Holistic health care (HHC) is a synonym for complete patient care, and as such an efficient clinical decision support system (CDSS) for HHC is critical to support the judgement of physician’s decision in response of patient’s physical, emotional, social, economic, and spiritual needs. The field of artificial intelligence (AI) has evolved considerably in the past decades and many AI applications have been deployed in various contexts. Therefore, this study aims to propose an AI-assisted CDSS model that predicts patients in need of HHC and applies an improved recurrent neural network (RNN) model, long short-term memory (LSTM) for the prediction. The data sources include in-patient’s comorbidity status and daily vital sign attributes such as blood pressure, heart rate, oxygen prescription, etc. A two-year dataset consisting of 121 thousand anonymized patient cases with 890 thousand physiological medical records was obtained from a medical center in Taiwan for system evaluation. Comparing with the rule-based expert system, the proposed AI-assisted CDSS improves sensitivity from 26.44% to 80.84% and specificity from 99.23% to 99.95%. The experimental results demonstrate that an AI-assisted CDSS could efficiently predict HHC patients.

The trend towards personalized healthcare has led to an increase in applying deep learning techniques to improve healthcare service quality and sustainability. With the increasing number of patients with multiple comorbidities, they need comprehensive care services, where comprehensive care is a synonym for complete patient care to respond to a patient’s physical, emotional, social, economic, and spiritual needs, and, as such, an efficient prediction system for comprehensive care suggestions could help physicians and healthcare providers in making clinical judgement. The experiment dataset contained a total of 2.9 million electrical medical records (EMRs) from 250 thousand hospitalized patients collected retrospectively from a first-tier medical center in Taiwan, where the EMRs were de-identified and anonymized and where 949 cases had received comprehensive care. Recurrent neural networks (RNNs) are designed for analyzing time-series data but are still lacking in studying predicting personalized healthcare. Furthermore, in most cases, the collected evaluation data are imbalanced with a small portion of positive cases. This study examined the impact of imbalanced data in model training and suggested an effective approach to handle such a situation. To address the above-mentioned research issue, this study analyzed the care need in the different patient groupings, proposed a personalized care suggestion system by applying RNN models, and developed an efficient model training scheme for building AI-assisted prediction models. This study observed several findings: (1) the data resampling schemes could mitigate the impact of imbalanced data on model training, and the under-sampling scheme achieved the best performance with an ACC of 99.80%, a PPV of 70.18%, an NPV of 99.87%, a recall of 82.91%, and an F1 score of 0.7602, while the model trained with the original data had a very low PPV of 6.42% and a low F1 score of 0.1116; (2) patient clustering with multi-classier could predict comprehensive care needs efficiently with an ACC of 99.87%, a PPV of 77.90%, an NPV of 99.90%, a recall of 92.19%, and an F1 score of 0.8404; (3) the proposed long short-term memory (LSTM) prediction model achieved the best overall performance with an ACC of 99.80%, a PPV of 70.18%, an NPV of 99.87%, a recall of 82.91%, and an F1 score of 0.7602.

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