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Saptarshi Purkayastha
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Risks and Opportunities of AI Recognition of Patient Race in Medical Imaging
Previous studies in medical imaging have shown disparate abilities of artificial intelligence (AI) to detect a person's race, yet there is no known correlation for race on medical imaging that would be obvious to human experts when interpreting the images. His recent work published in Lancet Digital Health demonstrates that deep learning models have extremely high accuracy at identifying self-reported race from medical images such as X-rays, MRIs and CTs. This ability raises serious concerns among some researchers. Such software might group patients, or influence their care, by factoring in race. These AI models work very well on poor quality, distorted and even images where many parts of the image were deliberately cut out. These types of categorizations could lead to inequality in providing health care and making recommendations, and human decision makers might not understand how and why AI models are making the recommendations. Engineers, clinical researchers and informaticians need to get together to identify how AI models are able to have these superhuman capabilities.
Professor Purkayastha's translation of research into potential ways to identify and mitigate risks of deploying AI models in clinical practice to avoid racial issues in healthcare treatment is another example of how IUPUI's faculty members are TRANSLATING their RESEARCH INTO PRACTICE.
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Item Sustainable mobile information infrastructures in low resource settings(IOS, 2010) Braa, Kristin; Purkayastha, SaptarshiDeveloping countries represent the fastest growing mobile markets in the world. For people with no computing access, a mobile will be their first computing device. Mobile technologies offer a significant potential to strengthen health systems in developing countries with respect to community based monitoring, reporting, feedback to service providers, and strengthening communication and coordination between different health functionaries, medical officers and the community. However, there are various challenges in realizing this potential including technological such as lack of power, social, institutional and use issues. In this paper a case study from India on mobile health implementation and use will be reported. An underlying principle guiding this paper is to see mobile technology not as a "stand alone device" but potentially an integral component of an integrated mobile supported health information infrastructure.Item Exploring the potential and challenges of using mobile based technology in strengthening health information systems: Experiences from a pilot study(Association for Information Systems, 2010-08-01) Purkayastha, Saptarshi; Sahay, Sundeep; Mukherjee, ArunimaThis paper empirically examines the challenges of introducing a mobile based reporting system (called SCDRT) within the public health system in India to strengthen the health information systems, and also discusses the approaches to address these challenges. Taking an “infrastructure” perspective, various socio$technical challenges relating to technology, operator and usage are discussed. Scaling, in geographical and functional terms, is discussed with a focus on aspects of “attractors” and “motivation.”Item Dyscover — An Orton-Gillingham approach inspired multi-sensory learning application for dyslexic children(IEEE, 2012-10) Purkayastha, Saptarshi; Nehete, Namrata; Purkayastha, JashodharaThe Orton-Gillingham (OG) instructional approach has been widely used in different pedagogical settings. This multi-sensory approach has been especially helpful in teaching children with dyslexia and other learning disabilities. In this paper, we show how due to modern-day innovation in ICT like touch-screens, accelerometers, gyroscopes, voice recognition, sound reproduction, powerful processing and wide availability of mobile devices, this approach can help more learners than ever. The paper presents personalization of OG using Gardner's theory of multiple intelligence and demonstrates a software application suited for language learning by dyslexies and pre-school children. We propose that since OG is a one-to-one teacher-student approach, it has special characteristics that can allow ICT devices to become more than teaching aids, but to be used as tutors.Item Big Data Analytics for developing countries – Using the Cloud for Operational BI in Health(Wiley, 2013) Braa, Jørn; Purkayastha, SaptarshiThe multi-layered view of digital divide suggests there is inequality of access to ICT, inequality of capability to exploit ICT and inequality of outcomes after exploiting ICT. This is evidently clear in the health systems of developing countries. In this paper, we look at cloud computing being able to provide computing as a utility service that might bridge this digital divide for Health Information Systems in developing countries. We highlight the role of Operational Business Intelligence (BI) tools to be able to make better decisions in health service provisioning. Through the case of DHIS2 software and its Analytics-as-a-Service (AaaS) model, we look at how tools can exploit Cloud computing capabilities to perform analytics on Big Data that is resulting from integration of health data from multiple sources. Beyond looking at purely warehousing techniques, we suggest understanding Big Data from Organizational Capabilities and expanding organizational capabilities by offloading computing as a utility to vendors through cloud computing.Item Overview, not Overwhelm: Framing Operational BI Tools using Organizational Capabilities(2013) Purkayastha, Saptarshi; Braa, JørnIn contexts where fragmentation of information systems is a problem, data warehouse (DW) has brought disparate sources of information together. While bringing data together from multiple health programs and patient record systems, how does one make sense of huge amounts of integrated information? Recent research and industry uses the term, “Operational BI” for decision making tools used in operational activities. In this paper, we highlight the use of DHIS 2, a large-scale, open-source, Health Management Information System (HMIS) that acts as a DW. Firstly, we present the results of a survey done in 13 countries to assess how Operational BI Tools are used. We then show 3 generations of BI Tools in DHIS 2 that have evolved from action-research done over 18 years in more than 30 countries. Secondly, we develop the Overview-Overwhelm (O-O) analytical framework for large-scale systems that need to work with Big Data. The O-O framework combines lessons from DHIS 2 BI Tools design and implementation survey results.Item A Post-development Perspective on mHealth -- An Implementation Initiative in Malawi(IEEE, 2013-03-18) Purkayastha, Saptarshi; Manda, Tiwonge Davis; Sanner, Terje AkselWhile the sheer number of mHealth implementations around the world have been increasing dramatically, authoritative voices on global health have tried to put the focus on quantifiable evaluations and comparisons of these projects (e.g. health outcomes, cost savings, efficiency) in order to channel donor funds and investments into proven and scalable solutions. Drawing on empirical data from an mHealth implementation in Malawi we argue that quantitative evaluation of health interventions often assumes a top-down and limited view on the developmental impact of mHealth. Through our action-research involvement with facility-based reporting of routine health data through mobile phones, we conclude that developmental impacts of mHealth are local and each locale experience a different developmental impact depending on the context of use and available resources. The paper contrasts global concerns for quantifiable development with local priorities with respect to mHealth projects and information system (IS) interventions in health more broadly.Item OpenScrum: Scrum methodology to improve shared understanding in an open-source community(2014) Purkayastha, SaptarshiWhile we continue to see rise in the adoption of agile methods for software development, there has been a call to study the appropriateness of agile methods in open-source and other emerging contexts. This paper examines Scrum methodology adopted by a large, globally distributed team which builds an open-source electronic medical records platform called OpenMRS. The research uses a mixed method approach, by doing quantitative analysis of source-code, issue tracker as well as community activity (IRC logs, Mailing lists, wiki) in pre and post Scrum adoption, covering a period of 4 years. Later we conducted semi-structured interviews with core developers and followed it up with group discussions to discuss the analysis of the quantitative data and get their views on our findings. Since the project is "domain heavy", contributors (developers and implementers) need to have certain health informatics understanding before making significant contributions. This puts knowledge-sharing and "bus factor" as critical points of management for the community. The paper presents ideas about a tailored Scrum methodology that might better suited for open-source communities to improve knowledge-sharing and community participation, instead of just agilityItem From Dyadic Ties to Information Infrastructures: Care-Coordination between Patients, Providers, Students and Researchers(Thieme, 2015-08-13) Purkayastha, Saptarshi; Price, A.; Biswas, R.; Jai Ganesh, A.U.; Otero, P.; BioHealth Informatics, School of Informatics and ComputingObjective: To share how an effectual merging of local and online networks in low resource regions can supplement and strengthen the local practice of patient centered care through the use of an online digital infrastructure powered by all stakeholders in healthcare. User Driven Health Care offers the dynamic integration of patient values and evidence based solutions for improved medical communication in medical care. Introduction: This paper conceptualizes patient care-coordination through the lens of engaged stakeholders using digital infrastructures tools to integrate information technology. We distinguish this lens from the prevalent conceptualization of dyadic ties between clinician-patient, patient-nurse, clinician-nurse, and offer the holistic integration of all stakeholder inputs, in the clinic and augmented by online communication in a multi-national setting. Methods: We analyze an instance of the user-driven health care (UDHC), a network of providers, patients, students and researchers working together to help manage patient care. The network currently focuses on patients from LMICs, but the provider network is global in reach. We describe UDHC and its opportunities and challenges in care-coordination to reduce costs, bring equity, and improve care quality and share evidence. Conclusion: UDHC has resulted in coordinated global based local care, affecting multiple facets of medical practice. Shared information resources between providers with disparate knowledge, results in better understanding by patients, unique and challenging cases for students, innovative community based research and discovery learning for all.Item Designing a drawing-based tool to manage EBRT process in an open-source oncology EMR system(AMIA Symposium 2015, 2015-11-14) Maheshwari, Manika; Purkayastha, SaptarshiThis paper describes the community-based participatory research to implement open source Oncology EMR for radiation practices. This tool facilitates better communication between Oncologist, Technician and Patient. The innovation is the use of a Drawing module embedded within the EMR system through which the Radiology technician can visualize medical images.Item Using cognitive fit theory to evaluate patient understanding of medical images(IEEE, 2017) Gichoya, Judy Wawira; Alarifi, Mohammad; Bhaduri, Ria; Tahir, Bilal; Purkayastha, Saptarshi; Radiology and Imaging Sciences, School of MedicinePatients are increasingly presented with their health data through patient portals in an attempt to engage patients in their own care. Due to the large amounts of data generated during a patient visit, the medical information when shared with patients can be overwhelming and cause anxiety due to lack of understanding. Health care organizations are attempting to improve transparency by providing patients with access to visit information. In this paper, we present our findings from a research study to evaluate patient understanding of medical images. We used cognitive fit theory to evaluate existing tools and images that are shared with patients and analyzed the relevance of such sharing. We discover that medical images need a lot of customization before they can be shared with patients. We suggest that new tools for medical imaging should be developed to fit the cognitive abilities of patients.