Medical Predictions from EHR using Artificial Intelligence

Vaishali Sharma,

Yash Rai,

Nitin Choubey​#1
Department of Information Technology,
SVKM’s NMIMS MPSTME

Mayank Sohani*2,
Department of Computer Engineering,
SVKM’s NMIMS MPSTME

Bhushan Inje*3
Department of Computer Engineering,
SVKM’s NMIMS MPSTME

Abstract

​ ​Traditional health care is developing towards a more digital and electronic phase with the fast growth of information technology.
Electronic Health Record (EHR) deals with fundamental patient data and data related to health care. EHRs can make a major contribution to
enhancing care and handling healthcare's increasing expenses.It remains a challenge to use and integrate EHRs to support collaboration to
increase the efficiency and effectiveness of health care.

Medicine is a domain in which projections are now becoming a requirement. This paper enhances the use of artificial intelligence (AI) as
technical method for future decision making in medicine. Not only because human intelligence is not sufficient to advance the above-mentioned
ideologies, but also because artificial intelligence processes have several advantages that are appropriate for this region. The combination of these
powerful characteristics in the same systems results in these beneficial characteristics: the accuracy of mathematics and the strength of present
techniques along with the vast quantity of data stored in the form of EHRs. Letting such significant technical elements remain unused would be a
true waste.

KEYWORDS:- electronic health record,artificial intelligence,decision making

1. Introduction
As with many other fields, the medical domain is defined by an evolution of understanding. There are many
instruments that attempt to decrease the danger of medical error. There is a very significant role here in diagnosis.
First of all, a system of decision-making is not meant to substitute the doctors. It's just making suggestions. The final
decision belongs to the human being.
A model for predicting medications is essential because there are certain medical conditions that humans can hardly
detect, a recommendation can create a distinction between life and death.
An electronic health record (EHR) reports clinical information from patients, including the ages, genders, diagnoses,
medications, allergies, treatment plans, dates of immunization, radiology images, laboratory and laboratory test
results, and medical history [1]. Usually, approved medical suppliers create and manage EHRs. The EHR can be
accessed immediately and safely by either the medical suppliers or the approved staff.

Figure 1: Model for Physician collaboration for Patient Centered Care [2]

This model shows the process of cooperation required to deliver patient centered care [8]. This patient centered
model of healthcare supported technology builds on what we know about the problems facing the implementation of
EHRs and uses the adaptation procedures to come at ways that both doctors and patients can use the techniques
more efficiently to enhance the quality of care.
EHRs can be shared with other organisations and health care providers engaged in the care of patients [7]. EHR's
patient history and treatment history can assist medical professionals diagnose and evaluate the disease of patients in
a convenient and efficient manner. Since the data in EHRs is extremely linked to the health of patients, it can be
used for diagnosis and treatment of disease.

This article introduces several processes from Artificial Intelligence's big domain, highlighting the advantages they
can bring to medical decision making. Some weaknesses of each scheme are also discussed; in order to get the most
artificially intelligent method for a specific task, they need to be emphasized. To emphasize the features of these
mechanisms, the mechanisms outlined in this article are applied to decision-making systems created for liver
diseases. Some of the features (pros and cons) can be found in the domain literature and are shown by the
decision-making systems outlined here. Some others were noted once these systems were developed.

2. Decision making in healthcare

​Decision-making is both a complex and complicated process that professionals in the healthcare sector undergo
daily [6]. It puts great pressure on them to make effective decisions on the basis of what little resources are
available. In this highly dynamic and complex healthcare industry, making the best decision possible is also stressful
for healthcare professionals at times [1].
Despite the difficulty of making efficient choices, it is essential to understand that any level of ineffective choices
should not be permitted to accommodate the healthcare industry and tolerate them. Patients expect the greatest
possible care, which can often be accomplished by efficient clinical choices [14].

Figure 2: Factors affecting the quality of decision-making[3]

This figure shows the factor affecting the quality of decision-making in a loop diagram. Factors that play a vital role
in improving the quality of decision-making are the accessibility of information, information and proof [3]. Equally
essential is timely access to well-organized health and medical data and access to information [3]. While healthcare
practitioners would naturally acquire understanding through job experiences, procedures and training, extra
resources such as online medical literature and journals will also significantly help improve understanding [3]. Such
improvements can therefore affect the decision-making quality.

3. Artificial Intelligence

Artificial Intelligence (AI) is the simulation by computers, particularly computer systems, of human intelligence
procedures. These procedures include learning (acquiring data and rules to use data), reasoning (using rules to arrive
at approximate or definite findings) and self-correction [5].
The domain of artificial intelligence consists of systems that behave in a manner that is deemed to be smart if a
human being does so. After the Second World War, AI began research, so it is a new field beyond other science
fields, an area that researchers can still use. In this industry, mechanisms can now be used efficiently to fix problems
associated with a wide range of applications requiring intelligent behaviour. This behavior may be linked to the
ability to perceive and learn, the capacity to make choices (e.g. when a vehicles to be driven in a game, when
establishing a medical diagnosis or therapy plan) or other elements related to a vehicle. Intelligent thinking Is a
human characteristic [10].
Artificial intelligence is accompanied by rationalistic method. This does not show the human strategy is
inappropriate, but many other procedures need to be engaged [15]. These procedures are component of engineering
and maths (including logic and probabilities) and use computer scientific power. Hence, this leads to the primary
advantage of artificial intelligence: it generates tools which should work better than humans. Although technology is
providing speed and energy, characteristics that exceeds human capacity to calculate, technology is away from being
judged by human beings. That's why beings are still the largest smart system standard.

4.Related Work
Due to their prospective benefits in medical diagnosis and analysis, electronic health records have gained
considerable attention. Jensen et al. (2012) pointed out that clinical information describes patient phenotypes and
therapy, and EHRs can be used to develop fresh concepts of patient-stratification to reveal unknown correlations of
disease. DesRoches et al. (2008) researched the percentage of doctors using EHRs and the connection between
individual patients ' acceptance and features and their methods. The findings stated that these documents were
thought by the doctors who used EHRs to improve the quality of care. Miriovsky et al. (2012) indicated that fast
accumulation of clinical documents could support the therapy and diagnosis of cancer. Hence, EHR is a critical
element of the growth and execution of clinical proof [13].
Due to the adequate and useful medical data linked to the health extraction of patients from EHRs, some research
and research focused on EHRs. Zheng et al. (2017) suggested a model based on semi-automated machine learning to
define type 2 diabetes in EHRs from clinical information [12].
TABLE-1
SUMMARY FOR RELATED WORK
5. Methodologies

The domain of AI offers a wide range of alternatives to issues requiring reasoning. This paper outlines two such
approaches that are suitable for predictions in the medical field: one such approach is a system completely based on
knowledge along-with the involvement of logic and another system which is based on probability and reasoning.

A. Knowledge-Based
This approach is used to implement the process of human-reasoning which is based on logic, on the
representation of knowledge. This knowledge-base plays the most important role in this kind of approach.
It contains a set of sentences which are related to each other, but do not prove to be identical to the
sentences which are used in a natural language. This kind of system exhibits the following advantage i.e.
the representation of this technical knowledge in a language which closely resembles the natural language
makes it easier to understand and build such a system, thereby making it a flexible system and allowing
 transparency at the same time. The language used in such systems is defined on certain rules, and these
rules make it a composite and a well-defined system [1].
Therefore, the above mechanism states the facts that an automated decisional system should contain, to
obtain a solution for a problem that the system is concerned about.
Unfortunately, this system also has certain drawbacks i.e. sometimes the expression of the logic that is to be
used in the system, makes it difficult to obtain the conclusions.
One more problem that might occur is that, when the original knowledge is transformed into the set of
rules, the information content might get damaged.
However, the easy implementation of the knowledge based decisional system with simple rules, still is the
main advantage for this system, which offers the results such as true or false that are very clear and are
based on logic. Since the results offered are supported mathematically and are closely related to the natural
language therefore, they are trusted and accepted by the people related to the medical field [2].
Any discussion in and around the field of Artificial Intelligence is incomplete without describing the
accuracy of the system, which is defined by the precision of the result.
A simple system will always get a correct result, but it not the same in case of a complex system which
might generate unexpected results.

B. Probability and Reasoning

When a complex bit of information is used as the input to the decisional system, in that case the
knowledge-based approach fails, where this approach comes into use. In such a condition solution can be
obtained through statistical methods. So, in this case the database consists of standardized information of as
many patients as possible, so in the case of new patient database is analysed by statistical approach in order
to get the probability of that particular disease. This approach associates each and every possible output to a
probability. Thereby the solutions offered by this method is considered to be more precise in comparison to
the earlier method (which was based on logic) which infers whether a framed sentence used is true or false
[1].

6. Conclusion

This article outlined two significant domains of artificial intelligence processes which can be the case used to create
decisive medical prediction systems. General characteristics of these systems, the benefits and the drawbacks of
each were emphasized. The systems' advantages are evident. They can, on the one side, ease the doctors ' work,
saving time, energy and efforts (else which would be implemented on too many other things they would have to do).
Therefore, doctors can focus on more important operations. An automated system, on the other hand, can detect
indiscernible things (things that are hardly noticeable or that are the outcome of complicated calculation and
reasoning, things that are not at all obvious or that are the impact of too many variables).It is not easy to draw a line
between the artificially intelligent thinking and the humanly thinking, but one thing is certain for sure: the automated
machines can be useful in their suggestions, even if the last option is human.
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