A PROJECT REPORT

ON

ARTIFICIAL INTELLIGENCE IN TRACKING SOLUTIONS

FOR THE LOGISTICS IN A HOSPITAL IN REAL TIME

SUBMITTED TO THE

“SAVITRIBAI PHULE PUNE UNIVERSITY”

SUBMITTED BY

“AMIT DILIP JAGTAP”

(BATCH 2021-2022)

UNDER THE GUIDANCE OF

“PROF. SANTOSH KARAD”

PIBM TIRUPATI INSTITUTES OF MANAGEMENT

SHINDEWADI, PUNE-412205
 ACKNOWLEDGEMENT
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Artificial Intelligence in Tracking Solutions for the Logistics in a Hospital in Real
Time” I am deeply indebted to my lecturers & my faculties who gave me opportunity of
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for their kind support & suggestion for making project report.

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I xxxxxxxxxxxxx, student of “PIBM Tirupati Institute of Management, Pune”, hereby

declare that the project report on “Study on Artificial Intelligence in Tracking Solutions
for the Logistics in a Hospital in Real Time”, A Business and Career networking site is
an original and authenticated work done by me.

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 ABSTRACT
Advances in artificial intelligence have been increasing in many aspects of human
existence lately. A great deal has been said and written about the potential benefits
and drawbacks of its use in the healthcare industry. By drawing on previously
published research and suggesting a sustainable method based on gaps identified in
real-time interviews with pharmacy managers from across hospitals, this report
emphasizes the necessity of deploying artificial intelligence during a pandemic.

This paper is intended for everyone with an interest in artificial intelligence (AI),
but it's geared for business leaders in particular. The purpose of this dissertation is
to examine whether AI has had a significant and gradually increasing influence on
business. The goal is to find out what kinds of AI approaches are now in use and
what they are capable of.

It is an ongoing research and management challenge to create and integrate

artificial intelligence (AI) solutions in healthcare settings. Artificial intelligence
(AI) is expected to have a significant impact on the efficiency and effectiveness of
the healthcare industry. The number of real-world AI application cases, on the
other hand, is still rather small. This study presents a comparative approach from
nine European hospitals and eleven distinct use cases with probable application
areas and advantages of hospital AI technology as a first step toward organizing
and comparing such experiences.

Each of the contributors to this review and opinion piece has a unique perspective
on the topic at hand. For pandemic situations like COVID-19, this provides key
alternatives for improving outcomes. Data protection, privacy, and human
acceptability are among the anticipated benefits and obstacles highlighted. As a
whole, AI applications in hospitals have a wide range of use cases, which
necessitates a specialized deployment strategy in the healthcare industry. It's
possible to integrate in AI implementation projects specialist solutions for hospitals
in the areas of human–computer interface, data administration, and
communication.

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 TABLE OF INDEX

Sr. No. CHAPTERS PARTICULARS

INTRODUCTION

 Introduction to the Topic

 Industry Profile
1 CHAPTER 1

RESEARCH METHODOLOGY

 Statement of the Problem

 Objectives of the Study
 Scope of the Study
 Research Design
 Sampling
2 CHAPTER 2
 Limitations of the Study
DATA PRESENTATION, ANALYSIS AND
INTERPRETATION

 Data analysis
3 CHAPTER 3
 Data Interpretation
FINDINGS, SUGGESTION AND
CONCLUSION

 Conclusions
4 CHAPTER 4
 Suggestions

BIBLIOGRAPHY

5   ANNEXURE

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 CHAPTER 1
INTRODUCTION
What Is Artificial Intelligence (AI)?

Artificial intelligence (AI) is a term used to describe computers that are trained to
behave and think like humans in order to simulate human intellect. It may also be
used to describe any machine that demonstrates human-like characteristics such as
the ability to learn and solve problems.

Ability to reason and behave in a way that maximizes the likelihood of success is
an ideal quality in an artificial intelligence (AI).

Understanding Artificial Intelligence

Artificial intelligence conjures images of robots in the minds of most people. The
reason for this is that big-budget films and literature tell scenarios about human-
like robots that devastate the Earth. However, this couldn't be farther from reality.

Based on the idea that a computer can simply replicate human intellect and
perform tasks, from the most basic to the most complex, artificial intelligence has
been developed. Learning, thinking, and perception are some of the primary aims
of artificial intelligence (AI).

Previous artificial intelligence criteria are becoming obsolete as technology

progresses. A computer function such as optimum character recognition is no
longer regarded to be a kind of artificial intelligence since it is now considered a
standard computer function.

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AI has the potential to impact a wide range of sectors as it continues to evolve.
Math, computer science, linguistics, psychology and more all play a role in how
machines are wired.

Applications of Artificial Intelligence

Artificial intelligence may be used in a variety of ways. Many various businesses

and fields may benefit from this technology. It's being studied in the healthcare
business for administering pharmaceuticals and various treatments in patients, as
well as in the operating room.

Self-driving automobiles and chess-playing computers are two further instances of

devices having artificial intelligence. A decision made by any one of these devices
has a direct influence on the final outcome. After all, winning the game in chess is
the ultimate goal. In order to avoid a collision, the computer system in self-driving
vehicles must take into consideration all exterior data and calculate it.

For example, in the banking business, artificial intelligence is used to identify and
flag odd debit card use and significant account deposits, all of which aid the fraud
department of a bank. Artificial intelligence (AI) applications are now being
utilized to expedite and simplify trade. This is accomplished by simplifying the
estimation of securities' supply, demand, and price.

Categorization of Artificial Intelligence

There are two types of artificial intelligence: weak and strong. A system with weak
artificial intelligence is one that is just intended to do a single task. Video games
and personal assistants like Amazon's Alexa and Apple's Siri are examples of
systems with weak artificial intelligence (AI). When you have a query for the
virtual assistant, it will gladly provide you with an answer.

Artificial intelligence (AI) systems that are capable of doing human-like tasks are
known as "strong AI systems." These tend to be more sophisticated and difficult to
use. They've been trained to handle circumstances in which they'll need to come up
with their own solutions without the help of a human. Applications such as self-
driving automobiles and operating rooms use these technologies.

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In contrast to natural intelligence, which is expressed by people and animals,
artificial intelligence (AI), also known as machine intelligence, is presented by
machines. An "intelligent agent," according to most AI textbooks, is any
technology that can observe its surroundings and take activities to increase the
likelihood of it attaining its objectives.. To characterize robots that simulate
"cognitive" capabilities associated with the human mind, such as the ability to
learn and solve problems, the phrase "artificial intelligence" is often used.

The AI effect is phenomena that occur when activities formerly thought to need
"intelligence" are no longer included in the concept of AI. In Tesler's Theorem, a
joke states that "AI is anything that hasn't yet been done." Even though optical
character recognition (OCR) is already commonplace, it is typically left out of
discussions of what constitutes artificial intelligence (AI). Artificial Intelligence
(AI) encompasses a wide range of skills, including the ability to interpret human
speech, compete at the highest level in strategic game systems (such as chess and
Go), operate autonomously in content delivery networks, and simulate military
operations, among others.

For more than 60 years, artificial intelligence (AI) has witnessed multiple waves of
excitement, followed by disappointment and funding losses (known as "AI

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winters"), followed by new methods to success and fresh investment. AI was
formed as an academic subject in 1955. AI research has long been separated into
subfields that don't always interact with one another well. Specific aims (e.g.
"robotics" or "machine learning"), the use of specific techniques (e.g. "logic" or
artificial neural networks"), or fundamental philosophical differences underlie
these subfields of study. Social influences have also influenced sub-fields
(particular institutions or the work of particular researchers).

Reasoning, knowledge representation, planning, learning and natural language

processing are only some of the classic AI research challenges. One of the field's
long-term aims is to gather general intelligence. Computational intelligence and
symbolic AI are examples of approaches. The field of artificial intelligence (AI)
makes use of a wide range of techniques, including various forms of search and
mathematical optimization, as well as neural networks and other approaches based
on statistics, probability, and economics. From computer science to information
engineering to mathematics to psychology to language and philosophy to many
other disciplines are all a part of the subject of artificial intelligence (AI).

Human intelligence "can be so thoroughly specified that a computer can imitate it,"
according to the field's founders. This gives rise to philosophical debates regarding
the nature of the mind and the propriety of developing intelligent machines. Since
antiquity, myth, literature, and philosophy have examined these topics. Some fear
that if artificial intelligence (AI) continues to advance at its current rate, it will
pose a threat to mankind. Others fear that AI, in contrast to past technology
revolutions, would result in a massive loss of economic opportunities for workers.

This century has seen an explosion in Artificial Intelligence (AI) techniques thanks
to advances in computer power, large data sets and theoretical understanding. AI
techniques are now integral to the technology industry, helping to solve many
challenging problems in the fields of computer science, software engineering and
operations research.

History

Ancient mythological automaton Talos shown on a silver didrachma from Crete.

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Since antiquity, stories featuring artificial entities with the ability to think have
been used to convey their stories. Examples include Mary Shelley's Frankenstein
and Karel apek's RUR. Many of the concerns posed by these individuals and their
destinies are now being debated in the field of artificial intelligence ethics.

In antiquity, philosophers and mathematicians started to explore mechanical or

"formal" thinking. As a result of Alan Turing's theory of computing, which
proposed that a computer could imitate every possible act of mathematical
deduction by shuffling basic symbols like "0" and "1," the study of mathematical
logic was directly linked to his theory. The Church–Turing thesis asserts that
digital computers can imitate any formal reasoning process. Neurobiology,
information theory, and cybernetics all contributed to the idea of developing an
electronic brain, along with other findings. Turing recommended shifting the topic
from whether or not a computer was intelligent to whether or not it is conceivable
for a machine to exhibit intelligent behaviour." McCullouch and Pitts' 1943 formal
design for Turing-complete "artificial neurons" was the first effort now commonly
accepted as AI.

At a Dartmouth College workshop in 1956, John McCarthy invented the name

"Artificial Intelligence" to separate the topic from cybernetics and avoid the
influence of cyberneticist Norbert Wiener. This session was the birthplace of AI
research. Researchers such as CMU's Allen Newell, John McCarthy, Herbert

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Simon, Marvin Minsky, and Arthur Samuel all went on to become pioneers in the
field of artificial intelligence (AI). Astonishing" computer systems developed by
them and their pupils included checkers tactics (c. 1954), word problems in
algebra, establishing logical theorems (Logic Theorist, first run c. 1956), and
English speaking programmes (Speak English). Throughout the 1960s, the U.S.
Department of Defense was significantly funding research, and facilities were
created across the globe. Herbert Simon, one of the AI's early pioneers, projected
that machines will be able to do every task that a human could in the next two
decades. As Marvin Minsky put it in his book, "Artificial Intelligence" will be
"significantly solved" within a generation.

Some of the remaining chores were too tough for them to comprehend. In 1974,
both the British and American governments stopped funding exploratory research
into artificial intelligence because of criticism from Sir James Lighthill and the
continued pressure from the US Congress to support more productive programmes.
An "AI winter" was eventually coined, a time in which securing financing for AI
initiatives became more difficult.

The commercial success of expert systems, a kind of AI software that simulates the
knowledge and analytical abilities of human experts, rekindled interest in AI
research in the early 1980s. Artificial intelligence (AI) had a burgeoning business
by 1985, with sales exceeding $1 billion. U.S. and British governments were
motivated by Japan's fifth generation computer programme to reinstate financing
for academic research. Artificial Intelligence (AI) once again fell into disdain in
1987, when the Lisp Machine business collapsed.

MOS VLSI technology, in the form of complementary MOS (CMOS) transistor

technology, allowed for the creation of realistic artificial neural network
technology in the 1980s. Carver A. Mead and Mohammed Ismail's Analog VLSI
Implementation of Neural Systems, published in 1989, and was a seminal work in
the subject.

In the late 1990s and early 2000s, artificial intelligence (AI) started to be employed
in logistics, data mining, medical diagnostics, and other areas of application. In
addition to Moore's law and transistor count and new connections between AI and

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other fields (such as statistics, economics, and mathematics), the success was due
to a commitment by researchers to mathematical methods and scientific standards,
as well as a greater emphasis on solving specific problems. It was on May 11,
1997, when Deep Blue became the first computer to defeat a reigning world chess
champion, Garry Kasparov.

During 2015, the number of Google software projects that incorporate artificial
intelligence went from "sporadic use" in 2012 to more than 2,700 projects,
according to Bloomberg's Jack Clark. In addition, Clark provides evidence of AI's
progress since 2012, including decreased mistake rates in image processing. The
advent of cloud computing infrastructure and an increase in research tools and
datasets has led to an increase in inexpensive neural networks, he says.
Additionally, Microsoft has developed a Skype system that can automatically
translate between languages and Facebook has developed a system that can explain
photos to those who are visually impaired. An estimated one-in-five businesses
claimed to have "integrated AI in certain services or processes" in a 2017 poll.
According to some analysts, China is on the verge of becoming a "AI powerhouse"
as a result of its massive data supply and quickly expanding research output. It has
also been noted that artificial intelligence claims have been overblown on a
number of occasions.

AI and Healthcare

Artificial Intelligence (AI) is a critical innovation area in health care and in

hospitals. There are special issues in the provision of medical treatment in
European nations and elsewhere in the globe that need smart health care supported
by AI technologies such as Machine Learning (ML). However, it is not only the
COVID-19 epidemic that has brought to light the present issues and difficulties
that European hospitals face. Because of the advancements in medicine over the
previous several decades, people have become older, frailer, and more ill owing to
a longer lifespan.

In addition, medical treatment and illness are growing more sophisticated. Medical
workers are becoming more and more specialized as a result of increasing medical
complexity, which cannot in general be met by smaller hospitals in rural locations.

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Additionally, the EU27's population of over 80-year-olds is expected to double
from 6.1 percent in 2020 to 12.5 percent in 2060, a demographic shift that is
currently taking place in Europe. As a result, the health care system will see an
increase in the number of seniors with particular health issues. A scarcity of
physicians and nurses is already forming in several European countries as the
number of young, well-trained medical professional’s declines.

Increased fiscal pressures on hospitals are exacerbated by the rising number of

elderly and multi-morbid patients with complicated conditions, as well as the lack
of qualified staff. Medical resources and medical sustainability are threatened by
an increase in chronic illnesses owing to an ageing population and a lack of
medical professionals. Artificial Intelligence (AI) solutions must be developed to
alleviate the stress of growing workloads and help offer efficient, effective and
high quality health care in order to protect European citizens' health and well-
being.

In this environment, adaptability and agility are essential, and limiting the use of
AI to only efficiency misses the purpose in many circumstances. Artificial
Intelligence (AI) applications will be more essential than just efficiency benefits
since they will offer up a greater variety of actionable alternatives, from
individualized medical diagnosis and treatment to options in care, sourcing, and
logistics. The continuing COVID-19 pandemic has the potential to provide a
number of advantages, and they should be investigated further, particularly in
terms of data analysis and preventing health care workers in hospitals from coming
into touch with patients who do not need to be exposed to the virus.

The use of artificial intelligence (AI) in the battle against pandemics, such as
COVID-19, may assist hospitals concentrate resources on pandemic patients' care
in both present and future conditions. Thus, most AI applications aim to reduce the
amount of human interactions and hospital visits in order to reduce the potential
spread of viral pandemics such as COVID-19 and other by using contactless
analysis, diagnosis, and treatment (e.g. self-treatment and prevention). In
particular, artificial intelligence (AI) has the potential to improve medical
treatment and assist medical professionals. Specific application areas are provided
to characterize the current status of AI in hospitals and the health care industry.

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With relation to the implementation of AI applications in hospitals, there are two
particular concerns that need to be answered: What are the criteria and hospital
settings for AI applications? These initiatives were found via a survey of European
hospitals conducted by the authors. As a consequence, care, diagnosis, and
logistics are the primary areas of AI use in hospitals. AI has the most medical and
economic promise in these three areas, according to the hospitals polled. The study
builds on this by describing 11 use scenarios in nine European hospitals, showing
how AI can help hospitals be more agile and efficient while also boosting service
quality and choice while linked with core hospital workflow and value addition
operations. As a follow-up question, how can AI use cases be structured to prevent
building isolated solutions that are difficult to transfer between hospitals? To
enable a comprehensive approach to AI application implementation and transfer,
this article proposes three core support areas.

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Due to advances in AI software and technology, AI is now being used in a wide
range of technological domains, including the Internet of Things (IoT), machine
vision (MoV), autonomous driving (ADAS), natural language processing (NLP),
and robotics. Researchers in the biomedical areas have been aggressively using AI
to aid enhance analysis and treatment results and, as a result, raise the overall
efficiency of the healthcare business. This is particularly noteworthy. The number
of publications in this field during the previous two decades, from 1999 to 2018,
may be shown in Fig.. In the previous five years, interest has risen significantly,
and it can be predicted that this trend will continue. The advantages that artificial
intelligence (AI) may provide to biomedicine have been anticipated for many
decades. In reality, a number of studies have examined the potential of artificial
intelligence in biomedical engineering. AI and its biomedical applications have
made considerable strides forward.

AI has the potential to make significant contributions in the areas of

personalization, prediction, prevention, and participation in healthcare. We believe
that AI will continue to evolve and mature as a potent biomedical tool, based on an
assessment of the advances achieved. Main AI applications will be the focus of this
paper's remaining sections. Details information processing and algorithm
implementation, while focusing on illness diagnosis and prediction

AI for living assistance

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Artificial intelligence (AI) applications using appropriate smart robotic systems are
opening the way for advances in the quality of life for the elderly and handicapped.
People with loss of autonomy (PLA) may now take use of smart home features and
solutions that use wireless sensor networks, data mining, and artificial intelligence
(AI). To train neural networks (NNs) to detect human facial emotions as
instructions, specialized image-processing techniques are required. As a result,
persons with impairments may operate wheelchairs and robot support vehicles
without the need for a joystick or sensors connected to the body.

It is possible for persons who are blind to live and work alongside their sighted
counterparts thanks to a "ambient intelligent system" named RUDO. People who
are visually impaired may utilize this intelligent assistant's many functions from a
single user interface. An AI "smart assistant" can provide pregnant women with
nutritional and other recommendations throughout the most critical periods of
pregnancy. A combination of its own intelligence and "cloud-based
communication channels amongst all those interested" allows it to provide
"advanced" ideas.

Using a sparse Bayesian classifier with a radar Doppler time–frequency signature

fall detection system, seniors' fall risks and problems may be decreased. For
"ambient assisted living" (AAL), systems with "smart communication architecture"
(SCA) have been developed to enable AI processing of information gathered from
various communication channels or technologies, and thus to determine the
occurrence of events in the network environment and the assistance needs of
elderly people. In smart homes, "ambient intelligence" enables "ageing in place"—
that is, ageing at home—by providing older people with activity awareness and
help. SALSA, for example, is an intelligent agent that may assist the elderly in
their daily pharmaceutical routines, for example. The use of ML in motion analysis
and gait analysis may alert researchers to potentially harmful behaviours and
prompt the implementation of countermeasures.

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Cloud computing or edge intelligence may be used to evaluate the data collected
by sensors in this circumstance. To trigger alarms or preventive measures, a
judgement is made on what actions are essential. People with long-term memory
loss may benefit from AI-based expert systems that work in combination with
mobile devices and personal digital assistants (PDAs) to improve their memory
and enable them to live more independently. Expert system for memory
rehabilitation (ES-MR) has been extended to include "non-expert" users.

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Artificial intelligence in healthcare

An X-ray of a hand is shown, and computer software automatically determines the

bone's age.

Machine learning algorithms and software, often known as artificial intelligence

(AI), are used in healthcare to simulate human cognition in the analysis, display,
and interpretation of complicated medical and health care data. AI is a broad
phrase. A key feature of artificial intelligence (AI) is its capacity for making
educated guesses about the true meaning of incoming data.

Traditional healthcare technology can't compare to AI's capacity to collect data,

analyze it, and provide a clear result to the end user. Deep learning and machine
learning techniques are used by AI to do this. Pattern recognition and logic
generation are both possible with these methods. Using a large quantity of data to
train machine learning models is essential for gaining relevant insights and
predictions. There are two ways in which AI systems vary from humans: When a
goal is set, algorithms are literal: they can only understand what they are
programmed to do, and some deep learning algorithms are black boxes; algorithms
can predict with extreme precision but offer little to no comprehensible explanation
of the logic behind their decisions aside from data and algorithm type.

Medical AI applications are primarily designed to examine how treatment or

preventative methods affect patient outcomes. Diagnoses, treatment protocols,
drugs, tailored medicine, patient monitoring and care are just a few of the areas
where AI is being used. For illness prevention and diagnosis, AI algorithms may
also be utilized to examine massive volumes of data from electronic health records.

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The Mayo Clinic, Memorial Sloan Kettering Cancer Center, and the British
National Health Service (NHS) have all created AI algorithms for their respective
departments. Several large technology firms, including IBM and Google, have
created healthcare-specific AI algorithms. With the use of artificial intelligence
(AI), hospitals are pursuing operational initiatives that help them save money while
increasing patient satisfaction, ensuring their staffing and workforce demands are
met. The United States government is now spending billions of dollars to advance
the development of artificial intelligence (AI) in the healthcare industry.
Companies are creating solutions that assist healthcare management in improving
utilization, minimizing patient boarding, reducing length of stay, and optimizing
staffing levels.

Data privacy, job automation, and representation biases are just a few of the ethical
issues that arise when using AI in healthcare, which is still in its early stages.

Current Status

There has been a rise in AI research in a variety of medical professions. Artificial

Intelligence (AI) will play a major role in healthcare research in the United States
during the next five years as the new corona virus spreads over the world.

Dermatology

Developing deep learning has been closely linked to image processing in

dermatology, which is an imaging-heavy specialty. As a result, dermatology and
deep learning are a perfect match. Dermatology uses three sorts of images:
contextual, macro, and micro. Deep learning demonstrated significant gains in each
modality. Han et al. demonstrated the ability to identify keratinocytic skin cancer
using facial images. Images of skin lesions were used by Esteva et al. to accurately
classify cancers at the dermatologist level. Noyan et al. used a convolutional neural
network to identify 94% of microscopic Tzanck smear pictures of skin cells with
high accuracy.

Radiology

Imaging techniques such as computerized tomography and magnetic resonance are

used in the radiology discipline to aid in the detection and diagnosis of illness in

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patients. According to the Radiology Society of North America, AI in radiology
has grown quickly in recent years, growing from 0% to 3, 17%, and 10% of total
articles from 2015-2018. When it comes to detecting pneumonia in patients, an
algorithm developed by researchers at Stanford University outperformed the
radiologists who participated in the study. It is possible to identify problems and
track changes over time in cancer using imaging using AI in oncology. Since then,
a number of firms and vendor-neutral systems have emerged to offer machine
learning platforms that can be trained to identify a broad spectrum of illnesses,
such as ICOMETRIX, QUIBIM, ROBOVISION, and UMC Utrecht's IMAGRT

The annual meeting of the Radiological Society of North America includes talks
on artificial intelligence in imaging. Radiologists are hopeful about the future of AI
processing in radiology since it will enable them to see more patients and reduce
the amount of time they spend interacting with patients. Medical imaging has a
history of fast improvement in both capacity and dependability of new
technologies, even if it isn't always as excellent as a trained eye in distinguishing
between malignant and benign growths. Certain radiologists are concerned about
the rise of AI technology in radiology since it can outperform them in some
circumstances where they can't.

Screening

AI might be used to characterize and evaluate the results of maxillofacial surgery

or the evaluation of cleft palate treatment in terms of face beauty or age
appearance, according to recent advancements.

Skin cancer might be identified more effectively by an artificial intelligence system

(using a deep learning convolutional neural network) than dermatologists,
according to a report published in the Annals of Oncology journal in 2018. 86.6
percent of skin cancers were correctly identified by dermatology experts, compared
to 95 percent by CNN's automated skin cancer detection system.

Using a Google DeepMind algorithm, researchers will present an AI system in

January 2020 capable of beating human specialists in the identification of breast
cancer

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98 percent sensitivity and 97 percent specificity were announced by the University
of Pittsburgh's AI algorithm in July of 2020, making it the most accurate method of
detecting prostate cancer to date.

Psychiatry

AI applications in psychiatry are still in the early stages of development. Chatbots,

conversational agents that mimic human behaviour and have been examined for
anxiety and depression, are one area where the evidence is growing rapidly.

Many applications in the sector are developed and suggested by private firms, such
as Facebook's screening for suicidal thoughts in 2017. Professional, ethical, and
regulatory issues arise when these apps are used outside of the healthcare system.

Primary care

AI technologies have made primary care one of their primary areas of focus.
Decision assistance, predictive modelling, and business analytics are all examples
of how artificial intelligence (AI) in primary care has been put to use. Artificial
Intelligence (AI) has advanced rapidly in recent years, but general practitioners'
views on the use of AI in primary care are still quite restricted.

Disease diagnosis

A study by Jiang, et al. (2017) found that a number of AI approaches, including

support vector machines, neural networks, and decision trees, have been applied
for a wide range of disorders. To ensure that "classifications accord with the results
as much as feasible...", each of these strategies has a "training target."

There are two methods for illness diagnosis/classification: "Artificial Neural

Networks (ANN) and Bayesian Networks (BN)." ANN was proven to be superior
and capable of classifying diabetes and cardiovascular disease more correctly.

Medical Learning Classifiers (MLCs) have made it possible for AI to assist

clinicians in the diagnosis of patients by manipulating large amounts of electronic
health records (EHRs). Complex medical disorders and a long history of electronic
medical data make it more likely that cases will be duplicative. Patients with rare
diseases are less likely to be the only ones who have ever had it, but doctors still

21
face significant difficulties in finding patients with identical symptoms elsewhere.
It is in the patient's best interest when AI is used not only for the purpose of
helping doctors identify comparable instances and therapies, but also to take into
account key symptoms and guide them in asking the right kinds of questions.

Telemedicine

Virtually treating patients through telemedicine has revealed the emergence of AI

applications. Artificial Intelligence (AI) may aid in the care of patients remotely by
monitoring their data through sensors. Wearable technology may make it possible
to keep tabs on a patient all the time and pick up on subtle changes that people
would miss. Artificial intelligence algorithms may be used to compare the data
with previously obtained data and notify clinicians if any discrepancies are found.

Artificial intelligence may also be used in chat-bot therapy. However, other studies
argue that relying on chatbots for mental health treatment does not provide the
reciprocity and responsibility of care that should exist in the interaction between
the patient and the provider of mental health care (whether it is a chat-bot or
psychologist).

As the average age of the population rises as a result of improved health, artificial
intelligence may be helpful in the care of the ageing population. Caretakers can
monitor a patient's routine behaviours and be alerted if anything out of the ordinary
occurs, thanks to devices like environment and personal sensors. Since
technologies are meant to map out house layouts and identify human activities,
there are issues concerning monitoring restrictions in order to respect a person's
privacy.

Electronic health records

The digitization and dissemination of information in the healthcare business are

impossible without electronic health records (EHR). The next stage is to apply
artificial intelligence to analyse the data and deliver new information to clinicians,
now that around 80% of medical practices are using EHRs.

Natural language processing (NLP) is a technique that reduces the number of

medical words in a report by finding and matching those that are similar. For

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example, the phrases heart attack and myocardial infarction signify the same thing,
but clinicians may choose to use one over the other. These discrepancies are
consolidated using NLP algorithms, allowing for the analysis of bigger datasets.
Another use of NLP is to identify repetitive terms in a physician's notes due to
overuse and only maintain the important information. The information input by the
current patient's doctor is analysed by other apps using concept processing to
display comparable situations and assist the physician in remembering to provide
all important facts.

Additionally, AI algorithms may assess a patient's record and forecast their

likelihood of contracting a disease based on their prior knowledge and family
history, in addition to making content updates to an EHR. A rule-based system,
analogous to how people use flowcharts to make choices, is one kind of generic
algorithm. To make sense of all the information it receives, this system develops a
set of rules that link individual observations to a final diagnosis. As a result, the
algorithm may analyze a new patient's data to see whether they are at risk of
developing a certain ailment or disease. It is possible to uncover any unresolved
problems and save time by using algorithms that can analyze a patient's data based
on aggregate data. It has been observed that predictive modelling of electronic
health records (EHR) data may predict individual therapy response with 70–72
percent accuracy. Because the number of electronic medical records (EMRs)
increases every five years, these techniques are becoming more useful. In order to
process all this data manually, doctors lack the capacity to do so, and AI can aid
them in their work.

Drug Interactions

Drug interactions may now be detected in medical literature because to advances in

natural language processing. The greater the number of drugs a person is taking,
the greater the risk of a drug-drug interaction occurring. Data on drug-drug
interactions has been extracted from medical literature using machine learning
methods to address the problem of monitoring all known or suspected interactions.
The DDI Extraction Challenge, in which a team of Carlos III University academics
compiled a corpus of material on drug-drug interactions to develop a standardized
test for such algorithms, culminated in 2013 with the consolidation of their efforts.

23
Competitors were assessed on their ability to reliably identify which medications
were demonstrated to interact and the features of their interactions from the text. It
has been used by researchers to assess the efficacy of their algorithms for years
now.

Other algorithms employ user-generated input, such as electronic health records

and/or adverse event reports, to discover drug-drug interactions. The FDA's
Adverse Event Reporting System (FAERS) and the World Health Organization's
VigiBase enable clinicians to report probable adverse reactions to medicines.
Drug-drug interactions may be detected using deep learning algorithms that
analyze these data.

Creation of new drugs

Exscientia (a British start-up) and Sumitomo Dainippon Pharma (a Japanese

pharmaceutical company) collaborated to develop DSP-1181, a molecule of the
OCD therapy medication, using artificial intelligence (Japanese pharmaceutical
firm). The medicine was developed in only one year, compared to the normal five
years spent by pharmaceutical corporations on comparable initiatives. Trials on
humans using DSP-1181 have been approved.

Artificial intelligence has been used by Insilico Medicine to create six new
inhibitors of the DDR1 gene, which is a kinase target involved in fibrosis and other
disorders, according to a paper published in September 2019. The novel chemicals
were created in 21 days using a method called Generative Tensorial Reinforcement
Learning (GENTRL), and a lead candidate was tested in mice and showed
promising results.

Deep Genomics, a Canadian firm, announced this month that its AI-based drug
discovery platform has discovered a target and a therapeutic candidate for Wilson's
illness. An exon-skipping impact of the Met645Arg genetic mutation, which
affects the ATP7B copper binding protein, is intended to be corrected by the
candidate, DG12P1.

Use Cases Descriptions and Expectations

24
Approaches that intelligently exploit heterogeneous data from diverse sources and
revolutionary AI-based methods for assisting medical diagnosis in clinics are being
proposed in the area of diagnosis. Artificial Intelligence (AI) may be used to
diagnose coronary artery disease, monitor the condition of the baby during birth,
diagnose epidermolysis bullosa (a rare hereditary illness), and automatically
diagnose arrhythmias. All of these use cases generate a wide range of data, making
it difficult for medical professionals to make sense of it, while also opening the
door to the development of new AI-based approaches for aiding in diagnosis and
clinical decision-making. There are several diagnostic aspects that can only be
detected by AI-based approaches. Clinical tools that are widely accepted, widely
utilized, and have actual value for patients, physicians, and society can only be
developed via close cooperation between technological and medical professionals.

1. Use Case 1: Coronary Artery Disease Diagnosis

Coronary CT angiography (CCTA) has the greatest sensitivity (95–99 percent) and
specificity (64–83 percent) of all commonly available diagnostic techniques for
detecting coronary artery disease (CAD), and it has lately established itself as the
primary diagnostic tool for stabilizing chest discomfort. Some patients' diagnoses
and symptoms are still unclear following CCTA, necessitating further imaging
procedures (myocardial perfusion and/or invasive coronary angiography) in order
to determine the appropriate course of therapy. Predicting which patients need
additional imaging in order to get the most accurate diagnosis would save money
and time, both of which are important considerations when dealing with chest pain
patients. To put it another way, the goal is to create a tool that can assess a patient's
likelihood of developing prognostic CAD so that personalized treatment decisions
may be made. Clinical recommendations that emphasize CCTA's use in the
diagnosis of patients with suspected coronary artery disease (CAD) would likely
lead to an increase in the number of CAD patients being sent to hospitals for
diagnostic imaging in the future. Computer-learning algorithms such as the
Disease State Index (DSI), which was originally developed to help clinicians
diagnose Alzheimer's disease, could be used to train a number of contemporary
CCTA studies and essential clinical data such as age, sex, cardiovascular risk
factors, and medication could be used to train the algorithm.

25
2. Use Case 2: AI Based Automatic Arrhythmia Analysis

The most prevalent long-term arrhythmia is atrial fibrillation (AF), which is linked
with a high rate of mortality and other negative consequences (stroke, heart failure,
death). Stroke risk is five times higher when a person has atrial fibrillation (AF).
Anticoagulation treatment has been shown to dramatically lower the risk of AF-
related stroke. In the case of paroxysmal AF (PAF), the condition is self-
terminating. Diagnosing PAF might be difficult because of the short duration,
asymptomatic nature, and low frequency of episodes. Stroke is thought to be
responsible for EUR 45 billion in annual expenses in Europe. Stroke is the leading
cause of death in the European Union, accounting for 9 percent (or 0.4 million
fatalities) of all EU deaths each year for a total of 1.5 million persons. The three
most clinically relevant patient categories where PAF is often under diagnosed are
those with cryptogenic stroke (CS), transient ischemic attack (TIA), and cardiac
surgery. Patients with TIA or cryptogenic stroke and cardiac surgery patients are
screened for PAF using state of the art AI-based arrhythmia analysis methods in
this use case. Wearable sensors equipped with AI-based automated arrhythmia
analysis allow for extended monitoring periods with enhanced patient usability,
while still requiring minimum effort from healthcare providers. Artificial
Intelligence (AI)-based non-invasive approaches for PAF screening employing
simple wearable ECG or PPG monitoring in cardiac surgery, CS and TIA patients
might lead to an increase in PAF detection. These monitoring techniques will be
simple to use and low-cost. Patients may avoid stroke-related problems including
paralysis, aphasia, and persistent pain by getting an accurate diagnosis of PAF as
soon as possible. Direct medical expenditures for a stroke may be reduced by up to
EUR 20,000 while indirect costs can be reduced by more than EUR 100,000.
(Disability-adjusted life years lost).

3. Use Case 3: Fetal State Assessment during Labour

Before and during childbirth, the use of intermittent heart rate auscultation has
been largely supplanted by the use of cardiotocography (CTG), commonly referred
to as electronic foetal monitoring (EFM). Visible CTG tracing interpretation has
become more difficult due to the lack of specificity in visual interpretation.
Evidence suggests that EFM leads to medical treatments that aren't essential, like

26
as caesarean sections and vaginal births with their accompanying health risks and
financial expenses. For example, the lack of specificity in diagnosing prenatal
hypoxia may be largely explained by observer variability. For foetal evaluation
during delivery, CTG recording has become commonplace in most hospitals across
the globe.

Electronic foetal monitoring (EFM) systems use software to record foetal and
maternal data, such as heart rate, contractions, and movements of the foetus
throughout pregnancy. CTG is now best understood by using the FIGO
classification, which is the most widely accepted approach in the field of
gynaecology and obstetrics. There are two measures used to evaluate the health of
a newborn: (1) arterial pH (blood from the umbilical cord) and (2) APGAR score
evaluation at 1, 5, and 10 minutes after delivery. Observers (obstetricians and
midwives) get immediate feedback on past CTG interpretations during delivery, as
well as a prognosis of foetal hypoxia/acidosis. Indicators of foetal hypoxia include
an arterial pH below 7.15, which is regarded as pathological.

At 5 minutes after birth, an APGAR score less than 7 is deemed pathologic.

According to this technique, a newborn's health state may be gauged by observing
five foetal characteristics—appearance, pulse, grimace, activity, and respiration—
after birth. Because of the issue of observer variability, there are four potential
results when a CTG is interpreted by an obstetrician or midwife: (1) a normal
CTG, (2) a pathological CTG, (3) a normal CTG, (4) a pathological CTG, and (5) a
pathological APGAR. With AI interpretation, the goal is to enhance scenarios 2
and 3, which in most situations will result in avoiding surgical procedures since
CTG's primary flaw is specificity, or executing treatments when one would
normally abstain from doing so (version 3) When foetal asphyxia is predicted (pH
7.15 or APGAR at 5 min 7), the AI system might offer feedback and/or warnings,
if necessary. The proposed AI (or ensemble of several AI instances) would help in
removing the existing great inter- and intra-observer variability and lead to a direct
and positive impact on effectiveness and efficiency through: (1) decrease of
unnecessary caesarean section and instrumental delivery; (2) increase of specificity
for identifying foetal hypoxia; (3) decrease of unnecessary health costs derived
from unnecessary surgical procedures.

27
4. Use Case 4: Diagnosis in Epidermolysis Bullosa, a Rare Genetic Disease

The European Union classifies an illness as uncommon if it affects fewer than one
person in every 2,000. More than 7,000 rare diseases (RDs) afflict people all over
the globe; roughly 80% of these have a genetic basis, and children account for
about 75% of those affected. An estimated 350 million individuals throughout the
world are afflicted with RDs. Between 5.5 and 7.5 years is the average time it takes
to correctly diagnose uncommon genetic illnesses in nations with superior
resources.

Nearly half of the initial diagnosis in Europe and the United States are incorrect.
Insufficient understanding of illness patho physiology and natural history, as well
as a scarcity of validated disease-specific biomarkers, make it difficult to
implement efficient diagnostic techniques. This is due in part to RDs' ignorance of
the real prevalence of disease. Inheritable genetic illnesses, epidermolysis bullosa
(EB) affects the skin and mucous membranes and causes severe, persistent blisters
and lesions to occur after even small frictions or traumas.

The severe blistering and accompanying scarring and abnormalities lead to a worse
quality of life and a shorter life expectancy in people with this uncommon genetic
ailment, which affects people of all sexes, ethnicities, and races. About 500,000
people throughout the globe and 36,000 people in the European Union are afflicted
by this condition (EU). Subtypes of epidermolysis bullosa include dystrophic,
junctional, EBS and Kindler Syndrome, based on gene alterations and skin
cleavage severity. Subtypes of EB have varying degrees of severity and clinical
symptoms, which are outlined below. Early detection approaches for the EB
subtype, illness progression prediction, and the selection of personalized, precision
therapy options must be developed quickly. An increasing number of "omics
technologies" are being used in the diagnosis, molecular sub typing and follow-up
prediction of EB via the use of next generation sequencing (NGS). An enormous
quantity of data that may be utilized to help EB sufferers can be gleaned from these
technologies, provided that powerful computational tools are available for their
integration and combinatorial analysis.

As an example of a rare genetic condition, early diagnosis, sub-classification, and

therapy stratification are all supported by cutting-edge AI algorithms designed

28
specifically for this use case. To support disease and disease subtype diagnosis,
identify distinctive features (genomic lesions, proteins and immune states)
associated with disease severity (biomarkers) for the prediction of disease
progression, and detect molecular signs, AI-based methods will be applied to the
integrative analysis of biological (genetics, molecular, immunological and image)
and epidemiological (medical records) data (precision therapeutics). Machine
learning (ML) algorithms may be taught to integrate phenotypic and clinical data
to priorities illness-related genes and mutations, predict the pathogenicity or
disease clinical significance of genetic variations, as well as identify pathogenic
variation combinations.

By unravelling the genetic and molecular actors and pathways that are impacted by
the disease, AI-based technologies may be utilized to better understand the illness
and identify potential treatment targets. Artificial intelligence and machine
learning may be used to discover gene expression anomalies and link
transcriptional patterns with molecular processes and clinical symptoms, as well as
to learn low frequency patterns and give automatic class attribution for diseases.
Results from these analyses might help doctors select the best treatment options
and identify reliable indicators of normal vs. pathogenic states and the response to
pharmacological treatments. Following the most recent consensus reclassification
of hereditary EB, AI approaches that concentrate on overcoming current
constraints in the proper identification of EB subtypes and in the prediction of the
clinical course of EB patients might attain at least the same average accuracy as
medical practitioners. Through (1) a reduction in the time required to identify the
correct subtype of the disease, (2) an increase in the number of diagnostic
biomarkers, and (3) an improvement in selection criteria for patients who will
benefit from f, AI-based integrative analysis of biological and medical data will
have a positive impact on both the efficacy and efficiency of treatment.

Four additional use cases for AI in the healthcare field include improving the
management and decision-making process, specifically in the chronic care pathway
and resources characterization, simulation of demand and prognosis, adverse
events detection and prevention, chronic resources management support tool, and
monitoring of the recovery process. By taking into account the temporary forecasts
of the frailty of the population and patients, new and creative methods for

29
simulation and prognosis would be made accessible for predicting the demand for
health resources for a certain characteristic population in an area

Using contactless determination of vital signs for recovery monitoring will assume
an advanced functional aspect by monitoring all patients, not only severe cases.
Because of fewer connections and gadgets, patients can do more with their lives. In
addition, nurses save time since they don't have to sterilize and install the devices
on the patient. Deep neural networks and hybrid algorithms may be used to analyse
vital signs in order to avoid critical conditions from developing, as the suggested
method does.

5. Use Case 5: AI Chronic Management and Decision Support Engine

WHO figures show that respiratory and cardiovascular illnesses are the biggest
killers and disablers in the world, respectively? For the purposes of the case study,
data from chronic patients with one of these four frequent pathologies: COPD,
asthma, coronary heart disease (e.g., a heart attack), or cerebro vascular illness will
be analysed (e.g., stroke). An AI-based approach to chronic care management
would aim to identify the routes and resources utilized, as well as predict the
demand for resources, in order to save costs. Data from patients' clinical
parameters (such as laboratory tests), utilization of resources, socio demographic
data (such as age and gender), as well as quality of life, might then be analysed
using machine learning (ML) Both the chronic care pathway and resource
characterization (which groups patients according to their degree of frailty and
maps routes) and the resource demand modelling and prognosis (which takes into
account the various pathways and patient strata) would be supported by the AI
engine.

6. Use Case 6: Chronic Resources Management Support Tool

Most hospitals, according to the institutions questioned, find it difficult to schedule

resources efficiently and effectively. Patients' beds, materials, medications, and aid
kits, medical equipment (e.g., diagnostic machines), and operating theatres are all
possible resources to schedule. The objective would be to automatically arrange
the use of the resources in question, as well as to track and improve quantitative
KPIs for the most important hospital indicators, such as cost, service quality,

30
delivery time, resource utilization, and so on. To achieve this goal, the following
activities must be completed: (1) translating hospital needs, which are frequently
expressed in medical language, into technical concepts; (2) defining the scheduling
problem to be addressed by the intelligent algorithm and input data; (3) developing
an intelligent algorithm to automatically schedule resource usage and measure
quantitative KPIs over time; and (4) testing and validating the intelligent algorithm
using real datasets.

7. Use Case 7: Adverse Events Identification and Prevention

Clinicians need assistance in detecting and preventing adverse clinical conditions

(ACCs), as well as recognizing the key treatment routes associated with them. The
system might assist clinicians in the automated detection of ACC, such as a
patient's response to a new medicine following a change in their treatment plan.
The AI tools could analyse data captured by vital signs monitoring systems, such
as heart rate, pressure, and body temperature, as well as information inferred by
dialogue systems based on natural language processing that would interact with the
patient on a regular basis to identify specific symptoms. Furthermore, the tools
would be able to assist clinical professionals in the event that a change in the
treatment route is required. The goal would be to use AI to detect and predict ACC
for individuals with non communicable chronic illnesses, namely cardiovascular
disorders. Preliminary models and tools for the automated detection of ACC would
be developed utilizing retrospective data and traditional machine learning methods,
as well as existing recommendations for the care of illnesses of interest. Such
models and tools, on the other hand, might be enhanced over time using a
continuous learning method. Following that, sophisticated classification algorithms
based on a mix of deep learning and reinforcement learning techniques might seek
to avoid ACC by analysing time series data reflecting the patient state progression
at various stages of the treatment route.

8. Use Case 8: Monitoring of the Recovery Process

The monitoring of the patient's recovery is an important hospital procedure. Vital

criteria must be regularly examined in order to attain a high, consistent quality.
Vital signs such as heart rate and respiration rate are important indications of
present health, emergency situations, and the healing process. People with chronic

31
conditions, in particular, benefit from constant monitoring. There is extensive
coverage in locations like as operating rooms and intensive care units, but little to
no coverage in conventional wards or floors. The goal would be to use remote
monitoring of vital factors like heart rate and breathing rate to enhance recovery
monitoring in a patient-friendly manner, particularly for chronic conditions.
Optical sensors with remote working modes and AI algorithms like CNNs, BNNs,
and adaptive optical flow might achieve this. To achieve the goal, the following
activities must be completed: (1) determining the best location for optical sensors
within the hospital; (2) analysing algorithms for remote vital parameter
determination in clinical environments; (3) transferring and implementing
algorithms in the clinical setting; (4) evaluating algorithms in the clinical setting
using synchronized reference systems; and (5) developing an interface protocol for
transmission. It should be assured that only the meta data, not the raw data, is sent,
respecting the patients' privacy.

In the sector of logistics, for example, AI may be used in three distinct ways, as
mentioned below. The optimization of resource consumption is the key emphasis.
AI is likely to aid in better predicting material usage and demands throughout the
process. Transport planning, in addition to material usage, is a key point in the
discipline of logistics.

9. Use Case 9: Material Consumption Recognition and Prognosis

Currently, the documenting of utilized materials with hospital patients at the

University Hospital in Essen, as well as many other hospitals throughout Europe, is
a non-digital paper-pencil procedure that consumes a significant amount of human
labour time. As a result, digital upgrades to automated capture systems for material
consumption are a popular requirement in hospitals, and this use case addresses it.
An unique care trolley is being created in collaboration with an industrial partner,
complete with a camera system and complementing AI-based software that uses
machine learning to automatically identify consumed goods with patient processes.
According to current state-of-the-art notions, user interaction may be incorporated.
It will give a data identification and prognosis tool that will link real material
consumption to patient cases, allowing for bottom-up procurement and logistical
planning and prognosis in hospitals.

32
10. Use Case 10: Optimization of Human-Robot Teams in Hospital Logistics
Operations

A reactive AI-based resource management and scheduling solution for material

transport logistic operations will help Odense University Hospital (OUH). The
main goal is to improve on current task management systems by incorporating an
AI-driven optimized scheduler that will be able to supervise all available robots
and plan, schedule, and assign tasks to the relevant hospital workforce, which will
primarily consist of logistic robots but also include employees. The suggested task
management software will have a variety of purposes, hence it will have a variety
of conceptual elements: (1) a Reinforcement Learning (RL)-based automated task-
generation system that evaluates the link between room utilization and material
needs to forecast what will be required where and when based on prior experience;
(2) a scheduling element that understands what transportation resources are
available to it, their state, and where they are, and can produce an ideal timetable
from transport demands provided by user input or task creation; (3) a reactive
planning element that will rework the schedule on a regular basis, such as every
hour or when new on-demand transport requests are received; (4) a transport
optimizing element that analyses the efficiency of the transport and adjusts
scheduling parameters to produce maximum transport with minimal energy use
and human task requests; (5) a route generator element that generates efficient
routes for the robots and sends these to robots with their new tasks; The task and
material flow reports collected and shared by OUH's hospital service and logistics
departments, which currently contain more than 555,000 entries describing various
material flow logistic cases, such as the transfer of medication, healthcare
equipment, and samples, will provide a variety of inputs and tasks. By upgrading
and customizing the present emergency messaging solution elevator status and
sensors in the hospital, the system may automatically acquire information from
multiple hospital software sources, such as human workforce positions supplied by
the proposed event-based messaging system.

11. Use Case 11: Co-Development and Evaluation

The Bayndr Hospital Söütözü in Ankara is one of the Bayndr Healthcare Group's
three high-capacity hospitals. Three hospitals, one medical centre, and seven

33
dentistry clinics make up the Bayndr Healthcare Group. All material management
systems in healthcare institutions may be monitored and managed from a single
location. This gives researchers another chance to look at the effects of upcoming
AI implementations on multi-location inventory systems. In terms of healthcare
logistics, the hospital has unique experiences and needs. It already has a barcode
scanning system in place for gathering healthcare and inventory data, which is
centralized for planning medical supply availability and logistical management.
However, a new image recognition and AI-based system may still help the hospital
in terms of time savings, reductions in human error, and an improvement in safety
by eliminating interaction between healthcare workers and patients. Furthermore,
in actuality, material management and operating room scheduling are inextricably
linked. When compared to independent material management systems, using OR
schedules to prompt the procurement of preoperative goods is predicted to
minimize inventory costs and boost operational efficiency. In comparison to
standalone applications such as automated inventory tracking, predictive logistics,
and cognitive automation, a deeper understanding of the impact of integrated AI
applications on healthcare logistics operations will present a number of challenges,
including data storage and management; data exchange, security and privacy, and
integrated decision-making.

Benefits and Challenges for AI in Hospitals

This part presents and discusses the specific advantages and data, as well as AI
application issues, based on the specified case studies and with a focus on
pandemic conditions like as COVID-19.

Specific aspects often related to the area of interest, e.g., diagnosis, care, treatment,
logistics, or rehabilitation, or to the targeted goals, e.g., increase the efficiency of a
certain health care process, improve its quality, or increase the service level,
distinguish the use cases presented in Table. The extensive descriptions of the
aforementioned case studies, on the other hand, show how common issues and
possible impediments to AI adoption in healthcare procedures impact all of the
institutions involved on a daily basis.

In particular, three major difficulties may be identified that must be addressed in

order to enable the efficient and successful use of AI tools and methods in the

34
healthcare delivery procedures that characterize European hospitals. The human
acceptability and true adoption of AI technologies in hospitals is the first factor to
consider. Resistance to automated and somewhat hidden instruments that aid in a
variety of healthcare services is a significant challenge to overcome. The
employment of such technologies in conventional diagnostic, care, and treatment
procedures is beneficial, but it is frequently accompanied by a lack of confidence,
especially among physicians and medical professionals. Furthermore, the use of
such AI solutions should not add to the complexity or time it takes to accomplish a
specific medical procedure, ensuring a suitable and well-designed connection with
human users.

The correct administration of medical data is the second barrier that must be
addressed in order to boost AI adoption in European hospitals. Some
characteristics identify this data, making its storage and use much more sensitive
than other data often acquired in digital contexts.

35
 Table. AI Use Cases, AI Methods and Outcomes

Contributions against
Use Case Objectives AI Method Data Available Defined Outcomes
Pandemic Situations

For the study, a

The aim of this Disease State Index
number of
study is to train a (DSI), which is a
contemporary CCTA
ML algorithm to method to quantify
studies imaged in
distinguish the probability to
Kuopio University
patients with belonging to a
Hospital (KUH) as
suspected CAD certain disease
well as ECG,
to those who population,
myocardial perfusion,
Diagnosis benefit from originally developed Algorithms and AI
invasive coronary Reduction of visits to
(1) MDS for further imaging to support clinicians solutions for doctors
angiography imaging the hospital, which
Coronary Artery studies and to in diagnosing supporting clinical
and essential clinical increases the patient and
Disease (CAD) those who don’t. Alzheimer’s decision making in CAD
data (age, sex and personnel safety.
diagnosis In other words, to Disease. It is diagnosis.
other demographic
evaluate the risk designed to be
data, medical history,
of the patient to ‘disease-agnostic’,
cardiovascular risk
have prognostic so that it can be used
factors and
CAD for equally well for
medication) are
customized other diseases,
gathered from existing
clinical decision- provided that data
clinical databases in
making. are available.
KUH.

Diagnosis In this use case, State-of-the-art AI 6000 24 h Holter Developed AF-screening Reduction of visits to
(2) AI based state-of-the-art based arrhythmia recordings with solution will enable long the hospital, which
automatic artificial analysis algorithms arrhythmia arrythmia monitoring increases the patient
arrhythmia intelligence (AI) are developed and annotations. time and increased rate of safety.
analysis based arrhythmia utilized to atrial Wearable sensor AF diagnosis. Wearable Possibility to assess
analysis fibrillation (AF) database: 700 patients sensors offer improved arrythmia of corona

41
 Contributions against
Use Case Objectives AI Method Data Available Defined Outcomes
Pandemic Situations

algorithms are
patient usability and AI
developed and screening in patients
assisted arrythmia
integrated into with transient
(300 patients with AF diagnosis requires
wearable sensors. ischemic attack
episodes) with minimal effort from
Development of (TIA) or cryptogenic
wearable sensors. healthcare professionals;
novel AI-based stroke (CS) and
New: TIA/CS AF diagnosis has
arrhythmia detection of post- patients remotely.
database is collected: important impact to
monitoring operative atrial Increases patient and
48h home monitoring patient itself, since
system aims to fibrillation in personnel safety.
of simultaneous anticoagulation may save
improve cardiac surgery
wearable PPG and the patient’s life (prevent
arrhythmia patients. Used
ECG-recordings from cardioembolic stroke).
detection: methods: neural
100 TIA/CS patients. Cost saving potential: one
Enable longer networks, deep
prevented stroke can save
non-invasive learning, ML.
120,000€ to society.
monitoring time.

Diagnosis Improving fetal Ensemble methods The maternity ward of The AI will focus on Assisting personnel in
(3) Medical assessment with (e.g., stacking and the Department for removing the existing diagnosis with AI in a
decision support accurate blending) combining Obstetrics and great inter- and intra- situation where there are
system for fetal prediction of Explainable AI (aka Gynecology in the observer variability while not enough experienced
assessment fetal hypoxia and XAI), neural University Hospital of achieving at least the personnel available due
during labor reduction of networks (e.g., CNN Bern will provide a same average accuracy as to the pandemic.
caesarean and and RNN), and dataset of medical doctors
instrumental gradient boosting cardiotocographic following the “Updated
delivery rates. techniques (e.g., (CTG) recordings. It 2015 FIGO Intrapartum
Develop an AI- XGBoost) includes physiological Fetal Monitoring
powered clinical data such as maternal Guidelines”. The
decision support heart rate, fetal heart integration of our AI-
system. rate, contraction powered system should

42
 Contributions against
Use Case Objectives AI Method Data Available Defined Outcomes
Pandemic Situations

lead to a direct and

strength. The dataset positive impact on
is labelled by MDs. effectiveness and
efficiency.

To support
disease
prediction and ML algorithms will
diagnosis be trained to Definition of AI-based
through the integrate phenotypic decision support systems
integration of and clinical data to This use case will to expedite diagnosis,
Assisting doctors’ in the
extensive improve accurate exploit data, correct misdiagnosis,
diagnostic process
biological data prediction of competencies, and diagnose previously
during the pandemic,
(images, progress of facilities of the undiagnosed, and stratify
Diagnosis when the resources to be
genomics, Epidermolysis Modena EB-Hub, the EB patients for advance
(4) Diagnosis in used for diagnosis is
molecular) and bullosa. AI-based center for diagnosis, therapeutic intervention
Epidermolysis limited.
epidemiological methods will also be research, assistance through the integrative
bullosa, a rare Maintaining normal
(immunological, used for disease and development of analysis of clinical
genetic disease procedures of
clinical, comprehension and innovative therapies phenotypes and patient
diagnosing other health
demographic, therapeutic target created in January health records, genetic
problems during the
lifestyles) to selection by 2020 at the General information, molecular
pandemic.
identify genomic unravelling the Hospital of Modena. levels, biochemical
lesions, proteins affected genetic and fingerprints and patient
and immune- molecular players images.
logical states and pathways.
associated
(biomarkers).

Care AI techniques ML techniques Historical clinical AI agent and tool for Reduction of the

43
 Contributions against
Use Case Objectives AI Method Data Available Defined Outcomes
Pandemic Situations

applied to
records for patients
analyze the
(neuronal networks; with chronic diseases.
pathways of
LSTM; statistics Data about care plans dimensioning demand of
(5) Chronic care chronic care
predictions and use of hospital resources, including
pathway and patients transmission risks by
modeling; random services and resources prognosis and simulation,
resources providing being able to re-
forest; decision (pathways) made by both at individual and
characterization, simulation and organize the pathways
trees). AI adjustment this group of patients population level.
simulation of prediction according to pandemic
to chronic care based on degree of Intelligent assistant for
demand and capacities about context.
attention, prototype frailty. Macro redefinition/optimization
prognosis. the demand of
testing, application parameters from of care plans
use of hospital
evaluation (KPI). population (estimate
services and
demand/prognosis)
resources

Test of algorithms in
Identification and
Machine Learning hospital of Bozen with
prevention of
Techniques such as either live settings or Control of patients with
critical
DNN, retrospective data. COVID-19 confined to
conditions:
Care Reinforcement Retrospective data as their homes, before
Analysis of vital AI tool for critical
(6) Critical Learning, Natural heart rate, respiration variations in their
signs, automatic conditions identification
Conditions Language rate, oxygen critical conditions.
recognition of and prevention along the
identification Processing and saturation and blood Increase in patient and
symptoms (e.g., chronic care pathway
and prevention Statistical Methods. pressure. Moreover, family safety, especially
skin rash, mood
Adjustment chronic general data such as in patients with COVID-
change) and
care, prototype, age, sex, weight, 19 who live alone.
direct interaction
evaluation (KPI). height and other
with patients.
diseases.

Care An intelligent Evolutive, self- Hospital models of Scheduling planning tool Reduction the

44
 Contributions against
Use Case Objectives AI Method Data Available Defined Outcomes
Pandemic Situations

processes for resource

algorithm is utilization.
learning and auto-
developed to Information: transmission risks.
adaptive techniques for optimal management
(7) Intelligent efficiently processes, cost, Better planning of
focused on chronic of hospital care resources
resources manage the service level, delivery resources in
care, prototype for patients with chronic
management scheduling of time, resource compatibility with
testing, validation diseases.
hospital utilization, medical pandemic demand.
through KPI.
resources. personnel
qualification.

Remote
Recordings from lab
determination of Software for vital Reduction the
Methods in the Area situations available;
vital parameters parameters. Transfer to transmission risks in
Care of computer vision more data will be
such as heart rate hospital environment; professionals by
(8) Monitoring and ML i.e., CNN, generated within the
and respiration continuous monitoring; reducing contact with
of the recovery BNN, adaptive Fraunhofer InHaus-
rate for an fast obstacle monitored admitted
process optical flow, SVM Centre, Test of
improved identification; safe patients with COVID-
etc. algorithms in hospital
recovery solution; contactless 19.
of Bozen
monitoring.

Logistics Develop an ML (computer - - -

(9) Material automatic vision, CNN): Used Material lists Automatic Improved
consumption material materials are - material forecasting for
recognition and documentation matched with patient Master and documentation pandemic related
prognosis on the care cases and their movement and transport uncertanities
wagon or the diagnoses and data of the - -
material store in treatments. Thus, it materials Transparent Dynamic
the nursing ward is known which and (order history) material management of
based on how many materials - consumption for limited material

45
 Contributions against
Use Case Objectives AI Method Data Available Defined Outcomes
Pandemic Situations

Demographic
individual patient
patient data
cases
(gender, age,
-
weight, etc.)
Specified case (such as masks,
computer vision. -
cost calculation protective visors
A material Patient
are needed by the - and clothing,
consumption treatment
individual patient Higher planning antiseptics, etc.)
prognoses is history
cases. reliability for by predicting
developed with -
material orders patients’ disease
the derived data. - Automatic
- trajectory
stock updates
- Immediate
for all
reaction to
materials on
material shortage
wagon

Logistics Optimize the Reinforcement - - -

(10) Optimizing internal logistics learning (multi- Hospital maps Status reports for Decreasing
logistic operations of the agent motion and - certain transmission
operations hospital by path planning) Data (sensor characteristics of risks to
considering both data, automated and healthcare
manual and operational manual logistics providers by
automatic data) from operations minimizing the
transport in a robots - patient contact.
resource operating at Recommendations -
management and the hospital for optimization Optimal
scheduling - of material management of
framework. Data from the transport critical resources
Generate hospitals - such as Intensive
recommendations material Better Care Unit (ICU)

46
 Contributions against
Use Case Objectives AI Method Data Available Defined Outcomes
Pandemic Situations

understanding of
management the events leading
system up to an incident
- report (e.g.,
Generating materials arrived
data from late, or robot
current stopped
hospital sensor unexpectedly)
for how to
infrastructure -
improve manual
- Facilitate future
and robotic beds.
Knowledge integration of
logistics, based
about areas robotic solutions
on gathered data.
that are in hospitals
frequented by -
visitors or Automatic
patients avoidance of
probably infections areas
infected with (e.g., areas
COVID-19 frequented by
visitors)

Logistics Integration of Predictive analytics - - -

(11) Co- optimization of and cognitive Material lists Adaption routines Centralized
development internal logistics automation - and experiences, planning of
and evaluation operations and Master and e.g., comparison material
material movement of material consumption and
consumption data of the recognition with shortage
materials barcode system -
- (already existing, Optimal

47
 Contributions against
Use Case Objectives AI Method Data Available Defined Outcomes
Pandemic Situations

Demographic
patient data
assignment/sche
- comparative case)
duling of critical
Patient -
resources
treatment Management of
(healthcare
database resources in
personnel, ICU,
- multi-location
operation rooms,
Availability of setting
etc.)
healthcare
resources

48
However, as COVID-19 eloquently shown, the usefulness of medical data is
enormous. The ability to systematically gather data on patient states, diagnoses,
treatments, and specified care, in particular, provides future hospitals with the
possibility to greatly improve the effectiveness and efficiency of healthcare services
supplied. The last aspect of AI structural adoption in European hospitals is technology
selection and ethical considerations. The former is represented by AI-based solutions,
which reflect the complicated and interconnected process of choosing a new
technology for adoption in healthcare services. The evaluation of the most suitable AI-
based technology to be used to facilitate diagnostic, treatment, or care activities is a
difficult process marked by unknown and many potential outcomes with various and
opposing situations. The latter is concerned with the ethical implications of AI tools
and procedures, ranging from machine-based medical decisions to individualized
treatments, from the sharing of personal health data to the acceptance of robot medical
workers.

Finally, a final component of the obstacles of implementing AI in hospitals must be

emphasized, namely, the right engagement of suitable stakeholders. Indeed, this final
problem is critical in ensuring physicians' actual use of AI-based solutions in everyday
hospital operations, patients' acceptance of revised treatments and procedures, and
local administrators' dedication to this new type of health care help. As a result, the
stakeholder commitment process is critical and should be carefully designed and
executed. Taking into account all of the aforementioned issues and potential
roadblocks, the following paragraphs provide various ways for overcoming these
hurdles, ensuring the adoption of AI solutions in European hospitals, and optimizing
the usefulness of the supplied innovation. Human–computer interface, medical data
space, and guideline and ethics are the three areas in which the recommended
activities are divided. It is shown how these transversal activities relate to the
application areas mentioned in the article.

49
Figure. Linkage between transversal activities and application areas for AI adoption
in European hospitals
Human–Computer-Interaction: Despite advancements in the area of health care data
analytics, which have resulted in an increasing number of prototypes and
technological advancements, real adoption by key stakeholders such as physicians
remains low. When the intelligence and analytical capabilities of the different systems
improve, this element will become more important. As a result, a greater emphasis on
human–computer interaction throughout the pre-design, design, and post-design
stages, as well as consideration of user, system, task, and interaction characteristics,
has the potential to boost AI adoption and user satisfaction in clinical practice.

Medical Data Space: Furthermore, data links in a Medical Data Space (MDS) with
distributed AI applications would aid resource sharing and assistance for particularly
and seriously afflicted areas and hospitals. Furthermore, thanks to AI analysis, total
data openness and analysis will aid in the early discovery and control of viral
epidemics. The Medical Data Space (MDS) is a subset of the International Data Space

50
(IDS), which offers a reliable, secure, and cross-domain data space that allows
organizations of all sizes and domains to develop a data economy. In 2015, R&D work
yielded IDS, which is being actively supported by the Industrial Data Space
Association. The OPC Foundation, the FIWARE Foundation, the Industrial Value
Chain Initiative, and the Platform Industry 4.0 are all involved. The IDS, and hence
the MDS, specify an architecture of data suppliers and consumers connected by
connectors to create a data space. The architecture is described in the IDS document,
which describes the layers of the architectural model, which identify the fundamental
components required to actualize a data space. The first prototype was shown at the
Hannover Messe in 2018. The MDS idea aims to link small data areas in hospitals for
analytics and the deployment of AI-based algorithms for research or internal hospital
usage. As a result, specific services are required to not only securely store and handle
medical data transfers while retaining the data owner's sovereignty, but also to comply
with standards for anonymity and security of personal medical data sets. The aspect of
data space value-added services becomes significant here, providing
pseudonymization and anonymization features in the process.

Patients' medical data is a highly sensitive and so regulated asset that must be handled
in a safe and protected setting. The Medical Data Space (MDS) builds on the
international data space to create a safe, regulated data storage and processing
environment that allows providers and consumers to develop a data economy while
maintaining sovereignty and control. The MDS takes this a step further by addressing
other medical concerns. The trusted connector, which connects both parties and
implements the agreed security and privacy regulations, is an important concept in
MDS. The MDS design also includes data-processing services (data-apps) that may
preprocess data before or after transmission, in addition to access management. The
linking of local data spaces in hospitals for analytics and the use of AI-based
algorithms for research or hospital internal usage will be employed since AI-driven
smart hospitals depend mostly on data targets. As a result, specific services are
required to not only securely store and handle medical data transfers while retaining
the data owner's sovereignty, but also to comply with standards for anonymity and
security of personal medical data sets. The aspect of value-added services (data-apps)

51
for the data space becomes significant here, allowing for features such as
pseudonymization and anonymization. We want to show in future research that
medical data space technology may serve as a platform for the development and
deployment of revolutionary AI and data management data-apps. A pilot programme
for the study and management of in-hospital cardiac patient intervention therapy, with
the purpose of knowing and assessing numerous critical aspects that influence a
hospital's ability and capacity to offer treatment. The Evaggelismos Hospital in Athens
will be the site of this future exhibit.

Guidebook and Ethics: The need of organizing and managing technology issues in
health care is clearly shown, a notion that has been reaffirmed in light of the current
COVID-19 epidemic. Technology management concerns have a significant impact on
the ultimate outcome of any health process. Assessment, supply, prioritizing, proper
utilization, and exploitation are all difficult tasks. Data-driven management, health
technology evaluation, clinical practice standards, and medical leadership are the
primary problems that must be addressed in the current re-setting of health-care
delivery via technological innovation. Knowledge management and technological
innovation, with their ever-expanding potential, may undoubtedly serve as a cross-
cutting response to the system's desire for effectiveness and efficiency. Furthermore,
there are high hopes for information and communication technologies (ICT) in terms
of their contribution to the development of eHealth, as well as for artificial intelligence
(AI) and its many uses in medical practice and public health. Clinical practice must
alter as a result of technology innovation in order for health and care systems to be
able to cope with ongoing economic, socio demographic, and epidemiological
constraints. However, despite its importance and centrality, technical innovation must
be thoroughly analyzed and accompanied in order to verify that it really equates to
successful social innovation. In addition, as a joint study from EIT Health and
McKinsey recently highlighted. AI offers a lot of promise for bettering care outcomes,
patient experiences, and healthcare access. Healthcare systems are expected to be able
to give more and better treatment to more people as a result of AI's increased
productivity and efficiency. Finally, it may assist healthcare systems manage
population health more proactively by dynamically allocating resources where they

52
can have the most effect and need, primarily by speeding diagnostic times. According
to MedTech Europe, developing AI systems and algorithms for healthcare settings
necessitates specific skill sets that are in short supply, as well as investment in the
education and training of professionals involved (e.g., data scientists, practitioners,
software engineers, and clinical engineers).

Ethical concerns are a key roadblock to widespread AI application usage, since many
scenarios may result in dangers such as incorrect diagnosis or deviant treatment, as
well as dissension among workers owing to differing viewpoints on what constitutes
proper AI analysis and recommendations. As a result, before AI can contribute to
health care to its full capacity, not just HCI concerns, but also human-human
interaction and cooperation issues, as well as ethical dilemmas, must be resolved and
shared among people.

The role of governments in health development

People and communities have depended on indigenous medicines and healer expertise
to address their health care needs throughout history, whether at home or in small
institutions. Healing and religious belief are closely intertwined, therefore religion has
played an important role in healthcare. In ancient Egypt, the doctor was also a priest.
Hospitals and health facilities were often founded by churches and charitable groups,
and some of them have the names of priests and religious professors from European
nations. Religious leaders from Islam were among the first to establish health-care
facilities and hospitals, such as bimaristans, as well as well-known physicians and
medical schools. Local groups, religious and charitable organizations contributed to
develop organized health care services at a period when modern health care was only
accessible to rulers and rich citizens of great cities. These services are available in
various countries as a supplement to failing governmental institutions, particularly in
slums and remote areas. People in Europe and other parts of the world established
health insurance because they needed to be able to care for themselves in the case of
sickness or an accident. Following WWII, Germany's Bismarck and the United
Kingdom's Lord Beveridge promoted tax-based health insurance, while industrial
workers organized the first sickness funds. France's mutual aid and mutual societies

53
grew into a social assistance system that only covered a limited fraction of the
population in the late nineteenth and early twentieth century’s due to their voluntary
nature.

A significant impact was produced by the Beveridge Report on the creation of a

comprehensive social security system in France and other OECD nations after World
War II and the Second World War. When the economy is weak and government
coverage is limited, it is common practice in low-income nations to establish
community health insurance systems to offer social health protection for the general
public. Sickness funds are established by employers to assist employees and their
families in dealing with the social implications of illness or injury, as well as to
decrease the financial impact of illness and disability. Health care services are
essential for everyone today, but the unpredictability of illnesses and injuries, together
with their effect on life and well-being, validates people's and communities' efforts to
guarantee that they have access to health care services now and in the past.

The advancement of biomedical technology and the discovery of new discoveries,

such as antibiotics and other medical equipment, all contributed to the establishment
of modern health systems after World War II. Religious hospitals that had previously
been under the authority of local governments came under the administration of the
national government under France's policy of separation between state and religion
during the period of the French Revolution. Developing health systems was made
possible in large part by the sovereign obligations of national governments in areas
such as governance, health system infrastructure, and training of essential health staff
in all fields of medical and public health, among other things. With the notable
exception of Canada, the majority of OECD nations, with the exception of the United
States of America, supported medical schools and large hospitals, as well as health-
care worker education. This is reflected in the health-spending patterns of high-income
nations, with public funds accounting for 70 percent or more of overall health
expenditure in these countries. In countries where social protection is practically
ubiquitous, such as in Europe and Asia, this fact may account for a significant chunk
of the high share of public health care expenditure that exists in these countries. Even

54
in the most successful and developing countries, the shift to a market economy has not
resulted in governments abdicating their social responsibility for things like health
care development. Health has long been recognized as important in the creation of
social capital, and the preservation of health as a human right has long been
recognized as a fundamental human right.

Following World War, I, political upheavals throughout the world paved the way for
health to be recognized as a fundamental human right. The International Labor
Organization (ILO), which was founded in 1919 on the principles of "peace through
social justice" and works to protect workers from dangers such as illness, accidents,
and even death, was founded on the principles of "peace through social justice."
Specifically, the Universal Declaration of Human Rights states that "everyone has the
right to a standard of living sufficient for the health and well-being of himself and his
family," which includes "a standard of living that includes food, clothing, housing,
medical care, and necessary services." Additionally, the Declaration states that
"everyone has the right to security in the event of unemployment, sickness, disability,
widowhood, old age, or other lack of a livelihood due to circumstances beyond his
control." The World Health Assembly adopted the World Health Organization's
Constitution in 1948, which stated that "In order for governments to fulfil their
responsibilities for the health of their citizens, they must implement adequate health
and social policies, with the stated goal of "achieving the highest possible level of
health for all peoples" as their overarching goal.

In 1968, the Islamic Republic of Iran approved a law that secured the safety of
families and children. The Universal Declaration on the Eradication of Hunger and
Malnutrition, which was signed in 1974, emphasized the importance of efforts to
eradicate hunger and malnutrition across the world. In a 1975 statement, the Statement
of Rights for Disabled Those asserted the right of persons with disabilities to complete
rehabilitation and employment. In 1978, the Alma-Ata Declaration stated that "health
is an essential human right" and that "a major social target of governments,
international organizations, and the entire world community" should be to ensure that
"by the year 2000, all citizens in all countries will have the ability to lead a socially

55
and economically productive life." Human rights advocates have long argued that the
Alma-Ata Declaration is still relevant today because it states that "health is an
essential human right." The High Commissioner for Human Rights of the United
Nations has expressed support for these fundamental principles on a number of
different occasions. Mary Robinson, the previous commissioner from 1997 to 2002, is
commemorated "It is only through universal access to the whole spectrum of human
rights, including civil and political rights as well as economic, social, and cultural
rights, that a truly secure world can be achieved. It is a challenge for governments in
both the North and the South to widen their conception of security to include "security
beyond the state's limits." In the sphere of health development, a number of
declarations and treaties have had an impact on how governments function, especially
when political commitments made at various levels of government are taken into
account at the policymaking level.

In many ways, the political landscapes of established nations and developing

economies in the Eastern Mediterranean region are comparable. It is widely
acknowledged that many nations that were once controlled by colonial powers have
made significant contributions to the development of health systems, notably in the
organization of service delivery and the training of health professionals. Due to the
fact that health professionals in the Eastern Mediterranean region are trained in a
variety of languages, including English as well as French and Italian, there is a
positive impact on interpersonal contact between health care personnel and the people
they serve in this region. A large number of military and government officials from
colonial nations benefited from the network of hospitals and health services.

Industry Profile

Healthcare has become one of India’s largest sectors, both in terms of revenue and
employment. Healthcare comprises hospitals, medical devices, clinical trials,
outsourcing, telemedicine, medical tourism, health insurance and medical equipment.
The Indian healthcare sector is growing at a brisk pace due to its strengthening
coverage, services, and increasing expenditure by public as well private players.

56
India’s healthcare delivery system is categorised into two major components - public
and private. The government, i.e., public healthcare system, comprises limited
secondary and tertiary care institutions in key cities and focuses on providing basic
healthcare facilities in the form of primary healthcare centres (PHCs) in rural areas.
The private sector provides majority of secondary, tertiary, and quaternary care
institutions with major concentration in metros, tier-I and tier-II cities.

India's competitive advantage lies in its large pool of well-trained medical

professionals. India is also cost competitive compared to its peers in Asia and western
countries. The cost of surgery in India is about one-tenth of that in the US or Western
Europe. The low cost of medical services has resulted in a rise in the country’s
medical tourism, attracting patients from across the world. Moreover, India has
emerged as a hub for R&D activities for international players due to its relatively low
cost of clinical research.

Market Size

The Indian healthcare sector is expected to record a three-fold rise, growing at a

CAGR of 22% between 2016–22 to reach US$ 372 billion in 2022 from US$ 110
billion in 2016. By FY22, Indian healthcare infrastructure is expected to reach US$
349.1 billion.

In the Economic Survey of 2022, India’s public expenditure on healthcare stood at

2.1% of GDP in 2021-22 against 1.8% in 2020-21 and 1.3% in 2019-20.

In FY22, premiums underwritten by health insurance companies grew to Rs.

73,582.13 crore (US$ 9.21 billion). The health segment has a 33.33% share in the total
gross written premiums earned in the country.

The Indian medical tourism market was valued at US$ 2.89 billion in 2020 and is
expected to reach US$ 13.42 billion by 2026. According to India Tourism Statistics at
a Glance 2020 report, close to 697,300 foreign tourists came for medical treatment in

57
India in FY19. India has been ranked 10th in the Medical Tourism Index (MTI) for
2020-21 out of 46 destinations by the Medical Tourism Association.

The e-health market size is estimated to reach US$ 10.6 billion by 2025.

As per information provided to the Lok Sabha by the Minister of Health & Family
Welfare, Dr. Bharati Pravin Pawar, the doctor population ratio in the country is 1:854,
assuming 80% availability of 12.68 lakh registered allopathic doctors and 5.65 lakh
AYUSH doctors.

Road Ahead

India’s healthcare sector is extremely diversified and is full of opportunities in every

segment, which includes providers, payers, and medical technology. With the increase
in the competition, businesses are looking to explore the latest dynamics and trends
which will have a positive impact on their business. The hospital industry in India is
forecast to increase to Rs. 8.6 trillion (US$ 132.84 billion) by FY22 from Rs. 4 trillion
(US$ 61.79 billion) in FY17 at a CAGR of 16–17%.

India is a land full of opportunities for players in the medical devices industry. The
country has also become one of the leading destinations for high-end diagnostic
services with tremendous capital investment for advanced diagnostic facilities, thus
catering to a greater proportion of the population. Besides, Indian medical service
consumers have become more conscious towards their healthcare upkeep. Rising
income levels, an ageing population, growing health awareness and a changing
attitude towards preventive healthcare is expected to boost healthcare services demand
in the future. Greater penetration of health insurance aided the rise in healthcare
spending, a trend likely to intensify in the coming decade.

The Government aims to develop India as a global healthcare hub, and is planning to
increase public health spending to 2.5% of the country's GDP by 2025.

58
 CHAPTER 2
RESEARCH METHODOLOGY

In order to arrive at precise results and create a logical process flow, it is essential to
think about the best research approach. Pharmacy managers, clinicians, and healthcare
administrators will be the focus of this study. There will be a series of interviews with
the target audience and data mining will be carried out. Using a focused group
method, qualitative data is gathered and analyzed for the benefit of the majority. The
usage of artificial intelligence in a hospital setting will be discussed, and the potential
benefits and drawbacks will be presented in a two-way manner.

Statement of the Problem

Advances in artificial intelligence have been increasing in many aspects of human

existence lately. A great deal has been said and written about the potential benefits and
drawbacks of its use in the healthcare industry. By drawing on previously published
research and suggesting a sustainable method based on gaps identified in real-time
interviews with pharmacy managers from across hospitals, this report emphasizes the
necessity of deploying artificial intelligence during a pandemic.

Objectives of the Study

The main aim of the research is to avoid sudden scarcity of vital drugs and minimize
the loss of risk of patient’s lives.

The research objectives are formulated based on the aim of this study which are as
follows:

 To review the existing literature and understand the available artificial

intelligence techniques in healthcare that can be used in drug inventory
management.

59
  To collect data from healthcare professionals and pharmacy managers in a
hospital setup in real-time and understand the supply chain mechanism existing
currently.

 To understand the role of government in the healthcare system and draft a

process improvement plan between different stakeholders.

 To suggest a sustainable approach for dealing any future onset of healthcare

emergencies effectively and parallelly to manage the current ongoing
pandemic situation.

Scope of the Study

This research is intended for everyone with an interest in artificial intelligence (AI),
but it's geared for business leaders in particular. The purpose of this dissertation is to
examine whether AI has had a significant and gradually increasing influence on
business. The goal is to find out what kinds of AI approaches are now in use and what
they are capable of.

It is an ongoing research and management challenge to create and integrate artificial

intelligence (AI) solutions in healthcare settings. Artificial intelligence (AI) is
expected to have a significant impact on the efficiency and effectiveness of the
healthcare industry. The number of real-world AI application cases, on the other hand,
is still rather small. This study presents a comparative approach from nine European
hospitals and eleven distinct use cases with probable application areas and advantages
of hospital AI technology as a first step toward organizing and comparing such
experiences.

Method of Data Collection

There may be several kinds of data and information, some of which may be previously
unpublished, some of which may be full and some of which may be incomplete, and
some of which may be based on credible sources. The type of the data's source is

60
determined by the study's research challenge. Primary and secondary data are both
possibilities.

Primary Data:

During the process of conducting surveys, primary data is being gathered. In order to
collect primary data, the respondent must either fill out a questionnaire or have a one-
on-one interview. Both of these methods are used to gather the bulk of the project's
data.

Secondary Data:

These are the data which are already available in the form of print material, websites
and journals etc. The data in this project have been collected using some websites and
course material for that purpose

Research Design: The research design is descriptive in nature.

Target Audience: Employees of Hospitals

Sampling Method: Convenient sampling method would be used for the proposed
research.

Sample Size: 50

Data Collection method: Survey and General Observations

Instrument: Questionnaire

Statistical Tools:

The data are analyzed through statistical methods. Simple percentage analysis is used for
analyzing are used for analyzing the data collected.

Simple Percentage Analysis:

Percentage analysis is the method to represent raw streams of data as a percentage (a part
in100‐ percent) for better understanding of collected data.

61
Graphs:

Graphical representations are used to show the results in simple form. The graphs are prepared
on the basis of data that is received from the percentage analysis.

Limitation of the Study

 Respondent were reluctant to share their experience accurately

 Unwillingness of respected personnel of hospital industry to provide relevant
data for my study
 Time allotted for the project was not sufficient to go for detailed analysis of the
research problem.

62
 CHAPTER 3

DATA PRESENTATION, ANALYSIS AND INTERPRETATION

Q1. Gender

Interpretation:

90% respondents were make and 10% respondents were female

63
Q2. Age Group

Interpretation:

39% respondents were from 35-44 age groups but 20% respondents from 45 or more
age group

64
Q3. From how many years you have been working in healthcare sector?

Interpretation:

26% respondents have been working in healthcare sector from less than 2 years
however 23% respondents have been working in healthcare sector from 4 to less than
6 years

65
Q4. Job Level

Interpretation:

25% respondents were from junior level however 54% respondents were from middle
level

66
Q5. Did you know what artificial intelligence was before taking this survey?

Interpretation:

82% respondents replied Yes however 18% respondents replied No

67
Q6. Would you trust advanced AI to make moral decisions?

Interpretation:

90% respondents replied Yes however 10% respondents replied No

68
Q7. Do you think an AI could become part of society?

Interpretation:

72% respondents replied Yes however 28% respondents replied No

69
Q8. Would you personally accept an AI as part of society?

Interpretation:

39% respondents replied Yes however 10% respondents replied No

70
Q9. Have you heard about Artificial Intelligence?

Interpretation:

85% respondents replied Yes however 15% respondents replied No

71
Q10. What is your opinion about the maintenance of Patient's Records/Files in
Hospitals?

Interpretation:

22% respondents were somewhat satisfied however 26% respondents were somewhat
dissatisfied with the above statement

72
Q11. With respect to the above Question which would be better?

Interpretation:

95% respondents were Digital Records would be better however 5% respondents were
Manual Files would be better with the above statement

73
Q12. What if Case paper procedure is done online to save time and avoid crowd?

Interpretation:

18% respondents were somewhat necessary however 78% respondents were

Extremely necessary with the above statement

74
Q13. Do you think there should be a track of checking the availability of Drugs &
Pharmaceuticals?

Interpretation:

12% respondents were somewhat necessary however 87% respondents were

Extremely necessary with the above statement

75
Q14. What if the machine itself prompts on the insufficiency of any medicines?

Interpretation:

57% respondents were Better however 33% respondents were Good with the above
statement

76
Q15. Do you think AI could be dangerous? If so, why?

Interpretation:

62% respondents replied Yes however 38% respondents replied No

77
 CHAPTER 4
FINDINGS, SUGGESTION AND CONCLUSION
Conclusion

Artificial Intelligence and Machine Learning are both scientific and mythical
creations. The notion that robots might think and accomplish activities in the same
way that humans do dates back thousands of years. Cognitive facts represented by AI
and Machine Learning systems are also not new. It may be more accurate to think of
these technologies as the technical execution of strong and long-established cognitive
concepts.

Accept that we have a propensity to regard all important innovations as a Rorschach

test on which we project our anxieties and hopes about what constitutes a good or
happy world. However, the good potential of AI and machine intelligence does not lay
exclusively, or even mostly, in its technology. Its users are primarily to fault. We have
no reason not to trust ourselves to perform effectively with these technology if we
trust (in general) how our societies are presently controlled. And if we can put aside
our presentism and accept that old traditions warning us not to play God with
tremendous technology are instructive, we will likely be able to relax about their
employment.

AI is at the centre of a new enterprise to construct computational intelligence models.

The main idea is that intelligence (human or another) can be represented using symbol
structures and symbolic processes that can be coded into a digital computer. There's a
lot of argument about whether such a well constructed computer would be a mind or
merely simulate one, but AI researchers don't have to wait for the answer to that issue,
or for the hypothetical computer that could reproduce all of human cognition. Aspects
of intelligent behaviour, such as problem solving, inference, learning, and language
understanding, have already been implemented as computer programmes, and AI
systems can surpass human experts in very specific domains, such as identifying
soybean plant ailments. The present AI goal is to find techniques to communicate

78
commonsense knowledge and experience that enable persons to carry out regular
activities like holding a wide-ranging debate or navigating a crowded roadway. We
may need to create new machines to handle the complexity of human intellect, or we
may be able to run such programmes on standard digital computers.

Artificial intelligence and technology are two parts of life that never stop to captivate
and astonish us with new ideas, concepts, discoveries, products, and so on. AI is still
not implemented as represented in films (i.e. intelligent robots), but there are many
major efforts to get to that level and compete in the market, such as the robots that are
occasionally shown on television. Nonetheless, there are covert activities and
breakthroughs in industrial enterprises.

To various individuals, AI implies different things. AI is now employed for

information and automation, and its learning skills are limited. We're still a long way
from having completely self-aware AI software. Risk exists at all levels of AI. The
major AI systems mostly pose a threat to skilled jobs. AI with a higher degree of
intelligence might pose serious threats to humans. AI's advantages continue to rise,
ensuring that the technology is here to stay. Businesses and society as a whole will
need to learn to utilize and adapt to the new technologies. To stay competitive,
businesses will need to embrace AI, and people may need to modify their skill set to
stay employed. As AI technology advances, worries about legal obligations will
continue to arise.

The development of artificial intelligence, as well as its remarkable tools, is constantly

aimed at reducing the obstacles faced by pharmaceutical companies, which can have
an impact on the medication development process as well as the overall lifespan of the
product, which may explain the increase in the number of start-ups in this field. The
modern healthcare business is plagued with a variety of complex difficulties, such as
growing drug and treatment prices, and society as a whole is in desperate need of
significant reforms. With the application of artificial intelligence in pharmaceutical
product creation, it is possible to create personalized medications that have the
essential dose, release characteristics, and other necessary features to meet the specific

79
needs of each patient. Using the latest AI-based technologies will not only reduce the
time it takes for products to reach the market, but it will also improve product quality
and overall safety of the manufacturing process, as well as provide better resource
utilization and cost-effectiveness, highlighting the importance of automation.

The most major concern about the adoption of these technologies is the loss of jobs
that would result, as well as the rigorous laws that would be required for AI
deployment. These technologies, on the other hand, are just meant to make labour
simpler, not to entirely replace people. Not only can AI help with rapid and painless
hit compound discovery, but it can also help with synthesis pathway
recommendations, as well as the prediction of the necessary chemical structure and a
grasp of drug–target interactions and SAR.

As well as aiding with rapid decision-making, artificial intelligence may aid in the
subsequent inclusion of the generated drug in the appropriate dosage form as well as
its optimization. This results in faster manufacturing of higher-quality items with
consistent batch-to-batch consistency. Through extensive market research and
prediction, artificial intelligence may also assist in determining a product's safety and
efficacy in clinical trials, as well as ensuring that the product is placed and priced
correctly in the market. Despite the fact that no medications have yet been developed
using artificial intelligence-based techniques, and despite the fact that specific
difficulties exist in the implementation of this technology, AI is expected to become a
critical tool in the pharmaceutical industry in the not-to-distant future.

Suggestions

Artificial intelligence will play a significant role in the future of hospital health-care
systems, according to experts. Applications such as machine learning will aid in the
creation of processes in a range of areas inside the hospital, including medical
diagnostics, logistics, and patient care, as discussed in this article. Rules, linkages to
the Electronic Health Record (EHR), standards, medical device certifications, training
experts, pricing, and updates are all big problems, yet they are all solvable. In
particular, it is crucial to underline that artificial intelligence programmes will not

80
replace human doctors, but will rather support them in concentrating on vital human-
related duties and making correct diagnoses with less analysis and decision time. It is
hoped that this would allow them to spend more time and attention on the human side
of things, assisting patients. Increasing processing power and algorithmic innovations,
along with digitalization and advancements in data collection techniques and storage
technologies, have resulted in a state of affairs in which Artificial Intelligence (AI),
machine learning (ML), and robotic assistance are more prevalent than at any other
time in the history of medicine. These new technologies allow for the measurement of
individual risks based on predictions from big data analysis, as well as the monitoring
of large-scale medical trends, thanks to the use of big data analysis. Artificial
intelligence (AI) will play a crucial role in the administration of healthcare in the
future. In previous research, it has been shown that artificial intelligence offers game-
changing potential in a variety of healthcare sectors, including those described in this
article's use cases. Appointment scheduling, patient and resource scheduling, resource
utilization, and forecasting demand for emergency rooms, critical care units, and
ambulances are just a few of the challenges that artificial intelligence-based solutions
have successfully resolved in the medical field.

The COVID-19 outbreak has highlighted the issues that healthcare systems face, as
well as the potential for future pandemics. This has heightened interest in AI's
potential in healthcare as a tool for pandemic management and prevention. Recent
advances in artificial intelligence and machine learning may be able to assist in the
resolution of major issues in the response to COVID-19, such as the management of
limited healthcare resources, the development of individualized treatment regimens,
and the prediction of viral propagation rates. Wynants et al. have already identified 31
prediction models in a study of early COVID-19 tests conducted by Wynants et al.
According to the findings of this study, which included 11 use case studies from
European hospitals, the post-COVID-19 period in preparation for future pandemic
crises will likely involve sophisticated healthcare solutions in conjunction with
operation research modeling, with artificial intelligence (AI) playing a significant role.
Healthcare data management (HCI) is one of the concerns related with artificial
intelligence (AI) applications that have to be resolved as soon as feasible in order to

81
better prepare hospitals for future challenges, such as pandemics. If artificial
intelligence and machine learning are to be completely implemented in health-care
systems, this represents a significant challenge for health-care management research,
with consequences for hospital practice.

Five recommendations in advance of the introduction of artificial intelligence

1. Recognize the social risks implied by artificial intelligence

Recognizing that there is a problem is the first step toward resolving the situation.
According to the EIU, artificial intelligence is a clear and present risk to the future of
labour and privacy. There is no room for complacency or resignation when faced with
the reality of the situation.

2. Explain, educate and boost transparency

Demanding complete trust in algorithms is a certain way to create artificial

intelligence misinformation and skew reality. As Manuela Veloso, director of
Carnegie Mellon University's machine learning department, and one of 14 worldwide
experts interviewed for the project, explains, "The greatest threat confronting AI is a
loss of trust in the technology owing to a lack of clarity on how computers make
judgments." AI revolutionaries must describe their work and its ramifications for
society in the clearest way possible, and this includes those at the vanguard of the
revolution. According to the EIU, they have a great deal of power, which also entails a
great deal of accountability.

3. Adapt training and education to the new artificial intelligence society

Demanding complete trust in algorithms is a certain way to create artificial

intelligence misinformation and skew reality. As Manuela Veloso, director of
Carnegie Mellon University's machine learning department, and one of 14 worldwide
experts interviewed for the project, explains, "The greatest threat confronting AI is a
loss of trust in the technology owing to a lack of clarity on how computers make
judgments." AI revolutionaries must describe their work and its ramifications for

82
society in the most clear way possible, and this includes those at the vanguard of the
revolution. According to the EIU, they have a great deal of power, which also entails a
great deal of accountability.

4. Regulation and improving the treatment of data

According to the findings of the research, the utilization of data will be one of the
most important issues of the twenty-first century. It advocates for the implementation
of particular criteria that allow for the correct use of aggregate anonymous data in
response to modern concerns about cyber security and privacy. These restrictions, on
the other hand, should not prevent data from being transferred over state boundaries.

5. Build bridges and enhance communication

A number of gaps in understanding concerning the progress of artificial intelligence

are identified in the article, but the most important is most likely the gap in
information between company technical professionals and political leaders.

A sensible public policy to limit the bad repercussions of artificial intelligence while
not restricting its favourable aspects — for example, in the employment market — is
suggested by this study

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 QUESTIONNAIRRE

Q1. Gender
Male Female

Q2. Age
18-24 Years 25-34 Years

35-44 Years 45 or more

Q3. From how many years you have been working in the company?
Less than 2 Years 2 to less than 4 Years
4 to less than 6 Years More than 6 Years

Q4. Job Level

Junior Middle Senior

Q5.  Did you know what artificial intelligence was before taking this survey?

Yes No

Q6.  Would you trust advanced AI to make moral decisions?

Yes No

Q7.  Do you think an AI could become part of society?

Yes No

87
Q8.  Would you personally accept an AI as part of society?

Yes No Possibly Probably not

Q9. Have you heard about Artificial Intelligence?

Yes No

Q10. What is your opinion about the maintenance of Patient's Records/Files in

Government Hospitals?
Somewhat satisfied
Somewhat dissatisfied
Neutral
Extremely satisfied
Extremely dissatisfied

Q11. With respect to the above Question which would be better?

Digital Records (Sync with cloud)
Manual Files

Q12. What if Case paper procedure is done online to save time and avoid crowd?
Somewhat necessary
Neutral
Extremely necessary

Q13. Do you think there should be a track of checking the availability of Drugs &
Pharmaceuticals?
Somewhat necessary
Neutral
Extremely necessary

88
Q14. What if the machine itself prompts on the insufficiency of any medicines?
Better
Good
OK
Doesn’t help much
Bad Idea

Q15.  Do you think AI could be dangerous? If so, why?

Yes No

89