Healthcare Service Managers and Administrators Using AI to Determine Patients Access to Clinical Treatment Name of the University Author Note Abstract How managers use AI to Determine patients access

Running head: AI TO DETERMINE PATIENTS ACCESS TO CLINICAL TREATMENT
How managers use AI to Determine Patients Access to Clinical Treatment
Name of the Student
Name of the University
Author note

1AI TO DETERMINE PATIENTS ACCESS TO CLINICAL TREATMENT
Abstract
Healthcare service managers or administrators have to deal with the healthcare laws,
technology, medical interventions, facilities, patient database and clinical workforce
simultaneously. This type of work needs intense concentration and mental strength. With a
larger number of consumers, the work pressure also increases due to the expanding database
and internal cardinality as well as complexity. In this situation, an enhanced data processing
and decision making system could ease the process of healthcare decision making for a
healthcare administrator or medical service manager. The purpose of this project is to explore
the possibilities of utilising AI to aid the management decision process for determination of
patient’s access to clinical treatment. The aims of this research were exploring the current
advancement of the AI and fining its appropriate implementation in healthcare industry for
decision making process.
The project is aimed to collect information of advancement of AI from 3 AI system
developers and programmers. At the same time, the information regarding current needs in
healthcare management operation will be collected from 3 professional clinical managers,
healthcare service managers and administrators. The semi-structured interview based data
collection will be used to collect the in depth information is a structured manner. Therefore,
in this research, qualitative data analysis procedure has been used to analyse the information
collected from interviews.
It has been found from the data collection process that Artificial Intelligence (AI)
incorporation into acute care carries to the bedside a fresh origin of mental idea. The major
advantage of using AI system according to the results AII can reduce the unnecessary
investment of time, workforce and procedures. As recommendation, it has been found that in

2AI TO DETERMINE PATIENTS ACCESS TO CLINICAL TREATMENT
order to adopt the new technology the infrastructure of the healthcare system should be
changed while providing adequate training to the employees.

3AI TO DETERMINE PATIENTS ACCESS TO CLINICAL TREATMENT
Table of Content
Chapter 1: Introduction..............................................................................................................5
1.1 Background......................................................................................................................5
1.2 Problem Statement...........................................................................................................6
1.3 Research Questions..........................................................................................................7
1.4 Aims and Objectives........................................................................................................7
1.5 Significance of this research............................................................................................9
Chapter 2: Literature Review...................................................................................................10
2.1 Introduction....................................................................................................................10
2.2 Implementation of AI in healthcare informatics............................................................11
2.3 Decision making in healthcare.......................................................................................13
2.4 Role of gatekeepers........................................................................................................15
2.5 AI in healthcare decision making...................................................................................16
2.6 Barriers in adaptation process........................................................................................18
2.7 Summary........................................................................................................................20
2.8 Literature gap.................................................................................................................21
Chapter 3: methodology...........................................................................................................21
3.1 Introduction....................................................................................................................21
3.2 Research Design.............................................................................................................22
3.3 Data collection...............................................................................................................22
3.4 Data analysis..................................................................................................................24
3.5 Ethical Consideration.....................................................................................................24

4AI TO DETERMINE PATIENTS ACCESS TO CLINICAL TREATMENT
3.6 Summary........................................................................................................................25
Chapter 4: Data analysis and findings......................................................................................25
4.1 Introduction:...................................................................................................................25
4.2 Grounded theory Map....................................................................................................26
4.3 Code frequency..............................................................................................................37
4.4 Discussion......................................................................................................................38
4.4 Summary........................................................................................................................40
Chapter 5: Conclusion..............................................................................................................41
5.1 Summary........................................................................................................................41
5.2 Linking with Objectives.................................................................................................42
5.3 Conclusion......................................................................................................................43
5.4 Recommendations..........................................................................................................45
References:...............................................................................................................................47
Appendices...............................................................................................................................50
Appendix 1:..........................................................................................................................50

5AI TO DETERMINE PATIENTS ACCESS TO CLINICAL TREATMENT
Chapter 1: Introduction
1.1 Background
Healthcare seems to be a universe of rational and evidence-based medicine choices.
Rarely accessible, adequate or applicable in terms of natural requirements, scientific evidence
does not tackle objectives when funds are more than ever inadequate worldwide to an
increasingly voracious scheme. Medical and health service managers or health administrators
are the personnel who plan, direct and coordinate medical and health services by managing
different clinical areas, medical practices and medical practitioners (McGivern et al. 2015).
Healthcare service managers or administrators have to deal with the healthcare laws,
technology, medical interventions, facilities, patient database and clinical workforce
simultaneously (Spehar, Frich and Kjekshus 2012).
Clearly, the working procedure of a clinical manager is very complicated and time
consuming. AI is already being used to predict, model and slow the spread of disease in
epidemic situations around the world, including in resource-poor settings. At the same time,
with the advancement of linear programming to neural network based programming and
genetic algorithms have made the Automated Software application more efficient, versatile,
robust and powerful (Ghahramani 2015). With the advancement and cumulated
implementation of these techniques the artificial intelligence has been increasing its utility
since past 10 years. Healthcare seems to be a universe of rational and evidence-based
medicine choices. Rarely accessible, adequate or applicable in terms of natural requirements,
scientific evidence does not tackle objectives when funds are more than ever inadequate
worldwide to an increasingly voracious scheme. Literature indicates that proof is not
adequate to affect the decision-making method while a broad variety of "participants"
compete. A gatekeeper function for secondary health care has been allocated to physicians in

6AI TO DETERMINE PATIENTS ACCESS TO CLINICAL TREATMENT
several nations. For several factors, many ethicists reject this task, focusing on the damage
that would be inflicted on doctor-patient interactions by intrusion of social statements. Over
the past few years, more and more focus has been paid to normative problems around the
position of gatekeeper. From complex database management, problem solving to
procedurally generated simulation AI has increased its implementation in various part of
human civilisation while having a huge potentiality of further advancement as well (Jiang et
al. 2017).
1.2 Problem Statement
A medical service manager or administrator has to deal with multiple dataset in a
stipulated time while having the responsibility of taking several cost effective and beneficial
decisions. This type of work needs intense concentration and mental strength. With a larger
number of consumers, the work pressure also increases due to the expanding database and
internal cardinality as well as complexity. It includes the patient’s pathophysiological details,
previous reports, existing insurance, and current available facilitation. In this situation,
finding most appropriate treatment guidance or managing the most profitable insurance
becomes very difficult and often causes wrong decision making. At the same time, the
workload fluctuates very much. A wrong decision yields unnecessary expenses for both
consumers as well as healthcare service providers. In this situation, an enhanced data
processing and decision making system could ease the process of healthcare decision making
for a healthcare administrator or medical service manager. However, there are other
arguments as well that states that, it can cause more delay of process time to deliver a correct
healthcare plan. At the same time, there are few articles available on this topic, where most of
the papers are based on secondary study. Hence, a primary study can help to perceive the
situation and potential implication at further level.

7AI TO DETERMINE PATIENTS ACCESS TO CLINICAL TREATMENT
1.3 Research Questions
From the above problem statement, it can be clearly seen that there are several
components that are still unknown and that can help to gauge the potential benefit of using AI
aided decision making process. The exploration of current AI advancement is very essential
in this situation to understand the potential implementation of it. At the same time,
understanding the purpose and procedure of healthcare decision making process is also
important to predict the range of work that AI needs to deliver. On the other hand, the space
of practical implication is not explored properly. Besides, the healthcare organisations should
adopt certain strategy and techniques to adopt this technology as their regular operational
tool. Therefore, currently the questions of this research are:
 How much advancement AI has made to be implemented in decision making process?
 What are the fields of operation in healthcare management decision making process
that needs technological support?
 How can AI system be implemented advanced in healthcare management decision
making?
 What are the strategies required to adopt the AI aided decision making process by
healthcare industry?
1.4 Aims and Objectives
From the above points it can be interpreted that the advancement of AI can be also
utilised to simplify the complex operations of Medical and health service managers or health
administrators in many ways. The purpose of this project is to explore the possibilities of
utilising AI to aid the management decision process for determination of patient’s access to
clinical treatment. Hence, the objectives of this project are: