultimately, this framework advocates for a paradigm shift toward proactive, continuity-centric systems in maternal risk management, fostering theoretical advancements in AI-driven healthcare analytics.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 10 July 2025 | Article: 52

Near–Real-Time Health Inequity Detection: A Disparity Surveillance Framework for Service Access Monitoring
Health inequities persist as a critical challenge in modern healthcare systems, often manifesting through unequal access to essential services. This conceptual manuscript introduces a novel disparity surveillance framework designed for near-real-time detection of health inequities in service access monitoring. By integrating artificial intelligence-driven analytics with infrastructural orchestration, the framework emphasizes proactive identification of access disparities across diverse populations. Drawing from theoretical foundations in public health equity and AI governance, we propose the near-real-time inequity monitoring architecture (NRIMA). This layered system incorporates data ingestion, disparity analytics, and adaptive feedback mechanisms to enhance surveillance efficacy. Without relying on empirical data or model training, the architecture focuses on theoretical constructs such as risk propagation models and decision confidence formulas to interpret potential inequities. Key components include modular layers for real-time signal processing and governance-compliant orchestration, ensuring ethical deployment in clinical and community settings. The framework’s unique feedback topology promotes dynamic adjustments to monitoring protocols, mitigating biases in service allocation. Through literature synthesis, we highlight alignments with existing AI applications in health surveillance while advancing conceptual uniqueness. Ultimately, this work contributes to theoretical discourse on AI-enabled equity in healthcare, advocating for infrastructural innovations that prioritize inclusivity and timeliness in disparity detection.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 10 July 2025 | Article: 53
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AI-driven Diagnostics Artificial Intelligence in Health Informatics Artificial Intelligence in Healthcare Big Data in Healthcare Clinical Data Mining Clinical Decision Support Systems Clinical Informatics Computer Vision Connected Health Systems Deep Learning Digital Health Digital Healthcare Innovation Digital Transformation in Healthcare Electronic Health Records Ethical AI in Healthcare Explainable AI Health Data Analytics Health Data Privacy Health Informatics Health Information Management Health Information Systems Health System Optimization Health Technology Assessment Healthcare Data Science Healthcare Informatics Healthcare Information Security Healthcare Management Healthcare Management Information Systems Intelligent Medical Systems Internet of Medical Things (IoMT) Interoperability in Healthcare Systems Machine Learning Medical Data Analytics Medical Data Management Medical Imaging Mobile Health (mHealth) Natural Language Processing Precision Medicine Predictive Analytics Remote Patient Monitoring Smart Healthcare Systems Telemedicine Wearable Health Technologies e-Health




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