{"id":"https://openalex.org/W4415376621","doi":"https://doi.org/10.3389/fdgth.2025.1642750","title":"Valuing diagnostic AI: a structured reimbursement model for learning healthcare systems","display_name":"Valuing diagnostic AI: a structured reimbursement model for learning healthcare systems","publication_year":2025,"publication_date":"2025-10-21","ids":{"openalex":"https://openalex.org/W4415376621","doi":"https://doi.org/10.3389/fdgth.2025.1642750","pmid":"https://pubmed.ncbi.nlm.nih.gov/41195286"},"language":"en","primary_location":{"id":"doi:10.3389/fdgth.2025.1642750","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fdgth.2025.1642750","pdf_url":"https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2025.1642750/pdf","source":{"id":"https://openalex.org/S4210170686","display_name":"Frontiers in Digital Health","issn_l":"2673-253X","issn":["2673-253X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Digital Health","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2025.1642750/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5031585475","display_name":"Jan Kirchhoff","orcid":null},"institutions":[{"id":"https://openalex.org/I4210124377","display_name":"Neu-Ulm University of Applied Sciences","ror":"https://ror.org/03ggzay52","country_code":"DE","type":"education","lineage":["https://openalex.org/I4210124377"]}],"countries":["DE"],"is_corresponding":true,"raw_author_name":"Jan Kirchhoff","raw_affiliation_strings":["Institut DigiHealth, Hochschule Neu-Ulm, Neu-Ulm, Germany","medicalvalues GmbH, Karlsruhe, Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institut DigiHealth, Hochschule Neu-Ulm, Neu-Ulm, Germany","institution_ids":["https://openalex.org/I4210124377"]},{"raw_affiliation_string":"medicalvalues GmbH, Karlsruhe, Germany","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5087968655","display_name":"Christian Schieder","orcid":"https://orcid.org/0000-0002-3004-5037"},"institutions":[{"id":"https://openalex.org/I4210091978","display_name":"Ostbayerische Technische Hochschule Amberg-Weiden","ror":"https://ror.org/00gm0aw40","country_code":"DE","type":"education","lineage":["https://openalex.org/I4210091978"]},{"id":"https://openalex.org/I4210109620","display_name":"Klinikum Weiden","ror":"https://ror.org/02506kf89","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I4210109620"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Christian Schieder","raw_affiliation_strings":["Weiden Business School, OTH Amberg-Weiden, Weiden, Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Weiden Business School, OTH Amberg-Weiden, Weiden, Germany","institution_ids":["https://openalex.org/I4210109620","https://openalex.org/I4210091978"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5051937514","display_name":"Fabian Berns","orcid":"https://orcid.org/0000-0002-7033-3789"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Fabian Berns","raw_affiliation_strings":["medicalvalues GmbH, Karlsruhe, Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"medicalvalues GmbH, Karlsruhe, Germany","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5019200935","display_name":"Johannes Schobel","orcid":"https://orcid.org/0000-0002-6874-9478"},"institutions":[{"id":"https://openalex.org/I4210124377","display_name":"Neu-Ulm University of Applied Sciences","ror":"https://ror.org/03ggzay52","country_code":"DE","type":"education","lineage":["https://openalex.org/I4210124377"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Johannes Schobel","raw_affiliation_strings":["Institut DigiHealth, Hochschule Neu-Ulm, Neu-Ulm, Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Institut DigiHealth, Hochschule Neu-Ulm, Neu-Ulm, Germany","institution_ids":["https://openalex.org/I4210124377"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5031585475"],"corresponding_institution_ids":["https://openalex.org/I4210124377"],"apc_list":{"value":1900,"currency":"USD","value_usd":1900},"apc_paid":{"value":1900,"currency":"USD","value_usd":1900},"fwci":5.6939,"has_fulltext":true,"cited_by_count":2,"citation_normalized_percentile":{"value":0.96190049,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":98,"max":99},"biblio":{"volume":"7","issue":null,"first_page":"1642750","last_page":"1642750"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T13690","display_name":"Quality and Safety in Healthcare","score":0.9868000149726868,"subfield":{"id":"https://openalex.org/subfields/3607","display_name":"Medical Laboratory Technology"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T13690","display_name":"Quality and Safety in Healthcare","score":0.9868000149726868,"subfield":{"id":"https://openalex.org/subfields/3607","display_name":"Medical Laboratory Technology"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.9513000249862671,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.9390000104904175,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/reimbursement","display_name":"Reimbursement","score":0.9065999984741211},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.5724999904632568},{"id":"https://openalex.org/keywords/payment","display_name":"Payment","score":0.5460000038146973},{"id":"https://openalex.org/keywords/incentive","display_name":"Incentive","score":0.4918999969959259},{"id":"https://openalex.org/keywords/value-based-purchasing","display_name":"Value-Based Purchasing","score":0.48429998755455017},{"id":"https://openalex.org/keywords/documentation","display_name":"Documentation","score":0.4562999904155731},{"id":"https://openalex.org/keywords/corporate-governance","display_name":"Corporate governance","score":0.4375999867916107},{"id":"https://openalex.org/keywords/clinical-decision-support-system","display_name":"Clinical decision support system","score":0.39640000462532043},{"id":"https://openalex.org/keywords/variety","display_name":"Variety (cybernetics)","score":0.39070001244544983}],"concepts":[{"id":"https://openalex.org/C2779703844","wikidata":"https://www.wikidata.org/wiki/Q760125","display_name":"Reimbursement","level":3,"score":0.9065999984741211},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5724999904632568},{"id":"https://openalex.org/C145097563","wikidata":"https://www.wikidata.org/wiki/Q1148747","display_name":"Payment","level":2,"score":0.5460000038146973},{"id":"https://openalex.org/C29122968","wikidata":"https://www.wikidata.org/wiki/Q1414816","display_name":"Incentive","level":2,"score":0.4918999969959259},{"id":"https://openalex.org/C2908924136","wikidata":"https://www.wikidata.org/wiki/Q7156607","display_name":"Value-Based Purchasing","level":3,"score":0.48429998755455017},{"id":"https://openalex.org/C56666940","wikidata":"https://www.wikidata.org/wiki/Q788790","display_name":"Documentation","level":2,"score":0.4562999904155731},{"id":"https://openalex.org/C39389867","wikidata":"https://www.wikidata.org/wiki/Q380767","display_name":"Corporate governance","level":2,"score":0.4375999867916107},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.4244000017642975},{"id":"https://openalex.org/C63527458","wikidata":"https://www.wikidata.org/wiki/Q5133829","display_name":"Clinical decision support system","level":3,"score":0.39640000462532043},{"id":"https://openalex.org/C136197465","wikidata":"https://www.wikidata.org/wiki/Q1729295","display_name":"Variety (cybernetics)","level":2,"score":0.39070001244544983},{"id":"https://openalex.org/C2776983043","wikidata":"https://www.wikidata.org/wiki/Q986008","display_name":"Payment system","level":3,"score":0.3804999887943268},{"id":"https://openalex.org/C112930515","wikidata":"https://www.wikidata.org/wiki/Q4389547","display_name":"Risk analysis (engineering)","level":1,"score":0.3691999912261963},{"id":"https://openalex.org/C107327155","wikidata":"https://www.wikidata.org/wiki/Q330268","display_name":"Decision support system","level":2,"score":0.3305000066757202},{"id":"https://openalex.org/C2776007630","wikidata":"https://www.wikidata.org/wiki/Q2798912","display_name":"Accountability","level":2,"score":0.329800009727478},{"id":"https://openalex.org/C188198153","wikidata":"https://www.wikidata.org/wiki/Q1613840","display_name":"Limiting","level":2,"score":0.321399986743927},{"id":"https://openalex.org/C524218345","wikidata":"https://www.wikidata.org/wiki/Q31218","display_name":"Health economics","level":3,"score":0.32019999623298645},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3197999894618988},{"id":"https://openalex.org/C2988170871","wikidata":"https://www.wikidata.org/wiki/Q11000047","display_name":"Healthcare system","level":3,"score":0.3131999969482422},{"id":"https://openalex.org/C195094911","wikidata":"https://www.wikidata.org/wiki/Q14167904","display_name":"Process management","level":1,"score":0.3070000112056732},{"id":"https://openalex.org/C47344431","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Health policy","level":3,"score":0.3012999892234802},{"id":"https://openalex.org/C2776291640","wikidata":"https://www.wikidata.org/wiki/Q2912517","display_name":"Value (mathematics)","level":2,"score":0.3009999990463257},{"id":"https://openalex.org/C162118730","wikidata":"https://www.wikidata.org/wiki/Q1128453","display_name":"Actuarial science","level":1,"score":0.2957000136375427},{"id":"https://openalex.org/C56739046","wikidata":"https://www.wikidata.org/wiki/Q192060","display_name":"Knowledge management","level":1,"score":0.29339998960494995},{"id":"https://openalex.org/C184356942","wikidata":"https://www.wikidata.org/wiki/Q830382","display_name":"Best practice","level":2,"score":0.2784000039100647},{"id":"https://openalex.org/C137992405","wikidata":"https://www.wikidata.org/wiki/Q1137608","display_name":"Health administration","level":3,"score":0.267300009727478},{"id":"https://openalex.org/C3019080777","wikidata":"https://www.wikidata.org/wiki/Q1754768","display_name":"Cost effectiveness","level":2,"score":0.267300009727478},{"id":"https://openalex.org/C2775924081","wikidata":"https://www.wikidata.org/wiki/Q55608371","display_name":"Control (management)","level":2,"score":0.266400009393692},{"id":"https://openalex.org/C68991459","wikidata":"https://www.wikidata.org/wiki/Q11700776","display_name":"Value proposition","level":2,"score":0.26579999923706055},{"id":"https://openalex.org/C109359841","wikidata":"https://www.wikidata.org/wiki/Q728944","display_name":"Inclusion (mineral)","level":2,"score":0.26190000772476196},{"id":"https://openalex.org/C2776204158","wikidata":"https://www.wikidata.org/wiki/Q7156607","display_name":"Pay for performance","level":3,"score":0.2531999945640564}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.3389/fdgth.2025.1642750","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fdgth.2025.1642750","pdf_url":"https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2025.1642750/pdf","source":{"id":"https://openalex.org/S4210170686","display_name":"Frontiers in Digital Health","issn_l":"2673-253X","issn":["2673-253X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Digital Health","raw_type":"journal-article"},{"id":"pmid:41195286","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41195286","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in digital health","raw_type":null},{"id":"pmh:oai:doaj.org/article:a7559c6fe41045d290b34f7a9c2f068e","is_oa":true,"landing_page_url":"https://doaj.org/article/a7559c6fe41045d290b34f7a9c2f068e","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Digital Health, Vol 7 (2025)","raw_type":"article"},{"id":"pmh:oai:europepmc.org:11393175","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12584051","pdf_url":null,"source":{"id":"https://openalex.org/S4306400806","display_name":"Europe PMC (PubMed Central)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1303153112","host_organization_name":"European Bioinformatics Institute","host_organization_lineage":["https://openalex.org/I1303153112"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Text"}],"best_oa_location":{"id":"doi:10.3389/fdgth.2025.1642750","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fdgth.2025.1642750","pdf_url":"https://www.frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2025.1642750/pdf","source":{"id":"https://openalex.org/S4210170686","display_name":"Frontiers in Digital Health","issn_l":"2673-253X","issn":["2673-253X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Digital Health","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4415376621.pdf","grobid_xml":"https://content.openalex.org/works/W4415376621.grobid-xml"},"referenced_works_count":9,"referenced_works":["https://openalex.org/W2808876959","https://openalex.org/W4280516220","https://openalex.org/W4281706229","https://openalex.org/W4320892149","https://openalex.org/W4389000729","https://openalex.org/W4400733940","https://openalex.org/W4403420201","https://openalex.org/W4407960574","https://openalex.org/W4410831061"],"related_works":[],"abstract_inverted_index":{"AI-based":[0],"diagnostic":[1,180],"decision":[2,54],"support":[3,156,225],"systems":[4,65,99,171],"(DDSS)":[5],"play":[6],"a":[7,107,148,204,240,247,269],"growing":[8],"role":[9],"in":[10,17,24,38,49,142,228,260],"modern":[11],"healthcare":[12,21,230,271],"and":[13,28,43,56,70,103,120,127,137,168,182,197,257,279],"hold":[14],"considerable":[15],"promise":[16],"contributing":[18],"to":[19,68,92,100,155,211,265],"learning":[20,104,229,270],"systems,":[22,164],"settings":[23],"which":[25,208],"clinical":[26,62,101,200],"practice":[27],"data-driven":[29],"insights":[30],"are":[31,35,90],"closely":[32],"integrated.":[33],"DDSSs":[34],"increasingly":[36],"used":[37],"radiology,":[39],"cardiology,":[40],"laboratory":[41],"diagnostics":[42,136],"pathology,":[44],"where":[45],"they":[46],"assist":[47],"clinicians":[48],"interpreting":[50],"complex":[51],"data,":[52],"standardized":[53],"making,":[55],"improving":[57],"outcomes.":[58],"However,":[59],"despite":[60],"their":[61,117,138],"relevance,":[63],"such":[64,81],"remain":[66],"difficult":[67],"evaluate":[69],"integrate":[71],"within":[72],"current":[73],"reimbursement":[74,114,144,151,177],"structures.":[75],"Traditional":[76],"key":[77],"performance":[78],"indicators":[79],"(KPIs),":[80],"as":[82,172,246],"case":[83],"costs,":[84],"turnaround":[85],"times,":[86],"or":[87],"documentation":[88],"completeness,":[89],"insufficient":[91],"capture":[93],"the":[94,125,131,157,166,188,216,235,266],"nuanced":[95],"contributions":[96],"of":[97,134,140,159,184,268,282],"AI":[98,261],"value":[102,133],"cycles.":[105],"As":[106],"result,":[108],"DDSS":[109,160],"often":[110],"operate":[111],"outside":[112],"established":[113],"logics,":[115],"limiting":[116],"broader":[118],"adoption":[119],"sustainability.":[121],"This":[122],"article":[123],"addresses":[124],"economic":[126,252],"regulatory":[128],"disconnect":[129],"between":[130],"measurable":[132],"AI-assisted":[135],"lack":[139],"inclusion":[141],"existing":[143,212],"frameworks.":[145],"It":[146,263],"introduces":[147],"structured,":[149],"point-based":[150],"model":[152,217],"specifically":[153],"designed":[154],"integration":[158],"into":[161],"real-world":[162],"payment":[163,227],"using":[165],"German":[167],"American":[169],"coding":[170],"reference":[173],"models.":[174],"By":[175],"linking":[176],"levels":[178],"with":[179,254],"complexity":[181],"degree":[183],"contribution":[185],"from":[186],"AI,":[187],"proposed":[189],"framework":[190,236],"promotes":[191],"fair":[192],"compensation,":[193],"encourages":[194],"meaningful":[195],"use,":[196],"supports":[198],"responsible":[199],"deployment.":[201],"We":[202],"document":[203],"multi-criteria":[205],"point":[206],"calibration":[207],"is":[209,237],"anchored":[210],"codes.":[213],"In":[214,232],"addition,":[215],"fosters":[218],"an":[219],"auditable":[220],"feedback-driven":[221],"structure":[222],"that":[223,250],"could":[224],"adaptive":[226],"systems.":[231],"this":[233],"way,":[234],"not":[238],"merely":[239],"pricing":[241],"tool;":[242],"it":[243],"also":[244],"serves":[245],"governance":[248],"mechanism":[249],"aligns":[251],"incentives":[253],"ethical,":[255],"clinical,":[256],"operational":[258],"priorities":[259],"adoption.":[262],"contributes":[264],"realization":[267],"system":[272],"by":[273],"enabling":[274],"continuous":[275],"refinement,":[276],"transparent":[277],"valuation,":[278],"sustainable":[280],"implementation":[281],"AI-driven":[283],"diagnostics.":[284]},"counts_by_year":[{"year":2026,"cited_by_count":2}],"updated_date":"2026-05-21T06:26:12.895304","created_date":"2025-10-21T00:00:00"}
