Toward Production-Ready Federated Learning in Healthcare: Privacy, Orchestration, and Governance in MLOps

Healthcare organizations often cannot freely centralize patient data because medical records are sensitive, regulated, and institutionally controlled. Federated learning offers a practical alternative by allowing hospitals and clinics to train a shared model while keeping raw data local. However, federated learning is not automatically production-ready or private by default. Model updates can still leak information, and decentralized training introduces operational challenges in deployment, monitoring, rollback, debugging, and governance. This paper examines how MLOps practices and the emerging idea of Federated Learning Operations (FLOps) can make federated healthcare machine learning systems scalable, reliable, and trustworthy. It answers three research questions: how containerization and orchestration support federated deployment, how privacy-preserving mechanisms affect trade-offs among privacy, utility, scalability, and operational complexity, and which post-deployment practices are most important for long-term governance. The central argument is that federated healthcare ML requires more than privacy-preserving algorithms. It needs an integrated MLOps architecture that combines reproducible deployment, secure orchestration, model versioning, audit logging, drift monitoring, heterogeneity management, and clear governance.

How sensitive do we want AI to be? Socio-communicative competencies of large language models in healthcare

Background. Effective clinical practice relies heavily on the socio-communicative skills of medical professionals. Large language models (LLMs) have been proposed for tasks such as triaging patients, report drafting or translating medical jargon to support informed decision-making. These applications require both factual and social competence. This study evaluates dialogues between LLMs and participants to assess the current state of socio-communicative competencies displayed in LLM-generated texts. Methods. We extracted a subset of extended dialogues from the HELP-Med dataset, comprising 1800 conversation transcripts of interactions between human participants seeking medical information and three different LLMs, GPT 4o, Llama 3 and Command R+. Two experts coded the transcripts for demonstrations of socio-communicative behaviours (non-hostility, sensitivity, structuring, non-intrusiveness) using the IC-MD instrument, originally designed to evaluate interactional competencies in medical student admissions. Results. The LLMs in our study showed strength in non-hostility, mixed results in sensitivity and non-intrusiveness and performed poorly in structuring. Conclusion. Current LLMs lack the consistent and reliable socio-communicative skills needed for safe and effective use as healthcare advisors. While existing frameworks for assessing interactional competencies may support the development of more socially responsive LLMs, they will require adaptation to account for the differences in desirable behaviour between humans and LLMs.

PAMF: Prior-Aware Multimodal Fusion for Incomplete Time Series Data

In healthcare, multimodal time series tasks often operate on incomplete observations in practice, for example when ECG segments are lost because electrodes detach or an entire respiratory channel is unavailable during overnight monitoring. Such missingness typically appears in two structurally distinct patterns: within-modality missing, where values are absent within an otherwise observed modality, and modality-level missing, where an entire modality is unavailable. Existing methods typically represent unobserved data implicitly through masks or missing embeddings, without learning instance-specific missing information, and most are designed for only one missingness pattern. A natural approach is to explicitly estimate the missing data; however, existing imputation methods treat missingness uniformly despite their different structural priors, and the imputation process is often isolated from downstream tasks, preventing downstream tasks from guiding imputation toward more informative representations. To address these limitations, we present PAMF, a multimodal time-series framework that explicitly handles different missingness patterns while coupling imputation with downstream prediction through prior-aware flow matching and weight sharing. Specifically, the method initializes the flow-matching source state with type-specific priors to distinguish two missing types. It further connects imputation and classification through architecturally matched encoders with weight sharing, transferring task-relevant representations into the imputation process. Experiments on multiple multimodal healthcare time-series benchmarks show that the proposed method achieves the strongest overall downstream performance across diverse datasets and missing settings compared with existing baselines.