EcoFair: Trustworthy and Energy-Aware Routing for Privacy-Preserving Vertically Partitioned Medical Inference

Privacy-preserving medical inference must balance data locality, diagnostic reliability, and deployment efficiency. This paper presents EcoFair, a simulated vertically partitioned inference framework for dermatological diagnosis in which raw image and tabular data remain local and only modality-specific embeddings are transmitted for server-side multimodal fusion. EcoFair introduces a lightweight-first routing mechanism that selectively activates a heavier image encoder when local uncertainty or metadata-derived clinical risk indicates that additional computation is warranted. The routing decision combines predictive uncertainty, a safe--danger probability gap, and a tabular neurosymbolic risk score derived from patient age and lesion localisation. Experiments on three dermatology benchmarks show that EcoFair can substantially reduce edge-side inference energy in representative model pairings while remaining competitive in classification performance. The results further indicate that selective routing can improve subgroup-sensitive malignant-case behaviour in representative settings without modifying the global training objective. These findings position EcoFair as a practical framework for privacy-preserving and energy-aware medical inference under edge deployment constraints.

Evaluating a Multi-Agent Voice-Enabled Smart Speaker for Care Homes: A Safety-Focused Framework

Artificial intelligence (AI) is increasingly being explored in health and social care to reduce administrative workload and allow staff to spend more time on patient care. This paper evaluates a voice-enabled Care Home Smart Speaker designed to support everyday activities in residential care homes, including spoken access to resident records, reminders, and scheduling tasks. A safety-focused evaluation framework is presented that examines the system end-to-end, combining Whisper-based speech recognition with retrieval-augmented generation (RAG) approaches (hybrid, sparse, and dense). Using supervised care-home trials and controlled testing, we evaluated 330 spoken transcripts across 11 care categories, including 184 reminder-containing interactions. These evaluations focus on (i) correct identification of residents and care categories, (ii) reminder recognition and extraction, and (iii) end-to-end scheduling correctness under uncertainty (including safe deferral/clarification). Given the safety-critical nature of care homes, particular attention is also paid to reliability in noisy environments and across diverse accents, supported by confidence scoring, clarification prompts, and human-in-the-loop oversight. In the best-performing configuration (GPT-5.2), resident ID and care category matching reached 100% (95% CI: 98.86-100), while reminder recognition reached 89.09\% (95% CI: 83.81-92.80) with zero missed reminders (100% recall) but some false positives. End-to-end scheduling via calendar integration achieved 84.65% exact reminder-count agreement (95% CI: 78.00-89.56), indicating remaining edge cases in converting informal spoken instructions into actionable events. The findings suggest that voice-enabled systems, when carefully evaluated and appropriately safeguarded, can support accurate documentation, effective task management, and trustworthy use of AI in care home settings.