Context-Driven Patient Knowledge Fusion
Keywords:
Context-Aware Clinical Intelligence, Clinical Decision Support Systems (CDSS), Predictive Care Coordination, Proactive Healthcare Analytics, Patient Knowledge Modeling, Clinical Workflow Optimization, Context-Aware Computing, Healthcare Informatics, Predictive Modeling, Artificial Intelligence (AI).Abstract
Clinical decision support systems assist healthcare professionals at the point of care, addressing complex tasks such as disease diagnosis and prognosis, therapy selection, and medication interaction checking. However, these systems remain largely reactive, generating alerts and recommendations only when specific conditions are met within the clinical workflow—often too late to enable effective preventive action. What is needed instead is a broader, domain-independent intelligence capable of proactively analyzing clinical data to predict potential problems and identify preventive opportunities across all clinical contexts and levels of granularity, while coordinating care among providers, patients, and health information systems.
Care coordination constitutes a second, higher level of abstraction in this framework. Whereas reactive systems respond to clinical events after they occur, proactive systems anticipate these events and initiate preparatory actions—notifications, reminders, and alerts—in advance. Predictive care coordination thus operates not only within the clinical-problem domain but extends across all related domains. Domain-specific intelligence modules—for example, predictive models for diabetes management in acute care—can be integrated into this architecture, forming a domain-independent system that satisfies the core requirements of context-aware clinical intelligence. This paper formally defines such a system as the Context-Aware Clinical Intelligence Framework for Unified Patient Knowledge Modeling and Predictive Care Coordination.
References
1. Shang, Y., Tian, Y., Zhou, M., Zhou, T., Lyu, K., Wang, Z., Xin, R., Liang, T., Zhu, S., & Li, J. (2021). EHR-oriented knowledge graph system: Toward efficient utilization of non-used information buried in routine clinical practice. IEEE Journal of Biomedical and Health Informatics, 25(7), 2463–2475.
2. Gazzotti, R., Faron, C., Gandon, F., Lacroix-Hugues, V., & Darmon, D. (2022). Extending electronic medical records vector models with knowledge graphs to improve hospitalization prediction. Journal of Biomedical Semantics, 13, Article 6.
3. Xiao, G., Pfaff, E., Prud’hommeaux, E., Booth, D., Sharma, D. K., Huo, N., Yu, Y., Zong, N., Ruddy, K. J., Chute, C. G., & Jiang, G. (2022). FHIR-Ontop-OMOP: Building clinical knowledge graphs in FHIR RDF with the OMOP Common Data Model. Journal of Biomedical Informatics, 134, Article 104201.
4. Gorle, R. (2023). Machine learning-based access risk detection in cloud identity and access management systems. Journal of International Crisis and Risk Communication Research, 241–252.
5. Zhou, D., Gan, Z., Shi, X., Patwari, A., Rush, E., Bonzel, C.-L., Panickan, V. A., Hong, C., Ho, Y.-L., Cai, T., Costa, L., Li, X., Castro, V. M., Murphy, S. N., Brat, G., Weber, G., Avillach, P., Gaziano, J. M., Cho, K., Liao, K. P., … Cai, T. (2022). Multiview incomplete knowledge graph integration with application to cross-institutional EHR data harmonization. Journal of Biomedical Informatics, 133, Article 104147.
6. Zou, Y., Pesaranghader, A., Song, Z., Verma, A., Buckeridge, D. L., & Li, Y. (2022). Modeling electronic health record data using an end-to-end knowledge-graph-informed topic model. Scientific Reports, 12, Article 17868.
7. Sachdeva, S., & Bhalla, S. (2022). Using knowledge graph structures for semantic interoperability in electronic health records data exchanges. Information, 13(2), Article 52.
8. Murali, L., Gopakumar, G., Viswanathan, D. M., & Nedungadi, P. (2023). Towards electronic health record-based medical knowledge graph construction, completion, and applications: A literature study. Journal of Biomedical Informatics, 143, Article 104403.
9. Hänsel, K., Dudgeon, S. N., Cheung, K.-H., Durant, T. J. S., & Schulz, W. L. (2023). From data to wisdom: Biomedical knowledge graphs for real-world data insights. Journal of Medical Systems, 47(1), Article 65.
10. Aldughayfiq, B., Ashfaq, F., Jhanjhi, N. Z., & Humayun, M. (2023). Capturing semantic relationships in electronic health records using knowledge graphs: An implementation using MIMIC III dataset and GraphDB. Healthcare, 11(12), Article 1762.
11. Soman, K., Nelson, C. A., Cerono, G., & Baranzini, S. E. (2023). Time-aware embeddings of clinical data using a knowledge graph. Pacific Symposium on Biocomputing, 28, 97–108.
12. Mondeddula, S. R. (2022). Machine learning-based credit risk assessment for intelligent lending and default prediction in financial services. Journal of International Crisis and Risk Communication Research, 5(1), 113–121.
13. Xu, D., Zhu, H., Huang, Y., Jin, Z., Ding, W., Li, H., & Ran, M. (2023). Vision-knowledge fusion model for multi-domain medical report generation. Information Fusion, 97, Article 101817.
14. Varshney, D., Zafar, A., Behera, N. K., & Ekbal, A. (2023). Knowledge grounded medical dialogue generation using augmented graphs. Scientific Reports, 13, Article 3310.
15. Alam, F., Babaei Giglou, H., & Malik, K. M. (2023). Automated clinical knowledge graph generation framework for evidence based medicine. Expert Systems with Applications, 233, Article 120964.
16. Mashetty, S. (2023). A comparative analysis of patented technologies supporting mortgage and housing finance. Educational Administration: Theory and Practice.
17. D’Auria, D., Moscato, V., Postiglione, M., Romito, G., & Sperlì, G. (2023). Improving graph embeddings via entity linking: A case study on Italian clinical notes. Intelligent Systems with Applications, 17, Article 200161.
18. Zheng, W., Yan, L., Gou, C., Zhang, Z.-C., Zhang, J. J., Hu, M., & Wang, F.-Y. (2021). Pay attention to doctor–patient dialogues: Multi-modal knowledge graph attention image-text embedding for COVID-19 diagnosis. Information Fusion, 75, 168–185.
19. Penaka, B. (2023). AI-driven predictive analytics for early detection of high-risk patients in cloud-based healthcare systems. International Journal of Medical Toxicology and Legal Medicine, 26(3), 118–124.
20. Kondylakis, H., Rao, P., Stefanidis, K., Aisopos, F., Jozashoori, S., Niazmand, E., Purohit, D., Rivas, A., Sakor, A., Iglesias, E., Vogiatzis, D., Menasalvas, E., Rodríguez González, A., Vigueras, G., Gómez-Bravo, D., Torrente, M., Hernández López, R., Provencio Pulla, M., Dalianis, A., … Vidal, M.-E. (2023). Knowledge graphs for enhancing transparency in health data ecosystems. Semantic Web.
21. Rajkomar, A., Oren, E., Chen, K., Dai, A. M., Hajaj, N., Hardt, M., Liu, P. J., Liu, X., Marcus, J., Sun, M., Sundberg, P., Yee, H., Zhang, K., Zhang, Y., Flores, G., Duggan, G. E., Irvine, J., Le, Q., Litsch, K., … Dean, J. (2021). Scalable and accurate deep learning with electronic health records. npj Digital Medicine, 4, Article 100.
22. Gadi, A. L. (2023). The role of AI-driven predictive analytics in automotive R&D: Enhancing vehicle performance and safety. Nanotechnology Perceptions.
23. Miotto, R., Wang, F., Wang, S., Jiang, X., & Dudley, J. T. (2021). Deep learning for healthcare: Review, opportunities and challenges. Briefings in Bioinformatics, 22(2), 1–14.
24. Shickel, B., Tighe, P. J., Bihorac, A., & Rashidi, P. (2021). Deep EHR: A survey of recent advances in deep learning techniques for electronic health record analysis. IEEE Journal of Biomedical and Health Informatics, 25(5), 1585–1601.
25. Topol, E. J. (2021). High-performance medicine: The convergence of human and artificial intelligence. Nature Medicine, 27, 44–56.
26. Potturi, P. (2023). Cloud-driven business intelligence modernization for scalable enterprise data integration and decision support. International Journal of Intelligent Systems and Applications in Engineering, 11, 387.
27. Esteva, A., Robicquet, A., Ramsundar, B., Kuleshov, V., DePristo, M., Chou, K., Cui, C., Corrado, G., Thrun, S., & Dean, J. (2021). A guide to deep learning in healthcare. Nature Medicine, 27, 24–29.
28. Rajkomar, A., Hardt, M., Howell, M. D., Corrado, G., & Chin, M. H. (2021). Ensuring fairness in machine learning to advance health equity. Annals of Internal Medicine, 174(6), 866–872.
29. Beam, A. L., & Kohane, I. S. (2021). Big data and machine learning in health care. JAMA, 325(13), 1317–1318.
30. Kolla, S. K. (2021). Adaptive graph-based framework for secure and efficient distributed data processing. Journal of Computational Analysis and Applications, 29(6), 1519–1523.
31. Krumholz, H. M. (2021). Big data and new knowledge in medicine: The thinking, training, and tools needed for a learning health system. Health Affairs, 40(1), 1–7.
32. Liu, X., Faes, L., Kale, A. U., Wagner, S. K., Fu, D. J., Bruynseels, A., Mahendiran, T., Moraes, G., Shamdas, M., Kern, C., Ledsam, J. R., Schmid, M. K., Balaskas, K., Topol, E. J., Bachmann, L. M., Keane, P. A., & Denniston, A. K. (2021). A comparison of deep learning performance against health-care professionals in detecting diseases from medical imaging: A systematic review and meta-analysis. The Lancet Digital Health, 3(6), e271–e297.
33. Reddy, V. A. R. (2023). API-first design as a strategy for healthcare system interoperability. South Eastern European Journal of Public Health, 224–247.
34. Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2021). An overview of clinical decision support systems: Benefits, risks, and strategies for success. npj Digital Medicine, 4, Article 17.
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