Bringing tech sector efficiency insights to palliative care

Professor Ciara Heavin, Dept of Business Information Systems (BIS), Cork University Business School, University College Cork.

My journey from business information systems to digital healthcare was a very personal one. After the birth of my first child, I was surprised to discover how much of my baby’s health data was handed over to external parties. It seemed problematic to me that health data should not be owned by, and used for the direct benefit of, the patient. The systems I had been working on for years could be applied in healthcare to empower patients, improve efficiency, and provide decision support for clinicians.

The new pathway led me to the project I am now working on with the Insight SFI Research Centre for Data Analytics: CommPAL (Community PalliAtIve Care).

CommPAL is a web and mobile AI-driven platform aimed at healthcare workers who are strained for time related to patient triaging, daily travel, planning and resource management. Specialist palliative care is a resource intensive service, and nurses are often spread thin trying to decide where they are most needed and when. AI can never replace humans in palliative care, but it can help them to make optimal use of their time and deliver gold standard care to patients.

My PhD was in the field of knowledge management for small to medium software companies and it has become clear to me that services like palliative care can benefit from the same commitment to efficiency, customer-centred service and data-driven decision making.

We are building CommPAL using data captured by nurses on the ground – each patient visit provides new insights into how best to keep people comfortably at home and out of Emergency Departments. We are also consulting with patient advocacy groups – people who have experience of their loved ones accessing palliative care services and who have knowledge to offer about what works.

We were concerned at first that nurses, patients and their families might be resistant to introducing AI into such a person-centred activity as palliative care. We have been surprised to discover that there is support for systems that can reduce the cognitive burden on nurses and potentially allow patients and their families to contribute to the data pipeline.

What does AI-supported palliative care look like? Intelligent triage is a major pillar – taking various data points such as geography, health data, patient availability, and nurse availability and using them to ensure the best decision-support for nurses when determining who is most in need. We are using machine learning techniques, in partnership with the Insight SFI Centre, to build these intelligent triage systems.

Optimisation techniques of the sort used routinely in business systems allow us to support smart decision making in palliative care by recommending the optimum patient caseload for a given day.

The CommPAL team is sensitive to the discomfort that some readers might feel at the comparison between palliative care services and business systems. The first? one is a sensitive and critical, person centred, highly human-skilled activity while the other can sound impersonal and technical. However, in my years as a Professor of Business Information Systems I have always been most interested in the complex interaction component between systems and people. My work has largely focused on socio-technical systems – how humans use and interact with technology and data and how that technology can be developed to keep humans in the loop and support our skills and decisions, not the other way around.

Palliative care services are under pressure and under-resourced all over the world. AI will not bridge that gap and cannot be a substitute for investment in people. However, the enthusiasm I have encountered from the nurses we are working with tells me that data-driven systems are long overdue in palliative care. The need is getting more complex with increases in medication, comorbidity and a range of other factors. AI-driven decision support for nurses is part of the future for palliative care.

CommPAL is due to be tested with real patient data in the coming months. To learn more visit https://commpal.ai/

Professor Ciara Heavin is Co-Director of Health Information Systems Research Centre, University College Cork. She is Chair of the University Ethics Committee, University College Cork and lectures in systems analysis and design, data modelling, database development and opportunity assessment and recognition in high technology firms. Prof Heavin is Chair of the IFIP WG8.3 Decision Support and Co-Editor-in-Chief of the Journal of Decision Systems.