Artificial intelligence after the bedside: co-design of AI-based clinical informatics workflows to routinely analyse patient-reported experience measures in hospitals
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Bibliographic record
Abstract
OBJECTIVE: To co-design artificial intelligence (AI)-based clinical informatics workflows to routinely analyse patient-reported experience measures (PREMs) in hospitals. METHODS: The context was public hospitals (n=114) and health services (n=16) in a large state in Australia serving a population of ~5 million. We conducted a participatory action research study with multidisciplinary healthcare professionals, managers, data analysts, consumer representatives and industry professionals (n=16) across three phases: (1) defining the problem, (2) current workflow and co-designing a future workflow and (3) developing proof-of-concept AI-based workflows. Co-designed workflows were deductively mapped to a validated feasibility framework to inform future clinical piloting. Qualitative data underwent inductive thematic analysis. RESULTS: Between 2020 and 2022 (n=16 health services), 175 282 PREMs inpatient surveys received 23 982 open-ended responses (mean response rate, 13.7%). Existing PREMs workflows were problematic due to overwhelming data volume, analytical limitations, poor integration with health service workflows and inequitable resource distribution. Three potential semiautomated, AI-based (unsupervised machine learning) workflows were developed to address the identified problems: (1) no code (simple reports, no analytics), (2) low code (PowerBI dashboard, descriptive analytics) and (3) high code (Power BI dashboard, descriptive analytics, clinical unit-level interactive reporting). DISCUSSION: The manual analysis of free-text PREMs data is laborious and difficult at scale. Automating analysis with AI could sharpen the focus on consumer input and accelerate quality improvement cycles in hospitals. Future research should investigate how AI-based workflows impact healthcare quality and safety. CONCLUSION: AI-based clinical informatics workflows to routinely analyse free-text PREMs data were co-designed with multidisciplinary end-users and are ready for clinical piloting.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it