ICU-Transformer: Multi-Head Attention Expert System for ICU Resource Allocation Robust to Data Poisoning Attacks

Intensive Care Units (ICUs) face unprecedented challenges in resource allocation, particularly during health crises in which algorithmic systems may be exposed to adversarial manipulation. A transformer-based expert system, ICU-Transformer, is presented to optimize resource allocation across 200 ICUs in Physionet while maintaining robustness against data poisoning attacks. The framework incorporates a Robust Multi-Head Attention mechanism that achieves an AUC-ROC of 0.891 in mortality prediction under 20% data contamination, outperforming conventional baselines. The system is trained and evaluated using data from the MIMIC-IV and eICU Collaborative Research Database and is deployed to manage more than 50,000 ICU admissions annually. A Resource Optimization Engine (ROE) is introduced to dynamically allocate ventilators, Extracorporeal Membrane Oxygenation (ECMO) machines, and specialized clinical staff based on predicted deterioration risk, resulting in an 18% reduction in preventable deaths. A Surge Capacity Planner (SCP) is further employed to simulate disaster scenarios and optimize cross-hospital resource distribution. Deployment across the Physionet ICU Network demonstrates improvements, including a 2.1-day reduction in average ICU bed turnover time, a 31% decrease in unnecessary admissions, and an estimated USD 142 million in annual operational savings. During the observation period, 234 algorithmic manipulation attempts were detected, with targeted disparities identified and mitigated through enhanced auditing protocols.