Understanding Challenges in Preserving and Reconstructing Computer-Assisted Medical Decision Processes

This paper addresses the problem of understanding preservation and reconstruction requirements for computer- aided medical decision-making. With an increasing number of computer-aided decisions having a large impact on our society, the motivation for our work is not only to document these decision processes semi-automatically but also to understand the preservation cost and related computational requirements. Our objective is to support computer-assisted creation of medical records, to guarantee authenticity of records, as well as to allow managers of electronic medical records (EMR), archivists and other users to explore and evaluate computational costs (e.g., storage and processing time) depending on several key characteristics of appraised records. Our approach to this problem is based on designing an exploratory simulation framework for investigating preservation tradeoffs and assisting in appraisals of electronic records. We have a prototype simulation framework called image provenance to learn (IP2Learn) to support computer-aided medical decisions based on visual image inspection. The current software enables to explore some of the tradeoffs related to (1) information granularity (category and level of detail), (2) representation of provenance information, (3) compression, (4) encryption, (5) watermarking and steganography, (6) information gathering mechanism, and (7) final medical report content (level of detail) and its format. We illustrate the novelty of IP2Learn by performing example studies and the results of tradeoff analyses for a specific image inspection task.