Optimized Tiny Machine Learning and Explainable AI for Trustable and Energy-Efficient Fog-Enabled Healthcare Decision Support System

The Internet of things (IoT)-based healthcare decision support system plays a crucial role in modern medicine, especially with the rise in chronic illnesses and an aging population necessitating continuous remote health monitoring. Current healthcare decision support systems struggle to deliver timely and accurate decisions with minimal latency due to limited real-time healthcare data and inefficient computational resources. There is a critical need for an optimized, energy-efficient machine learning model that reliably supports remote health monitoring within IoT and fog computing environments. Our study proposes an Optimized Tiny Machine Learning (TinyML) and Explainable AI (XAI) binary classification model for a trustable and energy-efficient healthcare decision support system, leveraging fog computing to optimize performance. The fog-based approach improves response times and enhances bandwidth usage, addressing critical needs such as reduced latency, higher bandwidth utilization, and decreased packet loss. To further improve efficiency, we incorporate the innovative mLZW data compression technique, significantly enhancing data communication efficiency and reducing response time to critical health alerts. However, limited real-time healthcare data records challenge machine learning classification performance. By implementing a TinyML algorithm, our system demonstrates superior performance to other machine learning models. The proposed optimized TinyML model achieves an impressive F1 score of 0.93 for health abnormalities detection, emphasizing its robustness and effectiveness. This paper highlights the potential of TinyML and XAI in delivering robust, trustworthy, and energy-aware healthcare solutions, making significant contributions toward effective remote health monitoring and decision support in fog-enabled IoT networks.