Integrating Artificial Intelligence, Electronic Health Records, and Wearables for Predictive, Patient-Centered Decision Support in Healthcare

This study explores how patients and stakeholders envision integrated digital health systems. BACKGROUND/OBJECTIVES: Integrating artificial intelligence (AI), wearable data, electronic health records (EHRs), and patient-reported outcomes could enable proactive and personalized healthcare. However, current solutions remain fragmented and poorly aligned with user expectations. This study aimed to explore patient and stakeholder needs for AI-driven integration and propose a conceptual framework to inform future system design. METHODS: As part of the NSF Innovation Corps (I-Corps) program, we conducted semi-structured interviews with 44 participants representing Health Enthusiasts, Chronic Condition Managers, and Low-Engagement Users. Interviews followed the I-Corps customer discovery framework and were thematically analyzed using a hybrid deductive-inductive approach. RESULTS: Participants highlighted four priorities: (i) interoperability and unification of data from wearables, EHRs, and self-reports; (ii) actionable personalization with predictive insights; (iii) trust and transparency in AI recommendations, often requiring clinician oversight; and (iv) usability through low-friction, intuitive interfaces. Age- and persona-specific differences emerged: younger participants favoring predictive features and older participants emphasizing safety, reassurance, and clinical integration. CONCLUSIONS: This exploratory qualitative study identified stakeholder needs that informed a conceptual framework for integrated digital health platforms. While preliminary, the framework provides a blueprint for future technical development and validation of patient- and provider-centered systems.