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International Journal of Production Research

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/tprs20

Application of artificial intelligence for resilient


and sustainable healthcare system: systematic
literature review and future research directions

Laxmi Pandit Vishwakarma, Rajesh Kr Singh, Ruchi Mishra & Archana


Kumari

To cite this article: Laxmi Pandit Vishwakarma, Rajesh Kr Singh, Ruchi Mishra & Archana
Kumari (2023): Application of artificial intelligence for resilient and sustainable healthcare
system: systematic literature review and future research directions, International Journal of
Production Research, DOI: 10.1080/00207543.2023.2188101

To link to this article: https://doi.org/10.1080/00207543.2023.2188101

Published online: 13 Mar 2023.

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INTERNATIONAL JOURNAL OF PRODUCTION RESEARCH
https://doi.org/10.1080/00207543.2023.2188101

REVIEW

Application of artificial intelligence for resilient and sustainable healthcare


system: systematic literature review and future research directions
Laxmi Pandit Vishwakarmaa , Rajesh Kr Singha , Ruchi Mishrab and Archana Kumaric
a Operations Management, Management Development Institute (MDI), Gurgaon, India; b Operations Management, Institute of Rural
Management, Anand (IRMA), Anand, India; c Gloucestershire Business School, University of Gloucestershire, Bristol, UK

ABSTRACT ARTICLE HISTORY


Recent years have witnessed increased pressure across the global healthcare system during the Received 7 October 2022
COVID-19 pandemic. The COVID-19 pandemic shattered existing healthcare operations and taught Accepted 25 February 2023
us the importance of a resilient and sustainable healthcare system. Digitisation, specifically adoption KEYWORDS
of Artificial Intelligence (AI) has positively contributed to developing a resilient healthcare system Artificial intelligence;
in recent past. To understand how AI contributes to building a resilient and sustainable healthcare disaster; healthcare;
system, this study based on systematic literature review of 89 articles extracted from Scopus and resilience; sustainability;
Web of Science databases is conducted. The study is organised around several key themes such as systematic literature review
applications, benefits, and challenges of using AI technology in healthcare sector. It is observed that
AI has wide applications in radiology, surgery, medical, research, and development of healthcare
sector. Based on the analysis, a research framework is proposed using an extended Antecedents,
Practices, and Outcomes (APO) framework. This framework comprises AI applications’ antecedents,
practices, and outcomes for building a resilient and sustainable healthcare system. Consequently,
three propositions are drawn in this study. Furthermore, our study has adopted the theory, con-
text and methodology (TCM) framework to provide future research directions, which can be used
as a reference point for future studies.

1. Introduction
water, food, toilets) and essential healthcare facilities
The healthcare system across the globe is changing dras- (Ivanov and Dolgui 2022; Pourhosseini, Ardalan, and
tically to deal with new life-threatening diseases such Mehrolhassani 2015). Therefore, Healthcare manage-
as COVID-19. Seddighi (2020) considers COVID-19 a ment is one of the most crucial parts of any disaster
natural disaster. Global healthcare is under pressure to management. Rapid advancements in medical technolo-
prepare and respond to emergencies during uncertain gies have inspired global health pioneers to work during
environments (Chee et al. 2021; Dwivedi et al. 2018). catastrophic situations (Hadley et al. 2020). The recent
The recent COVID-19 pandemic has brutally eroded improvements in the healthcare system apply AI as a
many healthcare systems across nations (KPMG 2022; powerful technology to positively contribute during the
UN 2022). At the same time, the impact of the COVID- unprecedented time (Ghasemi et al. 2021). Dohale et al.
19 pandemic has devastated multiple global economies (2022) and Lerch et al. (2022) highlighted that adopting
(Ardolino et al. 2022; Mishra, Singh, and Subramanian AI technology will help the firm to gain proactive and
2021). Natural disasters such as floods, wildfires, and reactive capabilities. These capabilities further contribute
hurricanes have caused global economic losses of $270 towards building resilience by helping the firms to better
billion in 2021 (Bloomberg 2022). The organisations had resist and recover during the unprecedented time (Jauhar
undergone such monster damages mainly because they et al. 2023; Mishra, Singh, and Papadopoulos 2022).
were unprepared to bear the magnitude of the COVID-19 Disasters harm many people’s health, cause loss of
pandemic (Ardolino et al. 2022), showing the importance lives and cause psychological disorders (Pourhosseini,
of organisations being resilient (Dohale et al. 2022). Not Ardalan, and Mehrolhassani 2015). Any rise in disaster
only economic damages, but these disasters have also led creates a heavy burden on the entire healthcare services.
to several tangible and intangible damages (Ruel and El Improper transfer of victims can lead to cardiac arrest,
Baz 2021). spinal cord injury, or even death. Hence, well-equipped
Disasters lead to a shortage of drugs, disturb medical emergency vehicles are necessary during disasters (Eliiyi
supplies, and interrupt basic nutrition facilities (drinking 2022). As a result, the demand for healthcare and medical

CONTACT Rajesh Kr Singh rajesh.singh@mdi.ac.in Operations Management, Management Development Institute (MDI), Gurgaon, 122001, India
© 2023 Informa UK Limited, trading as Taylor & Francis Group
2 L. P. VISHWAKARMA ET AL.

needs also increases (Pourhosseini, Ardalan, and Mehrol- are many challenges to the adoption of AI technology.
hassani 2015). Healthcare organisations suffer a high The emergence of cyber risks threatens the adoption
level of uncertainty and chaos during disasters (Forbes of AI technology (Radanliev et al. 2022a). Other chal-
2022a). The negative impacts of disasters on the environ- lenges, such as lack of quality data, ethical issues, and lack
ment stress the need for sustainability (Goodarzian et al. of physicians understanding the AI-based systems, have
2021). In this context, adopting AI helps prevent the huge been observed by many past researchers (Beltempo et al.
destruction caused by disasters (Forbes 2022a; Nguyen 2023; Joshua, Bhattacharyya, and Rao 2022). However,
et al. 2022). AI technologies are highly used in shaping looking at many benefits over challenges, the adoption
the healthcare system (Chattu 2021; Klumpp et al. 2021). of AI technology is increasing in the healthcare industry.
AI technology is considered one of the significant pillars Radanliev et al. (2022a) aim to promote the adaption of
of Medical 4.0 (Haleem and Javaid 2020) and has brought AI systems by creating a complementary between AI and
paradigm shifts in the healthcare industry (Awotunde cybersecurity.
et al. 2021; Yu, Beam, and Kohane 2018). The adoption of AI technology in healthcare has been
Radanliev et al. (2022b) and Straw (2020) encore that highly observed during the recent COVID-19 pandemic
AI is an opportunity for the healthcare industry through for developing reliable healthcare systems (Shringare,
which companies can escalate their stake to a higher Sarnayak, and Deshmukh 2023; Khamis 2022; Kalina
level and make a positive impact. According to For- 2022; Joshua, Bhattacharyya, and Rao 2022; Zainal and
tune Business Insights (2022), the global AI in healthcare Hamdan 2022; ElGohary et al. 2022; Uddin, Shorif, and
market size was valued at USD 10.54 billion in 2021 Sarker 2021). The healthcare system highly relies on
and is projected to increase to USD 164,10 billion by accuracy and intelligence; therefore, implementing AI
2029. Many healthcare organisations are getting bene- technology mitigates multiple problems (Shringare, Sar-
fited from the adoption of AI. For example, Microsoft nayak, and Deshmukh 2023). Richie (2022) and Hadley
Azure collaborated with Truveta Inc to develop a data- et al. (2020) revealed that the application of AI to build a
driven platform to work on a large scale globally. Alpha- resilient and sustainable healthcare system goes beyond
bet Inc. collaborated with Isomorphic Labs to detect dif- developed cities and extends healthcare support even
ferent ailments of multiple diseases using AI technology. to remote areas during disasters. AI technology deals
Hewlett Packard Enterprise Company collaborated with with a large amount of healthcare data, speed-up pro-
Ayar Labs to open a data-based innovation centre (For- cesses, and recognises intricate patterns (Forbes 2022b).
tune Business Insights 2022). Healthcare industries are AI contributes toward making the healthcare system to
using AI technology to refine patient treatments (Ana- be resilient and sustainable. Therefore, AI helps in man-
lytics Insight 2022). For instance, Enlitic, an healthcare aging healthcare resources optimally, uses low energy
industry AI company, uses deep learning algorithms to consumption, reduces carbon footprints, saves energy,
improve the accuracy of healthcare diagnosis (Analytics reduces losses, and saves more and more lives (Richie
Insight 2022). The firm uses AI – powered products to 2022; Badidi 2022; Sood, Rawat, and Kumar 2022; Hsu
analyze chest X-rays (Enlitic 2022). In another instance, et al. 2021; Yigitcanlar and Cugurullo 2020; Jung, Hur,
Owkin, the AI biotech company, uses AI to find the right and Kim 2018).
treatment for every patient (Analytics Insight 2022). The The importance of AI in healthcare management has
firm uses AI for drug discovery on a wider scale (Owkin drawn the attention of many researchers across the globe
2023). The AI models understand disease patterns and (Capasso and Umbrello 2022; Chee et al. 2021; Secinaro
complex biological intersections. It then discovers new et al. 2021; Satpathy et al. 2021; Straw 2020). The previ-
drug pathways and combinations (Owkin 2023). ous literature on AI applications in the healthcare sector
With the effective implementation of AI technol- is given in Appendix 2. Though these studies were con-
ogy, there is a continuous improvement in the global ducted during different periods, the applications of AI
healthcare system’s quality, reach, access, and affordabil- in building resilient and sustainable healthcare systems
ity (van der Schaar et al. 2021; Yigitcanlar and Cugu- were not the central ideas of these studies. Having seen a
rullo 2020; Sarbadhikari and Pradhan 2020; Haleem rise in disasters, we identify a clear gap in the AI litera-
and Javaid 2020). Therefore, in a highly uncertain and ture to build a resilient and sustainable healthcare system.
dynamic environment, AI technology provides many Since earlier literature did not address this dimension,
benefits (Hoppe, Härting, and Rahmel 2023; Ahsan and providing a comprehensive understanding of the evolu-
Siddique 2022; Leimanis and Palkova 2021). AI helps to tion of studies, nature of the analysis, research method-
provide primary and advanced treatment and medicines ologies used, major publication outlets, and geographical
to the victims (Chee et al. 2021). In addition, it sup- orientation of the studies. Based on this context, our first
ports restoring normality (Forbes 2022b). However, there research question is:
INTERNATIONAL JOURNAL OF PRODUCTION RESEARCH 3

RQ1: How has the literature on AI application for the stands different from past literature by conducting an
resilient and sustainable healthcare system evolved over in-depth investigation of the applications of AI to build
the years? a resilient and sustainable healthcare system. Our study
Further, given the wide application of AI in healthcare, provides fresh insights into AI adoption in healthcare lit-
the extent of literature on AI technology in the context of erature. Further, the manuscript has been organised into
a resilient and sustainable healthcare system is minimal four sections. Section 2 discusses the research method-
and under-researched (Dasgupta et al. 2022; Chattu 2021; ology. Section 3 examines the research findings. Section
van der Schaar et al. 2021; Milne-Ives et al. 2020). The 4 presents the research framework, current trends, and
recent literature has either only focused on the resilient future research directions. Section 5 provides the conclu-
healthcare system (Abdel-Basset, Chang, and Nabeeh sion and implications of the study.
2021; Sitharthan and Rajesh 2021; Wang and Alexan-
der 2021; Leimanis and Palkova 2021; Pascu-Gabara and 2. Research methodology
CEPOI 2021; Bansal et al. 2020) or the sustainable health-
care system (Richie 2022; Elavarasan et al. 2021; Rahman Following the guidelines of Behera, Bala, and Dhir
et al. 2021a; Mishra et al. 2021a; Ahmed et al. 2021; (2019), our study has used a systematic literature review
Hsu et al. 2021; Ahad et al. 2020; Yigitcanlar and Cugu- approach. The systematic literature review is selected
rullo 2020). As a result, a combination of resilience and because it helps in carefully identifying and synthesising
sustainability in the context of AI in healthcare is not the relevant literature (Palmatier, Houston, and Hulland
yet discussed in any single research work. To close this 2018). We aim to initially understand how AI technol-
gap, our work aims to provide a research framework by ogy in the healthcare industry has evolved over the years
addressing the research question as given below: and then examine how AI technology contributes to a
resilient and sustainable healthcare system. Our study has
RQ2: How do AI applications contribute to building a conducted a three-step systematic literature review sug-
resilient and sustainable healthcare system?
gested by Behera, Bala, and Dhir (2019). Step 1 focuses
Our research focuses on how AI applications can help on planning and performing the review protocol. Step 2
the healthcare system to be resilient and sustainable highlights practical screening criteria. Step 3 focuses on
during disasters. Our study elaborates on the applica- reporting the findings.
tions of AI in health services, health workforce, health
information, medical technology, health financing, and
Step 1: planning and conducting the review protocol
health leadership and governance. This study provides
an extensive and detailed review of the state-of-the-art Our study begins with a wide range of literature searches
research conducted in AI technology and healthcare. In in databases such as Scopus and Web of Science (WoS).
addition, study offers the extensive use of AI technol- Pranckutė (2021) highlights that the Web of Science and
ogy/techniques for the healthcare domain. Finally, study Scopus are the two most trusted and reliable extensive
examined the benefits of AI in building a resilient and databases in the field of academia. Web of Science is one
sustainable healthcare system. The paper presents a mul- of the largest database platforms, with a collection of
tidimensional review of the factors that create significant more than 21,100 peer-reviewed and high-quality schol-
technological, organisational, ethical, data, policy, politi- arly journals across multiple disciplines (WoS 2022). Sco-
cal and legal challenges for AI adoption. Unlike the pre- pus also has a high-quality research coverage of more
vious systematic reviews (Parviainen and Rantala 2021; than 84 million records published worldwide across var-
Wang and Alexander 2021; Pascu-Gabara and CEPOI ious disciplines (Elsevier 2022a, 2022b). The WoS and
2021; Ahad et al. 2020; Haleem and Javaid 2020; Angioni Scopus databases provide relevant literature from dif-
and Musso 2020; Sonnessa, Tànfani, and Testi 2017), ferent domains and cover the highest cited literature
the authors use the extended antecedents, practices, and annually (Pranckutė 2021). According to Sassanelli et al.
outcome themes to provide a novel research framework (2019) and Merli, Preziosi, and Acampora (2018), Sco-
drawn from the systematic literature review. It is also pus and WoS are the most used databases in management
observed that past studies lack in proving future research studies.
directions using any framework (Elavarasan et al. 2021; To get a broader perspective of the topic, different
Hsu et al. 2021; Wang and Wu 2021; Islam et al. 2021; keywords were used, such as ‘Artificial Intelligence,’ ‘AI,’
Haleem and Javaid 2020; Sarbadhikari and Pradhan 2020; ‘healthcare supply chain,’ ‘healthcare industry,’ ‘health-
Berquedich et al. 2020). Therefore, to fill this gap, study care sector,’ ‘resilience,’ ‘sustainability,’ and ‘COVID19’,
uses the theory, context and methodology framework for ‘COVID-19’, ‘Pandemic,’ both in the Scopus and WoS
providing future research directions. Hence, this study databases using ‘OR’ and ‘AND’ string commands in
4 L. P. VISHWAKARMA ET AL.

the title, abstract and the keywords section. The same used Zotero online tool to remove duplicate files. We
string commands were used in the Scopus and WoS initially combined the two different database files in the
databases. We wanted to cover the widespread applica- Zotero online tool, and then 23 duplicate entries were
tion of AI; hence we have used AI and artificial intelli- eliminated. Further, to maintain the scope and boundary
gence as the keywords during the search rather than using of the research, documents were eliminated after reading
the keywords such as ‘deep learning,’ ‘machine learning,’ the articles’ abstracts, which did not focus on healthcare,
and ‘neural networks.’ However, our study summarises sustainability, or resilience. The articles not discussing
the studies using the technologies coming under the much AI technology were also eliminated. We included
umbrella of AI. The selection of subject areas was essen- only those articles focusing on artificial intelligence and
tial to focus on business management and the health- resilience or artificial intelligence and sustainability in the
care domain. Therefore, the subject areas selected from healthcare domain. The articles discussing the applica-
the Scopus database are Social Science, Business Man- tions, benefits, or challenges of AI during the COVID-19
agement, and Decision Science. In contrast, the WoS pandemic were also considered. The COVID-19 pan-
database’s assigned subject areas are Health Care Sci- demic is a recent disaster (Seddighi 2020) that disrupted
ence Services, Computer Science, Operations Research many lives and severely affected the global healthcare sys-
Management Science, and Social Science Other Topics. tem (KPMG 2022; UN 2022). Finally, (n = 89, Appendix
Although no filter was used for the time frame, consid- 1) documents were regarded as ‘fit for the purpose’ of our
ering the discussed keywords and limitations, the study’s study and ‘relevant’ to the subject matter. The detailed
time frame is 26th September 2022. selection criteria are presented in Figure 1.

Step 2: practical screening criteria


3. Research findings
Newbert (2007) highlighted that peer-reviewed journals
3.1. Descriptive analysis
were selected to maintain the quality control of search
results and enhance the rigorous process. This eliminates Descriptive analysis, along with a systematic literature
the fewer rigorous articles, excluding, thus, the confer- review, helps present the knowledge comprehensively yet
ence papers, book chapters, and grey literature (Tranfield, in-depth manner. The analysis-synthesis the knowledge
Denyer, and Smart 2003). Furthermore, only documents that encapsulates the journey of AI in the healthcare
published in the English language were considered. We domain and explores how AI applications can help build

Figure 1. Search criteria for systematic literature review (as of September 26th, 2022).
INTERNATIONAL JOURNAL OF PRODUCTION RESEARCH 5

resilient and sustainable healthcare. The 89 documents 3.2. Thematic analysis


were deeply analyzed for the present systematic litera-
This section highlights the major themes and is divided
ture review. In the first part, specific characteristics such
into three sub-sections. First, section 3.2.1 discusses the
as year-wise classification, the type of the study, research
applications, sections 3.2.2 and 3.2.3 elaborate on the role
methods used, the count of authors, the geographical
of AI for resilient and sustainable healthcare systems,
location based on the first author’s institutional loca-
respectively, and section 3.2.4 illustrates the challenges of
tion, and the data collection method followed in the
AI technologies for a resilient and sustainable healthcare
reviewed articles were extracted from the papers. The
system.
second part aimed at looking at more in-depth con-
tent and focusing on the reviewed papers. Hence, it
3.2.1. Applications of AI in healthcare systems
discusses the themes of AI’s applications, benefits, and
The traditional healthcare systems are now changing and
challenges to building a resilient and sustainable health-
aiming to provide complete care to the patient’s phys-
care system. The articles published in the AI, resilient,
ical, economic, social, emotional, and spiritual needs
sustainable, and healthcare system drew initial attention
(Capasso and Umbrello 2022). In our study, AI applica-
in 2017 and have shown a markable growth after 2019
tions in the healthcare system have been observed across
(see Appendix 4). 31.46% and 47.19% of the reviewed
the six- health system building blocks. These building
articles were published in 2020 and 2021, respectively.
blocks of the healthcare system are adapted from the
Only 10.11% of the reviewed articles were published till
WHO conceptual framework (KPMG 2022; WHO 2010,
26th September 2022, with prospects for more studies
2021). The six- health system building blocks are: 1)
to occur soon. The 2020 and 2021 results highlight an
Health services, 2) Health workforce, 3) Health informa-
increase in papers published on the topic; the result could
tion, 4) Medical technologies, 5) Health finance, and 6)
be due to the COVID-19 pandemic and the possibility
Leadership and governance. The application of AI under
of the study in the resilient healthcare system. However,
these six building blocks is discussed in Table 1. The
the results of 2022 are partial, as only the initial eight
application of AI in health services has been observed
months of the year are considered. The type of publica-
as meeting patients’ needs and improving health ser-
tion (see Appendix 5) was mainly a literature review (con-
vices delivery. The health workforce discusses providing
stituting 51.80%) followed by 42.16% quantitative study,
the resources and reducing the burden on healthcare
2.40% mixed study consisting of both qualitative and
stakeholders using AI applications. AI in health infor-
quantitative research, and 3.61% following the qualitative
mation encore in shifting the traditional reactive health-
analysis.
care models to proactive models using medical data and
Several research methodologies (Appendix 6) were
technology advancements. AI in medical technology dis-
exhibited in the 89 articles. Out of the 89 articles, 51.80%
cusses the recent developments in the healthcare systems
of the studies followed a review methodology, 14.45%
to meet medical needs. Health finance examines health-
followed conceptual methods, 9.63% conducted experi-
care schemes in a subsidised manner using AI appli-
mentation and modelling, 8.43% completed case studies,
cations to get the maximum benefit and ensure trans-
and 6.02% followed a survey method. A good percentage
parency. AI in leadership and governance describes the
(92.1%) of the reviewed articles result from the collabo-
application of AI for a better understanding of medical
ration between several authors (papers with more than
needs from citizens’ perspectives. It further elaborates on
one author). Rest, 7.86% of studies are single-authored.
how AI can fulfil healthcare goals and provide positive
Our study’s geographical orientation (see Appendix 7) is
results.
built on the first author’s institutional location. 15.73%
AI is an umbrella of technologies consisting of
of reviewed articles were published in India, followed by
machine learning, deep learning, expert systems, compu-
14.61% and 6.74% of articles from the USA and China,
tational intelligence, robotics, neural networks, and deci-
respectively. The data collection method (see Appendix
sion support systems. Reviewed articles (see Appendix 3)
8) used in the reviewed articles shows that 51.804% of
provide an in-depth purpose of using AI technology and
review papers have collected data from various databases
techniques in different healthcare segments. For example,
such as Scopus or WoS, etc., 39.75% use secondary
chat bots were highly used during the COVID-19 pan-
databases (such as government data, industry datasets,
demic as social distancing was followed. It has also been
etc.), and 4.81% uses questionnaire, and 3.61% uses
found that AI is widely used for radiology and health-
interview method. The significant publications- 7.87%
care data management. Most AI models revolved around
coming dedicatedly from the journal ‘Sustainability’ fol-
detecting, diagnosing, treating, forecasting, monitoring,
lowed by 6.74% from ‘Sustainable Cities and Society’ and
and tracking COVID-19 infections.
‘Healthcare’.
6 L. P. VISHWAKARMA ET AL.

Table 1. Application of AI in Healthcare System.


Application of AI across
the six-healthcare
system building blocks Descriptions References
AI in Health Telemedicine Wang et al. (2021a); Wang and Alexander (2021); Mishra et al.
Services (2021a); Tan et al. (2020); Sarbadhikari and Pradhan 2020; Scott
et al. (2020)
Online consultations Klumpp et al. (2021); Parviainen and Rantala (2021); Li, Zhang, and
Safara (2021)
Automating healthcare services Wang and Wu (2021); Babic et al. (2021); Parviainen and Rantala
(2021); Umbrello et al. (2021); Saba et al. (2019)
Replaces the routine tasks- digital assistance Mishra et al. (2021a); Rahman et al. (2021b); Klumpp et al. (2021);
Sharma, Yadav, and Chopra (2020); Parviainen and Rantala
(2021); Li, Zhang, and Safara (2021)
Communication improvement- healthcare stakeholders Klumpp et al. (2021); Battineni, Chintalapudi, and Amenta (2020)
Personalized treatment and care Chattu (2021); Hsu et al. (2021); Wang and Wu (2021)
AI-based robots- Transferring essential and non-essential Rahman et al. (2021a); Wang and Wu (2021); Umbrello et al. (2021);
items Adly, Adly, and Adly (2020)
AI-based robots- Assistance during critical surgeries Richie (2022); Klumpp et al. (2021); Secinaro et al. (2021); Zemmar,
Lozano, and Nelson (2020); Haleem and Javaid (2020); Coombs
(2020)
Improves service execution accuracy and time Shankar et al. (2021); Adly, Adly, and Adly (2020); Loey, Manogaran,
and Khalifa (2020)
AI in Health Automates the repetitive tasks (reduces the unnecessary Rahman et al. (2021a); Sharma, Yadav, and Chopra (2020); Vaishya
Workforce burden in the healthcare workforce) et al. (2020); Naseem et al. (2020); Sun and Medaglia (2019)
Updates the healthcare and medical information instantly Popkova and Sergi (2022); Secinaro et al. (2021); Elleuch et al.
(2021); Islam et al. (2021); Scott et al. (2020)
AI in Health The electronic record of medical data (including past Chattu (2021); Sun and Medaglia (2019)
Information health records)
Remote access of the health information to the doctors, Chattu (2021); Leimanis and Palkova (2021); Mishra et al. (2021a);
patients, and administration Gunasekeran et al. (2021); Hoffman (2020); Angioni and Musso
(2020); Sarbadhikari and Pradhan (2020)
Improves knowledge management activities Wang and Wu (2021); Jung, Hur, and Kim (2018)
Health risk alerts Klumpp et al. (2021); Adly, Adly, and Adly (2020)
Clinical decisions Chattu (2021); Secinaro et al. (2021)
Meaningful healthcare information to government officials Khan et al. (2021); Haleem and Javaid (2020); Sun and Medaglia
and healthcare staff (2019)
AI in Medical Real-time information Popkova and Sergi (2022); Islam et al. (2021); Elleuch et al. (2021);
Technology Haleem and Javaid (2020)
Health outcomes prediction Dasgupta et al. (2022); Chattu (2021); Klumpp et al. (2021); Naseem
et al. (2020)
Drug discovery and development Peng et al. (2022); Dasgupta et al. (2022); Chattu (2021); Vaishya
et al. (2020); Adly, Adly, and Adly (2020); Naseem et al. (2020)
Vaccine development Rahman et al. (2021b); Sarbadhikari and Pradhan (2020); Vaishya
et al. (2020); Haleem and Javaid (2020); Coombs (2020); Bansal
et al. (2020)
Timely health data processing and analysis Rahman et al. (2021a); Klumpp et al. (2021); Secinaro et al. (2021)
It makes the tasks more effective and robust in terms of Alahmari et al. (2022); Klumpp et al. (2021); Hsu et al. (2021); Tan
computational speed and efficiency et al. (2020); Sun and Medaglia (2019)

AI-based Chatbots- digital assistance to the patients Milne-Ives et al. (2020); Parviainen and Rantala (2021); Battineni,
(booking appointments, making the payment process Chintalapudi, and Amenta (2020); Coombs (2020)
smoother, answering queries)
AI in Health Finance Helps the patients in finding the best public or private Aerts and Bogdan-Martin (2021); Ho, Caals, and Zhang (2020);
insurance providers Sonnessa, Tànfani, and Testi (2017)
It helps to combine the reimbursement schemes to get the Aerts and Bogdan-Martin (2021); Ho, Caals, and Zhang (2020)
maximum benefit
AI in Leadership It helps the government to cope with the complex Kankanhalli, Charalabidis, and Mellouli (2019); Sun and Medaglia
and Governance changing environment (2019)
Encourages innovative practices in the healthcare system Pascu-Gabara and CEPOI (2021); Wang and Wu (2021)
Manages individual data on government databases Rahman et al. (2021a); Khan et al. (2021)
It helps the government for surveillance purposes Badidi (2022); Sood, Rawat, and Kumar (2022); Chattu (2021);
Angioni and Musso (2020); Ho, Caals, and Zhang (2020); Scott
et al. (2020); Naseem et al. (2020)
AI chatbots help in improving communication between Secinaro et al. (2021); Battineni, Chintalapudi, and Amenta (2020)
citizens and governments
It helps to streamline the government’s administrative Klumpp et al. (2021); Battineni, Chintalapudi, and Amenta (2020);
burden in the healthcare system Sun and Medaglia (2019)
AI-based statistical models help government authorities to Wang and Wu (2021); Islam et al. (2021); Nasseef et al. (2021); Ahad
conduct decision-making processes et al. (2020); Sun and Medaglia (2019); Jung, Hur, and Kim (2018)
INTERNATIONAL JOURNAL OF PRODUCTION RESEARCH 7

3.2.2. AI for the resilient healthcare system 3.2.3. AI for the sustainable healthcare system
Due to the unpredictable nature of disasters, healthcare The destruction caused by disasters teaches the impor-
systems need to be resilient. Resilience helps to cope with tance of sustainability. Disasters and sustainability are
the uncertainties of a complex environment. After any directly or indirectly linked to each other. Alahmari
disaster, resilience determines the time to come back to et al. (2022) observed that climate change, a threat to
normalcy. Wiig et al. (2020) highlighted that resilient the environment, is proof that the planet’s condition is
healthcare is expected to withstand disruptive events deteriorating daily. The rising temperatures, increasing
and consistently deliver high-quality care. Nasseef et al. pollution, growing populations, and increasing urbanisa-
(2021) and Munawar et al. (2021) observed that AI tech- tion are decreasing sustainability and leading to different
niques reinforce and complement resilience strategies. global disasters. These threats are simultaneously deteri-
For building a resilient healthcare system, detecting the orating the citizens’ psychological and physical health. In
early warning of uncertainty is essential, and AI-based order to reduce the damage to the environment, there is
models help identify those early warning signals. In the a need for innovation among the healthcare stakehold-
recent wake of the COVID-19 pandemic, AI technology ers to understand and provide solutions, information,
allows for the early detection, diagnosis, classification, services, and community support structure for timely
treatment, and prevention of diseases (Peng et al. 2022; disease prevention and cure (Yigitcanlar and Cugurullo
Ogiela and Ogiela 2021; Al-Antari et al. 2021; Xue et al. 2020).
2021; Greenspan et al. 2020; Vaishya et al. 2020). Ahad et al. (2020) highlighted that AI technology is
Disasters like floods, virus outbreaks, and earth- one of the sustainability-enabled technologies. Muham-
quakes shatter internal and external healthcare stake- mad, Hossain, and Kumar (2021) encore the importance
holders. Managing and coping with internal and exter- of a sustainable city as it is directly related to providing
nal shocks is essential to build a resilient healthcare many health-related benefits. A highly polluted city, espe-
system. AI technology reduces the process execution cially in a densely populated urban town, causes adverse
time for multiple operations (Loey, Manogaran, and effects on people’s lives and leads to chronic related dis-
Khalifa 2020), thereby identifying the process execu- eases (Alahmari et al. 2022). Sustainability has different
tion loopholes (Li, Zhang, and Safara 2021). AI tech- dimensions and can be analyzed through different modes
niques stress developing adaptive systems to meet the and channels. For example, from a social perspective,
changing requirements over time. Disaster causes sig- sustainability can be achieved by developing a health-
nificant loss of lives; therefore, meeting medical needs care system that benefits all stakeholders, such as health-
during disaster becomes necessary. AI applications help care institutions, doctors, government, and patients. The
in the effective management of medical drugs and med- abnormal conditions, emergencies, and extreme condi-
ical equipment and identify and fulfil the supply and tions caused by disasters demolish the traditional health-
demand signals (Lai et al. 2020). AI devices help track the care information flow. However, recent AI technological
patient’s medical history (Chattu 2021; Berquedich et al. developments have made it possible to share the sensory
2020). data from the health sensors with remote doctors, to get
Managing relief operations requires coordination and the results and feedback of the reports or diseases in a few
collaboration among different parties to provide the nec- milliseconds (Alahmari et al. 2022; Rahman et al. 2021a).
essary items to the disaster victims. AI positively con- AI algorithms support healthcare services by provid-
tributes to factors that affect resilience and helps in ing accurate results in the healthcare ecosystems, irre-
knowledge sharing, information sharing, collaboration, spective of geographical distances and locations (Hos-
transparency, and increasing responsiveness (Abdel- sain, Muhammad, and Alamri 2019). AI offers remote
Basset, Chang, and Nabeeh 2021; Secinaro et al. 2021; access and control to doctors and patients (Gunasek-
Ahad et al. 2020). Because of AI’s dynamic capabilities, it eran et al. 2021; Sarbadhikari and Pradhan 2020) and
helps in enhancing the healthcare decision-making pro- improves the accessibility of healthcare data and health-
cess (Wang and Wu 2021; Islam et al. 2021; Lai et al. care services (Wang and Wu 2021; Khan et al. 2021).
2020; Jung, Hur, and Kim 2018). Improving internal and Richie (2022) and Zahid et al. (2021) highlighted that
external healthcare operations during disasters positively sustainable healthcare focuses on boosting and restor-
contributes to improving the overall efficiency of the ing public health parameters, thereby reducing the nega-
healthcare system (Ahsan and Siddique 2022). tive impacts on a sustainable city’s social, environmental,
and economic elements. Chattu (2021) revealed that AI
technology has much potential to improve the health-
care system, especially in low-resource areas. AI helps in
8 L. P. VISHWAKARMA ET AL.

accurate forecasting (Serte, Dirik, and Al-Turjman 2022; Zahid et al. (2021) highlighted that the digital healthcare
Comito and Pizzuti 2022; Tariq et al. 2021), which fur- environment demands transparency, data privacy, com-
ther leads to resource optimisation (Peng et al. 2022; patibility, data manipulation, user-centric design, data
Sood, Rawat, and Kumar 2022; Haleem and Javaid 2020; security, scalability, and interoperability. Mishra et al.
Adly, Adly, and Adly 2020). Remote care access to doc- (2021a) highlighted that the traditional manual proce-
tors and resource optimisation contributes to building a dures and delays in functionalities hinder AI technology
sustainable healthcare system. adoption. The lack of a skilled workforce is one of the sig-
nificant challenges in adopting AI technology. Previous
3.2.4. Challenges of AI in healthcare systems literature encores the need for proper training and edu-
The adoption of AI technology in the healthcare system cation for the rapid adoption of AI technology (Haleem
comes with significant challenges. These challenges are and Javaid 2020; Sarbadhikari and Pradhan 2020; Lau-
discussed in this section. Chattu (2021) highlighted that danski et al. 2020). Lack of government support, policies,
the healthcare system adopting AI technology is still in regulatory framework, and incentives is another major
the infancy stage, and many difficulties must be tack- challenge the organisation faces in adopting AI (Leimanis
led. Not all healthcare organisations have adopted AI and Palkova 2021; Aerts and Bogdan-Martin 2021; Hoff-
technology, and the reason behind the low adoption rate man 2020; Sarbadhikari and Pradhan 2020). Further, the
is the challenges faced by healthcare firms (Dasgupta challenges of AI in the healthcare system are discussed in
et al. 2022; Klumpp et al. 2021; Greenspan et al. 2020; depth in Table 2.
Sun and Medaglia 2019). The significant challenges faced
by the firms are the top management support regard-
ing the IT infrastructure, low investments, the mismatch 4. Research framework, current trends, and
between the human goals and machine output, and lack future research directions
of accountability (Ahsan and Siddique 2022). In addi-
4.1. Research framework for AI applications
tion, there are multiple technological challenges during
the adoption, such as the difficulty in algorithm readi- This section presents a research framework based on
ness and the lack of technology vendors (Secinaro et al. the findings of thematic analysis of AI applications in
2021; Aerts and Bogdan-Martin 2021; Ahad et al. 2020). building a resilient and sustainable healthcare system in

Table 2. Challenges of AI applications in Healthcare Systems.


Challenges of AI in
Healthcare Systems Description of challenges References
Technological Challenges Interoperability and Scalability issues Zahid et al. (2021); Hoffman (2020); Scott et al. (2020)
Complex interconnected systems Straw (2020); Sarbadhikari and Pradhan (2020)
Lack of technology vendors Aerts and Bogdan-Martin (2021)
Misuse of Technology Unberath et al. (2020)
Difficulty in readiness of algorithms Secinaro et al. (2021); Unberath et al. (2020)
Organisational Challenges Lack of Top Management Support Alahmari et al. (2022); Klumpp et al. (2021)
Lack of investments Ahsan and Siddique (2022); Alahmari et al. (2022); Aerts and Bogdan-Martin
(2021); Klumpp et al. (2021); Naseem et al. (2020)
Lack of stakeholder engagements Rahman et al., (2021a, 2021b); Sun and Medaglia (2019)
Lack of innovation, research, and Ahsan and Siddique (2022); Klumpp et al. (2021)
development
Lack of accountability Sun and Medaglia (2019)
Lack of skilled workforce Mishra et al. (2021a); Aerts and Bogdan-Martin (2021); Angioni and Musso
(2020)
Lack of performance evaluation Secinaro et al. (2021); Laudanski et al. (2020)
standards while using AI technology
Ethical Challenges Privacy and Security Breaches Badidi (2022); Rahman et al. (2021b); Ghayvat et al. (2021); Sarbadhikari and
Pradhan (2020); Haleem and Javaid (2020); Kankanhalli, Charalabidis, and
Mellouli (2019)
Lack of trust and transparency Ahsan and Siddique (2022); Klumpp et al. (2021); Hoffman (2020); Kumar, Raut,
and Narkhede (2020); Unberath et al. (2020); Laudanski et al. (2020); Sun
and Medaglia (2019)
Data Challenges Lack of quality data Peng et al. (2022); Popkova and Sergi (2022); Zahid et al. (2021); Yigitcanlar and
Cugurullo (2020)
Lack of data integration Sun and Medaglia (2019)
Policy, Political and Legal Lack of government support for the Capasso and Umbrello (2022); Kumar, Raut, and Narkhede (2020); Sun and
Challenges adoption of new technologies Medaglia (2019)
Lack of government policies and Alahmari et al. (2022); Klumpp et al. (2021); Mrówczyńska et al. (2019)
incentives
Lack of government-defined industry Babic et al. (2021); Laudanski et al. (2020)
standards for using AI
Political influences Mrówczyńska et al. (2019); Sun and Medaglia (2019)
INTERNATIONAL JOURNAL OF PRODUCTION RESEARCH 9

detail. Our study has adopted the extended Antecedents, (Figure 2). The framework describes the antecedents,
Practices, and Outcome (APO) framework to analyze practices, and outcomes of the application of AI in the
the key themes. The APO framework originated from healthcare system. Antecedents are driving factors for
the Antecedent-Behaviour-Consequence (ABC) model, practices, leading to the outcomes. The framework elab-
derived from the behavioural analysis branch of Psy- orates on the applications and challenges of AI in the
chology. The ABC model is used to understand the healthcare system. According to the literature discussed,
general and organisational behaviour induced by the the main antecedents include the top management sup-
antecedents, behaviours, and consequences (Nijhof and port needed for adopting AI technology in a healthcare
Rietdijk 1999). In addition, the ABC model is widely firm (Alahmari et al. 2022; Klumpp et al. 2021). IT infras-
used in management research as it helps to discover the tructure facilities must adopt AI technology, includ-
functional relationship between the behaviour and con- ing hardware and software support. The infrastructure
trol variables (Skinner 1966). In AI adoption, Yu, Xu, should support the timely information flow across the
and Ashton (2022) study the antecedents and conse- healthcare system. Lack of information sharing results in
quences. Furthermore, Baabdullah et al. (2021) examine the rise of uncertainty during any disaster. Information
antecedents and consequences to understand AI-based sharing helps in making operations more efficient and
business-to-business practices. effective. It further helps to gain a competitive advantage
Our study has extended the APO framework using for many healthcare firms. The IT infrastructure should
applications and challenges for adopting AI in the health- secure the environment and maintain privacy and secu-
care system. Based on this study, we propose a research rity (Kumar, Raut, and Narkhede 2020). Organisational
framework based on extended APO for AI applications culture, firm characteristics, and employee commitments
to build a resilient and sustainable healthcare system

Figure 2. Research Framework based on extended Antecedents, Practice and Outcomes for AI Application for building a resilient and
sustainable healthcare system.
10 L. P. VISHWAKARMA ET AL.

highlight how AI technology is accepted at the organi- The wide applications of AI provide several benefits
sational level (Ahsan and Siddique 2022; Alahmari et al. to the healthcare stakeholders such as patients, medi-
2022; Aerts and Bogdan-Martin 2021). Investments and cal experts, doctors, pharmacists, and hospital health-
government policies motivate the adoption of AI technol- care professionals in numerous ways. For example, in the
ogy in a healthcare system (Capasso and Umbrello 2022). sample of articles studied, it is found that using AI cre-
Klumpp et al. (2021) encore making research and devel- ates new experiences for healthcare stakeholders (Das-
opment investments encouraging firms to adopt AI. The gupta et al. 2022; Parviainen and Rantala 2021; Battineni,
adoption of AI in firms provides a competitive advantage Chintalapudi, and Amenta 2020; Berquedich et al. 2020;
(Rahman et al. 2021b). However, at the same time, it cre- Milne-Ives et al. 2020). This may be because the appli-
ates pressure on the firms lacking behind this adoption. cation of AI is cost-effective (Khan et al. 2021; Aerts
Thus, top management support is essential to facilitate and Bogdan-Martin 2021); provides remote access to
the adoption of AI practices in the healthcare system. health data (Leimanis and Palkova 2021; Mishra et al.
Therefore, in this context, the following proposition is 2021a; Gunasekeran et al. 2021); remote care to the
established: patients (Angioni and Musso 2020; Sarbadhikari and
Proposition 1: Pressure from the market will moti- Pradhan 2020); automates the repetitive tasks (Rahman
vate top management to support antecedents such as IT et al. 2021a; Sharma, Yadav, and Chopra 2020); reduces
infrastructure development and investments in R&D to the administrative burden (Klumpp et al. 2021; Sun and
facilitate the adoption of AI practices in the healthcare Medaglia 2019); reduces medical and human error (Peng
sector. et al. 2022; Islam et al. 2021; Yigitcanlar and Cugurullo
As stated by the literature review results, it is found 2020); saves time (Li, Zhang, and Safara 2021; Loey,
that the adoption of AI across different functions of the Manogaran, and Khalifa 2020). Thus proposition three
healthcare system, such as health service, health work- is defined as:
force, health information, medical technology, health Proposition 3: Healthcare firms adopting AI technology
finance, health leadership, and governance, changes the can create better experiences for healthcare stakeholders.
working pattern of the traditional healthcare system.
However, various healthcare processes still lack the adop-
4.2. Current trends and future research directions
tion of AI (Ahsan and Siddique 2022). During any dis-
aster, any healthcare system’s primary responsibility is The present section reveals the current trends and iden-
to save more individuals and speed up its operations. tifies relevant questions which can be taken up in future
AI technology helps in speeding up healthcare opera- studies. The result of the present study highlights signif-
tions. The practices such as collaboration, responsive- icant marking trends that have emerged from the sys-
ness, transparency, and knowledge management can con- tematic literature review conducted to understand the
tribute to adopting AI across different processes, which role of AI technology in building a resilient and sus-
further contributes to the resilience and sustainability tainable healthcare system. Given the field’s recency, the
of a healthcare system (Wang and Wu 2021; Jung, Hur, majority of the early work focused on conceptualising the
and Kim 2018). Collaboration among firms is essential AI models for monitoring (Rahman et al. 2021a), detec-
to building a resilient and sustainable healthcare sys- tion (Mishra, Singh, and Subramanian 2021; Pathan,
tem. Collaboration and Knowledge sharing help increase Siddalingaswamy, and Ali 2021; Dutta et al. 2020), con-
visibility and decrease the uncertainty, which results in trolling (Sim and Cho 2021), creating awareness (Jung,
a resilient healthcare system. Collaborating with firms Hur, and Kim 2018), classifying (Xu et al. 2021), diagno-
focusing on sustainable practices, working towards sus- sis (Sait et al. 2021; Lorencin et al. 2021; Almalki et al.
tainable development goals, practising life cycle assess- 2021; Battineni, Chintalapudi, and Amenta 2020) of dis-
ments, and having environment certifications positively eases. The possible reason behind this trend is the emer-
contribute towards a sustainable healthcare system. In gence of the COVID-19 pandemic. The havoc and life-
addition, Sun and Medaglia (2019) revealed that AI appli- threatening disease of COVID-19 have made the need for
cations are the enablers for increasing the efficiency and the development of AI models for monitoring, control-
effectiveness of different processes. These processes are ling, detecting diagnoses, and creating awareness of the
believed to contribute positively to the resilience and sus- diseases.
tainability of the healthcare system. Proposition 2 is thus Many studies have conducted reviews to understand
outlined in the context: the role of AI in different healthcare domains. The AI
Proposition 2: Adopting AI across different processes technology applications (Table 1) can be observed across
will improve the resilience and sustainability of the the healthcare system. The benefits of AI technology can
healthcare sector. be experienced by all the healthcare stakeholders, such
INTERNATIONAL JOURNAL OF PRODUCTION RESEARCH 11

as patients, doctors, hospital administration, and medical a healthcare firm’s different functional areas, especially
departments. The multiple benefits of AI technology in during any disaster. In addition, further study is needed
healthcare have drawn the attention of many researchers to build theories connected to AI technologies research
in this field. Hence, a significant increase in research is to comprehend and handle a variety of difficulties under
observed in this area (Figure 2). One of the possible rea- these themes from either customer’s perspective, which
sons behind this is the increasing number of medical in this case is majorly the patient’s or the organisation’s
emergencies and the initial stage of AI adoption in the perspective.
fourth industrial revolution. The adoption of AI is chang- Future studies can build a strong foundation of well-
ing the working patterns of the healthcare system by revo- established theories to understand ‘how’ and ‘why’ organ-
lutionising daily healthcare operations. Our study reveals isational resources or market competition encourages the
that the adoption of AI is observed mainly across health- adoption of AI technology across the healthcare sec-
care departments such as Radiology, Surgery, Medical, tor. Diffusion of innovation theory, for example, can
Research, and Development. On the other hand, many provide more insights into the current context, explain-
healthcare firms lack the adoption of AI technology, ing the factors that impact the customer’s or organisa-
mainly because of the organisational, technical, ethical, tion’s behaviour and motivation, respectively. Further-
data, policy, political and legal challenges (Table 2). more, future researchers can focus on how AI technology
can be initially adopted in one healthcare segment and
4.2.1. Future research directions further can be expanded to other healthcare segments. It
Our study aims to provide a foundation for researchers is also suggested that a longitudinal study be conducted
focusing on AI in the healthcare system. Furthermore, to confirm the phenomenon behaviour over time. For
our research findings in the AI field open up new avenues example, has the adoption of AI technology in health-
for future researchers. In particular, our study uses the care increased after the COVID-19 pandemic? Was the
Theory, Context and Methodology (TCM) framework to adoption helped the firm to build a resilient and sus-
provide the future research direction. The TCM frame- tainable healthcare system? It is also recommended that
work was previously adopted by various past researchers the results obtained should be compared with different
(Mishra, Singh, and Koles 2021b; Paul 2019). economic segments.
Further, future studies can test, modify and advance
4.2.1.1. Future directions- theory. The existing litera- the information systems model to explain the patient’s
ture review highly lacks using the theory for the adop- intention to use AI-based healthcare services. Addition-
tion of AI to build a resilient and sustainable healthcare ally, the decision-making process, performance improve-
system. It is observed that out of 89 reviewed arti- ment, innovation, and technological improvements are
cles in this study, only one article has used the theory. the elements that can be examined to offer further infor-
The neutrosophic theory is used by Sonnessa, Tànfani, mation to ensure a seamless experience. For example,
and Testi (2017). Hence future work must adopt theo- how can the organisation information processing the-
ries that can focus on how more healthcare firms can ory be linked with the AI technology adoption behaviour
adopt AI technology. Our attention is limited to the with enhanced firm performance?
current theoretical underpinnings in the area focused
on this study. There is a need to establish the link
with traditional theories. Therefore, future researchers 4.2.1.2. Future directions- context. The findings of
can work on using resource-based, dynamic capability, study reveal that despite having numerous applications
game, technology advancement, and systems theories. and benefits of AI, its adoption is still significantly less
For example, we could not identify a single work that among healthcare firms. Therefore, the factors impacting
links AI adoption in healthcare firms using the resource- the AI adoption strategies for the healthcare industry can
based or dynamic capability theory. Adopting a resource- be studied further. Future studies should focus on how
based, dynamic capability or game theory is important the technical, organisational, ethical, data, policy, polit-
because disasters are unprecedented. Therefore, health- ical and legal challenges should be minimised. Future
care organisations must maintain their resources over studies can conduct qualitative and quantitative analy-
time to gain a competitive advantage. The applications ses to drill down the applications and benefits discussed
of AI in health services, workforce, information, medical in this work. Future studies can focus on the applica-
technologies, finance, leadership, and governance are the tion of AI to overcome disruptions in healthcare supply
central themes under AI in healthcare literature. There- chain. Case studies can be undertaken to understand
fore, future studies can answer how a dynamic capability how healthcare firms are adopting AI technology across
or a resource-based approach might be used throughout their supply chain functions. Researchers should explore
12 L. P. VISHWAKARMA ET AL.

application of AI for supplier selection, efficient man- The reason behind this can be the impact of the COVID-
ufacturing of medicines, drug discovery, radiology, safe 19 pandemic. Based on the analysis of several papers, we
storage of medical goods in warehouses and distribution developed themes under the AI applications for building
centres, delivery of medicines among retailers, and risk a resilient and sustainable healthcare system, its benefits,
management among supply chain partners. Such used and challenges.
case scenarios will be helpful for healthcare firms in Our study reveals that AI technology is a powerful
adopting AI technology. Future studies should also tool during disasters. The AI application in the healthcare
explore issues of collaboration between AI and human sector is saving many lives by improving image analy-
physicians. sis, quick decision-making, drug discovery, automated
Future studies can also be conducted on the role of data collection, automated experiments, and executing
AI in healthcare sector for achieving Sustainable Devel- priority-based treatments, thereby improving the qual-
opment Goals (SDGs). Researchers can also answer how ity and care of the patients. AI technology is essential in
the new AI business models in the healthcare sector can healthcare by providing therapy, customised treatment,
be used to improve service quality and customer sat- and successful surgeries. It further offers innovative solu-
isfaction. Future studies can also focus on different AI tions in the healthcare domain and its associated fields.
technologies, such as machine learning, deep learning, When combined with other technologies, AI helps to
and artificial neural networks to increase the efficiency connect all the devices and systems used in the healthcare
of the healthcare system. domain. Integrated technology enables real-time capabil-
ities and improves decision-making processes by health-
care policymakers and professionals. The integration fur-
4.2.1.3. Future directions- methodology. Findings from
ther enhances the implementation of new techniques in
our study reveal that the current literature lacks qual-
the local, national and international healthcare systems
itative study. Only three out of 89 studies have con-
efficiently and swiftly.
ducted qualitative studies (see Appendix 5). Hence,
Drawing broadly on the literature, we developed an
qualitative studies should be given importance by the
extended APO framework on the applications of AI in
future researchers. Under the quantitative research, only
healthcare to build a resilient and sustainable healthcare
Elavarasan et al. (2021) and Abdel-Basset, Chang, and
system. The antecedents and practices discussed in this
Nabeeh (2021) have used the MCDM technique- TOP-
work contribute to understanding the state of technol-
SIS. Findings from our study further reveal that just two
ogy in industry and academia. Our study identifies the
studies have adopted the mixed methodology.
top peer-reviewed journal publishing in the context of AI
Consequently, we also recommend using the mixed
in healthcare. This study highlights that very few mixed
method for understanding the role of AI in the health-
methods studies are conducted in this healthcare domain.
care system for future researchers, as it will provide an
Hence, providing a research framework and proposi-
in-depth analysis of the topic. More quantitative and
tions in this study will enrich the AI literature for future
qualitative studies can be conducted to answer how
research. Our study highlights specific gaps in the liter-
using different data sources from multiple healthcare
ature and suggests promising future research directions
stakeholders such as patients, medical experts, doctors,
using the TCM framework.
pharmacists, and hospital healthcare professionals can
Our study provides some interesting AI applications
help in undewestanding critical problems of helathacre
for practitioners managing disaster operations. However,
sector.
many healthcare firms have not yet adopted some of these
applications. Our study will help healthcare professionals
understand AI’s role in building a resilient and sustain-
5. Conclusion and implications
able healthcare system. Our study will help healthcare
By conducting this systematic literature review, we found firms planning to adopt AI. The antecedents and prac-
that the AI application in the healthcare domain is quite tices discussed in this work will help the healthcare firms
fragmented. Hardly any study analysed applications of AI to understand the requirements for AI adoption. Fur-
in the context of resilience and sustainability simultane- thermore, study will help organisations to formulate AI
ously. This study contributes to the literature by bridging adoption strategies in healthcare systems during disaster
this gap. The study initially provides a descriptive analysis phases and normal conditions.
of the reviewed articles to analyze the evolution of the lit-
erature on AI applications for the resilient and sustainable
healthcare system. Interestingly, the articles published in
this context have shown significant growth after 2019.
INTERNATIONAL JOURNAL OF PRODUCTION RESEARCH 13

Data availability statement Ruchi Mishra is an Assistant Professor


in Production Operations Management &
Data related with this paper is available with authors and
QT area at Institute of Rural Manage-
will be available whenever required.AcknowledgementAuthors
ment Anand (IRMA), India. She holds
express sincere thanks to the editor and reviewers for provid-
her Fellow (Ph.D.) from National Institute
ing exhaustive review comments to improve the quality and
of Industrial Engineering (NITIE), Mum-
content of the paper.
bai, India. She has published papers in
journals such as Computer & Industrial
Disclosure statement Engineering, Annal of Operations Research, International
Journal of Logistics Management, Journal of Cleaner Produc-
No potential conflict of interest was reported by the author(s).
tion, IEEE Transactions on Engineering Management, Inter-
national Journal of Consumer Studies, Journal of Enterprise
Notes on contributors Information Management, and International Journal of Retail
& Distribution Management. Her major interests are in the
Laxmi Pandit Vishwakarma is currently areas of Digitalisation, Green Supply Chain Management
pursuing a fellowship programme in the and Supply Chain Aspects of Omnichannel Retailing. Email:
Operations Management area at Manage- ruchimishra@irma.ac.in
ment Development Institute (MDI), Gur-
gaon, India. She holds an MBA from Archana Kumari is a Lecturer in Glouces-
ICFAI Business School, Hyderabad, India tershire Business School, University of
and a B. Tech. in Electronics and Telecom- Gloucestershire Bristol, UK. Her research
munication Engineering from the Rungta interest entails international trade, sup-
College of Engineering & Technology, Chhattisgarh, India. She ply chain, artificial intelligence, regional
was awarded with Certificate of Best Paper at the 2nd Inter- development, etc. She has more than five
national Conference on Changing Business Paradigm (ICCBP- years of research experience and published
2022) held in India. She worked as a Research Associate at MDI a number of peer-reviewed articles in the
Gurgaon. She worked on a project titled ‘Indian Infrastructure domain of international business, supply chain, business eco-
Body of Knowledge (InBoK)’, an Niti Aayog initiative on Pro- nomics, strategy, and regional disparity. She has completed her
gram with the Quality Control of India (QCI) and IIM Indore PhD at the University of the West of England, UK. She has
to build the reference book. Her areas of interest include supply attended many conferences, including the 2019 Region’s Week
chain management, supply chain resilience, sustainability, and sponsored by the European Commission in Brussels on the pol-
Industry 4.0 technologies. Email: fpm21laxmi_p@mdi.ac.in icy implications of regional disparity. Previously, she worked
as a senior analyst for four years at Deloitte in India. Email:
Rajesh Kr Singh is Professor in Opera- archana_mbe2008@yahoo.com
tions Management Area at Management
Development Institute (MDI), Gurgaon,
India. His areas of interest include Supply References
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Appendices
Appendix 1: Research Papers considered for the SLR

Capasso and Umbrello (2022); Popkova and Sergi (2022); Alahmari et al. (2022); Comito and Pizzuti (2022); Peng et al. (2022); Dasgupta et al. (2022); Sood,
Rawat, and Kumar (2022); Richie (2022); Serte, Dirik, and Al-Turjman (2022); Badidi (2022); Ahsan and Siddique (2022); Chattu (2021); Babic et al. (2021);
Al-Antari et al. (2021); Pascu-Gabara and CEPOI (2021); Wang and Wu (2021); Satpathy et al. (2021); Ghayvat et al. (2021); Secinaro et al. (2021); Nasseef
et al. (2021); Parviainen and Rantala (2021); Sim and Cho (2021); Wang and Alexander (2021); Munawar et al. (2021); van der Schaar et al. (2021); Li, Zhang,
and Safara (2021); Aerts and Bogdan-Martin (2021); Ogiela and Ogiela (2021); Elleuch et al. (2021); Xue et al. (2021); Tariq et al. (2021); Umbrello et al.
(2021); Sait et al. (2021); Almalki et al. (2021); Zahid et al. (2021); DeGrave, Janizek, and Lee (2021); Xu et al. (2021); Shankar et al. (2021); Islam et al. (2021);
Khan et al. (2021); Gunasekeran et al. (2021); Klumpp et al. (2021); Pathan, Siddalingaswamy, and Ali (2021); Lorencin et al. (2021); Elavarasan et al. (2021);
Mishra, Singh, and Subramanian (2021); Ahmed et al. (2021); Abdel-Basset, Chang, and Nabeeh (2021); Rahman et al. (2021a); Rahman et al. (2021b);
Leimanis and Palkova (2021); Hsu et al. (2021); Sitharthan and Rajesh (2021); Chee et al. (2021); Kumar, Raut, and Narkhede (2020); Naseem et al. (2020);
Vaishya et al. (2020); Sharma, Yadav, and Chopra (2020); Berquedich et al. (2020); Ahad et al. (2020); Ho, Caals, and Zhang (2020); Hoffman (2020); Tan
et al. (2020); Laudanski et al. (2020); Alanazi et al. (2020); Greenspan et al. (2020); Straw (2020); Zemmar, Lozano, and Nelson (2020); Bansal et al. (2020);
Haleem and Javaid (2020); Angioni and Musso (2020); Sarbadhikari and Pradhan (2020); Yigitcanlar and Cugurullo (2020); Coombs (2020); Unberath et al.
(2020); Liu et al. (2020); Lai et al. (2020); Mohamadou, Halidou, and Kapen (2020); Scott et al. (2020); Battineni, Chintalapudi, and Amenta (2020); Santosh
(2020); Dutta et al. (2020); Adly, Adly, and Adly (2020); Milne-Ives et al. (2020); Loey, Manogaran, and Khalifa (2020); Mrówczyńska et al. (2019); Sun and
Medaglia (2019); Jung, Hur, and Kim (2018); Sonnessa, Tànfani, and Testi (2017)

Appendix 2: comparisons of the similar literature review conducted on AI and healthcare


Sample Time Frame for
Article Journal Focus Review Type Size Database Selected the study
Peng et al. (2022) Artificial intelligence Describes the applications of Literature Review NA Web of Science, ScienceDirect, NA
review AI to combat the COVID-19 IEEE Xplore Digital Library,
pandemic China national knowledge
infrastructure, EiCompendex,
and Google Scholar
Comito and Pizzuti Artificial Intelligence Illustrates the application Literature Review 146 ScienceDirect (SD), IEEE Xplore, February 2020 to
(2022) in Medicine of AI for forecasting and (Focused Review) Web of Science (WoS), Google March 2021
diagnosing the COVID-19 Scholar, Scopus, PubMed,
pandemic ACM Digital Library, arXiv and
medRxiv
Secinaro et al. BMC Medical Conducts cluster analysis for AI Bibliometric Analysis 288 Scopus 1992- January 2021
(2021) Informatics and applications in healthcare and Literature
Decision Making Review
Islam et al. (2021) Healthcare Provides an overview of Bibliometric Analysis 729 Web of Science 2020- February 2021
current research trends of AI
application to the COVID-19
pandemic
Khan et al. (2021) Expert Systems With Discusses the applications of Literature Review NA ScienceDirect, Google Scholar, NA
Applications AI-based techniques for the and Preprints from arXiv,
COVID-19 pandemic medRxiv, and bioRxiv
van der Schaar et al. Machine Learning Examines how Ai is used to Literature Review NA NA NA
(2021) mitigate the challenges
during the COVID-19
pandemic
Chee et al. (2021) International journal Describes the applications of Literature Review 14 PubMed, Embase, Scopus, August 2020-
of environmental AI to combat the COVID-19 (Systematic CINAHL, IEEE Xplore, and ACM October 2020
research and public pandemic in intensive care Review) Digital Library
health and emergency settings
Chattu (2021) Big Data and Cognitive Highlighted the application of Literature Review NA Web of Science, Scopus, NA
Computing AI, blockchain, and big data MEDLINE/PubMed, and
in medical and global health Google Scholar
Bansal et al. (2020) Journal of medical Analyses application of Literature Review NA NA NA
systems machine learning tech-
niques to battle the
COVID-19 pandemic
Milne-Ives et al. Journal of medical Assess the usability and Literature Review 31 PubMed, Medline (Ovid), 2008- November
(2020) Internet research effectiveness of AI-based (Systematic Excerpta Medica dataBASE, 2019
conversational agents in Literature Review) Cumulative Index to Nursing
healthcare and Allied Health Literature,
Web of Science, and the
Association for Computing
Machinery Digital Library
Naseem et al. (2020) Journal of Primary Discusses the applications of Literature Review 13 PubMed December 2019 -
Care & Community AI to combat the COVID-19 (Focused Review) April 2020
Health pandemic
Vaishya et al. (2020) Diabetes & Metabolic Describes the applications of Literature Review NA Pubmed, Scopus, and Google NA
Syndrome: Clinical AI to combat the COVID-19 Scholar
Research & Reviews pandemic
INTERNATIONAL JOURNAL OF PRODUCTION RESEARCH 21

Appendix 3: different AI technologies and applications in healthcare segments.

AI Technologies Applications References


Computational Intelligence-based Heuristic Greedy Best First Optimizing the lung cancer dataset Mishra et al. (2021a)
Search (GBFS) algorithm and Random Forest Classifier (RFC)
Deep neural network (DNN) -based object detection technique Human Detection Ahmed et al. (2021)
and Gaussian YOLOv3 algorithm
Deep learning convolutional neural network (DLCNN) Detecting COVID-19 infection using chest X-ray images Sait et al. (2021)
Deep Learning Models (DLM) Detecting COVID-19 using the chest X-ray images DeGrave, Janizek, and Lee (2021)
Deep Learning Models Detect, Diagnose and Classify COVID-19 using Xray images Al-Antari et al. (2021)
Agent-Based model decision support system Comparison of co-payments rules Sonnessa, Tànfani, and Testi (2017)
Deep learning-based Recurrent Neural Networks (RNN) Analyzing hospitalised patients’ data Hsu et al. (2021)
Machine learning-based Latent Dirichlet Allocation (LDA) Contributes to the cancer treatment process – Surgical Alahmari et al. (2022)
Algorithm Therapy, Chemo, and Radiation Therapy
Deep learning-based Classical data augmentation techniques Detecting COVID-19 using chest X-ray images Loey, Manogaran, and Khalifa (2020)
along with Conditional Generative Adversarial Nets (CGAN)
model
Logistic regression; Multilayer perceptron layer; Gradient Classifying and Assessing COVID-19 infections using chest Almalki et al. (2021)
boosting model; Bagging tree; Random Forest using X-ray images
machine learning and deep learning
Stimulus-response methods Human Interactive experiences using an AI Chatbot Battineni, Chintalapudi, and Amenta
(2020)
Cascaded recurrent neural network-based Barnacle Mating Diagnosis of COVID-19 infections using chest X-ray images Shankar et al. (2021)
Optimization (BMO) algorithm
A harmony search algorithm, genetic algorithm, Particle Diagnosis the diabetes disease using combined AI algorithms Li, Zhang, and Safara (2021)
swarm optimisation algorithm, and K-means
Artificial Neural Networks (ANN) and Fuzzy Interval Classifying, prioritization, and scheduling the COVID-19 Elleuch et al. (2021)
Mathematical Modeling patients.
Convolutional Neural Network (CNN) Model Classifying the clinical data for coronary heart disease. Dutta et al. (2020)
Optimized CNN Model Detect COVID-19 infection using X-ray images Pathan, Siddalingaswamy, and Ali
(2021)
Artificial Immune Decision Support System (AIDSS) Drug prescription to the home quarantine patients. Berquedich et al. (2020)
Machine Learning Monitoring and tracking the COVID-19-infected patients. Sitharthan and Rajesh (2021)
Machine Learning Discusses how AI can help at different stages to battle the Bansal et al. (2020)
COVID-19 pandemic
CNN Architecture Diagnosis and treatment of the COVID-19 infection using the Lorencin et al. (2021)
lungs X-ray images.
Supervised Learning Model Assess the severity of COVID-19 infections using lung Xue et al. (2021)
ultrasound and clinical information.
Machine Learning Chatbots for automated consultancy during the COVID-19 Parviainen and Rantala (2021)
pandemic.
Support Vector Machine (SVM) Networks Analyzing noise pollution in protected areas Mrówczyńska et al. (2019)
Machine Learning, Deep Learning, Natural Language Highlighting AI’s importance during the COVID-19 pandemic. Rahman et al. (2021b)
Processing, Expert Systems, Robots, and Robotics Processes
Active learning and Deep learning Discusses AI-driven tools to test and train multitudinal or Santosh (2020)
multimodal data
Machine Learning and Deep Learning Diagnosis and forecasting of the COVID-19 pandemic Comito and Pizzuti (2022)
Machine Learning and Deep Learning Discusses different applications for combating the COVID-19 Khan et al. (2021)
pandemic
Convolutional Neural Network Detect COVID-19 infection using chest X-ray images Pathan, Siddalingaswamy, and Ali
(2021)
Machine Learning Discusses different applications for combating the COVID-19 van der Schaar et al. (2021)
pandemic
Machine Learning Uses the past susceptible, infected recovered data for Alanazi et al. (2020)
combating the future COVID-19 infection
Convolutional Neural Network and Deep Learning Detecting the COVID-19 infections Serte, Dirik, and Al-Turjman (2022)
Natural Language Processing Discusses multiple conservational AI-based agents Milne-Ives et al. (2020)
Deep Learning Detect COVID-19 infection using CT scan images Dasgupta et al. (2022)
22 L. P. VISHWAKARMA ET AL.

Appendix 4: year-wise paper publication (As of 26th September 2022, N = 89)

Figure A4. Year-wise paper publication (As of 26th September 2022, N = 89).

Appendix 5: type of publication (N = 89)

Figure A5. Type of publications (N = 89).

Appendix 6: research methods used in the research papers (N = 89)

Figure A6. Research methods used in the research papers (N = 89).


INTERNATIONAL JOURNAL OF PRODUCTION RESEARCH 23

Appendix 7: top 10 geographical orientations of the reviewed papers

Figure A7. Top 10 geographical orientations of the reviewed papers.

Appendix 8: distribution of data collection method used in the research papers (N = 89)

Figure A8. Distribution of data collection method used in the research papers (N = 89).

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