Maturity Framework for Operationalizing Machine Learning Applications in Health Care: Scoping Review

Abstract

Background: The exponential growth of publications regarding the application of machine learning (ML) tools in medicine highlights the significant potential for ML to revolutionize the field. Despite the multitude of literature surrounding this topic, there are limited publications addressing the implementation and feasibility of ML models in clinical practice. Currently, Machine Learning Operations (MLOps), a set of practices designed to deploy and maintain ML models in production, is used in various information technology and industrial settings. However, the MLOps pipeline is not well researched in medical settings, where multiple barriers exist to implementing ML pipelines into practice. Objective: This study aims to detail how MLOps is implemented in health care and propose a maturity framework for the health care implementations. Methods: A scoping review search was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis. Results were synthesized using the 3-stage basic qualitative content analysis. We searched 4 databases (eg, MEDLINE, Embase, Web of Science, and Scopus) to include any studies that involved proof of concept or real-world implementation of MLOps in health care. Studies not reported in English were excluded. Results: A total of 19 studies were included in this scoping review. The MLOps workflow identified within the studies included (1) data extraction (19/19 studies), (2) data preparation and engineering (18/19 studies), (3) model training (19/19 studies), (4) measured ML metrics and model evaluation (17/19 studies), (5) model validation and test in production (14/19 studies), (6) model serving and deployment (15/19 studies), (7) continuous monitoring (14/19 studies), and (8) continual learning (13/19 studies). We proposed a 3-stage MLOps maturity framework for health care based on existing studies in the field, that is, low (5/19 studies), partial (1/19 studies), and full maturity (13/19 studies). There were 8/19 studies that discussed ethical, legislative, and stakeholder considerations for MLOps implementations in health care settings. Conclusions: We investigated the implementation of MLOps in health care with a corresponding maturity framework. It is evident that only a limited number of studies reported the implementation of ML in health care contexts. Hence, it is imperative that we shift our focus toward creating an environment that supports the development of ML health care applications, such as improving existing data infrastructure, and engaging partners to support the development of MLOps applications. Specifically, we can include patients, policymakers, and health care professionals in the creation and implementation of ML applications. One of the main limitations includes the varying quality of each extracted study in terms of how the MLOps implementation was presented. Hence, it was difficult to verify the presence and discuss in depth all steps of the MLOps workflow for each study. Furthermore, due to the inherent nature of a scoping review protocol, there may be a compromise on an in-depth discussion of each step within the MLOps workflow.

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