scholarly journals Implementation of Artificial Intelligence-Based Clinical Decision Support to Reduce Hospital Readmissions at a Regional Hospital

2020 ◽  
Vol 11 (04) ◽  
pp. 570-577
Author(s):  
Santiago Romero-Brufau ◽  
Kirk D. Wyatt ◽  
Patricia Boyum ◽  
Mindy Mickelson ◽  
Matthew Moore ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Decision Support ◽  
High Risk ◽  
Clinical Decision Support ◽  
Readmission Rate ◽  
Hospital Readmissions ◽  
Clinical Decision ◽  
Regional Hospital ◽  
Patient Centered ◽  
Readmission Rates

Abstract Background Hospital readmissions are a key quality metric, which has been tied to reimbursement. One strategy to reduce readmissions is to direct resources to patients at the highest risk of readmission. This strategy necessitates a robust predictive model coupled with effective, patient-centered interventions. Objective The aim of this study was to reduce unplanned hospital readmissions through the use of artificial intelligence-based clinical decision support. Methods A commercially vended artificial intelligence tool was implemented at a regional hospital in La Crosse, Wisconsin between November 2018 and April 2019. The tool assessed all patients admitted to general care units for risk of readmission and generated recommendations for interventions intended to decrease readmission risk. Similar hospitals were used as controls. Change in readmission rate was assessed by comparing the 6-month intervention period to the same months of the previous calendar year in exposure and control hospitals. Results Among 2,460 hospitalizations assessed using the tool, 611 were designated by the tool as high risk. Sensitivity and specificity for risk assignment were 65% and 89%, respectively. Over 6 months following implementation, readmission rates decreased from 11.4% during the comparison period to 8.1% (p < 0.001). After accounting for the 0.5% decrease in readmission rates (from 9.3 to 8.8%) at control hospitals, the relative reduction in readmission rate was 25% (p < 0.001). Among patients designated as high risk, the number needed to treat to avoid one readmission was 11. Conclusion We observed a decrease in hospital readmission after implementing artificial intelligence-based clinical decision support. Our experience suggests that use of artificial intelligence to identify patients at the highest risk for readmission can reduce quality gaps when coupled with patient-centered interventions.

An artificial intelligence-based clinical decision support system for large kidney stone treatment

2019 ◽  
Vol 42 (3) ◽  
pp. 771-779 ◽  
Author(s):  
Tayyebe Shabaniyan ◽  
Hossein Parsaei ◽  
Alireza Aminsharifi ◽  
Mohammad Mehdi Movahedi ◽  
Amin Torabi Jahromi ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Decision Support ◽  
Decision Support System ◽  
Clinical Decision Support ◽  
Support System ◽  
Kidney Stone ◽  
Clinical Decision Support System ◽  
Clinical Decision ◽  
Stone Treatment

Developing Clinical Decision Support System for Sleep Staging Tasks by Formulating Explanations from Artificial Intelligence: User-Centered Design and Evaluation. (Preprint)

2021 ◽  
Author(s):  
Jeonghwan Hwang ◽  
Taeheon Lee ◽  
Honggu Lee ◽  
Seonjeong Byun
Keyword(s):  
Artificial Intelligence ◽  
Decision Support ◽  
Design Process ◽  
Clinical Decision Support ◽  
User Study ◽  
Clinical Decision ◽  
Sleep Staging ◽  
User Centered Design ◽  
Iterative Design ◽  
User Centered

BACKGROUND Despite the unprecedented performances of deep learning algorithms in clinical domains, full reviews of algorithmic predictions by human experts remain mandatory. Under these circumstances, artificial intelligence (AI) models are primarily designed as clinical decision support systems (CDSSs). However, from the perspective of clinical practitioners, the lack of clinical interpretability and user-centered interfaces block the adoption of these AI systems in practice. OBJECTIVE The aim of this study was to develop an AI-based CDSS for assisting polysomnographic technicians in reviewing AI-predicted sleep staging results. This study proposed and evaluated a CDSS that provides clinically sound explanations for AI predictions in a user-centered fashion. METHODS User needs for the system were identified during interviews with polysomnographic technicians. User observation sessions were conducted to understand the workflow of the practitioners during sleep scoring. Iterative design process was performed to ensure easy integration of the tool into clinical workflows. Then, we evaluated the system with polysomnographic technicians. We measured the improvements in sleep staging accuracies after adopting our tool and assessed qualitatively how the participants perceived and used the tool. RESULTS The user study revealed that technicians desire explanations relevant to key electroencephalogram (EEG) patterns for sleep staging when assessing the correctness of the AI predictions. Here, technicians could evaluate whether AI models properly locate and use those patterns during prediction. Based on this, information in AI models that is closely related to sleep EEG patterns was formulated and visualized during the iterative design process. Furthermore, we developed a different visualization strategy for each pattern based on the way the technicians interpreted the EEG recordings with these patterns during their workflows. Generally, the tool evaluation results from the nine polysomnographic technicians were positive. Quantitatively, technicians achieved better classification performances after reviewing the AI-generated predictions with the proposed system; classification accuracies measured with Macro-F1 scores improved from 60.20 to 62.71. Qualitatively, participants reported that the provided information from the tool effectively supported them, and they were able to develop notable adoption strategies for the tool. CONCLUSIONS Our findings indicate that formulating clinical explanations for automated predictions using the information in the AI with a user-centered design process is an effective strategy for developing a CDSS for sleep staging.

Clinical Decision Support in the Era of Artificial Intelligence

JAMA ◽  
2018 ◽  
Vol 320 (21) ◽  
pp. 2199 ◽  
Author(s):  
Edward H. Shortliffe ◽  
Martin J. Sepúlveda
Keyword(s):  
Artificial Intelligence ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Decision

scholarly journals A Method for Medical Data Analysis Using the LogNNet for Clinical Decision Support Systems and Edge Computing in Healthcare

Sensors ◽  
2021 ◽  
Vol 21 (18) ◽  
pp. 6209
Author(s):  
Andrei Velichko
Keyword(s):  
Neural Network ◽  
Artificial Intelligence ◽  
Decision Support ◽  
Data Analysis ◽  
Decision Support Systems ◽  
Clinical Decision Support ◽  
Classification Accuracy ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Medical Data

Edge computing is a fast-growing and much needed technology in healthcare. The problem of implementing artificial intelligence on edge devices is the complexity and high resource intensity of the most known neural network data analysis methods and algorithms. The difficulty of implementing these methods on low-power microcontrollers with small memory size calls for the development of new effective algorithms for neural networks. This study presents a new method for analyzing medical data based on the LogNNet neural network, which uses chaotic mappings to transform input information. The method effectively solves classification problems and calculates risk factors for the presence of a disease in a patient according to a set of medical health indicators. The efficiency of LogNNet in assessing perinatal risk is illustrated on cardiotocogram data obtained from the UC Irvine machine learning repository. The classification accuracy reaches ~91% with the~3–10 kB of RAM used on the Arduino microcontroller. Using the LogNNet network trained on a publicly available database of the Israeli Ministry of Health, a service concept for COVID-19 express testing is provided. A classification accuracy of ~95% is achieved, and~0.6 kB of RAM is used. In all examples, the model is tested using standard classification quality metrics: precision, recall, and F1-measure. The LogNNet architecture allows the implementation of artificial intelligence on medical peripherals of the Internet of Things with low RAM resources and can be used in clinical decision support systems.

The Role of Artificial Intelligence in Clinical Decision Support Systems and a Classification Framework

2020 ◽  
pp. 167-186
Author(s):  
Steven Walczak
Keyword(s):  
Artificial Intelligence ◽  
Decision Making ◽  
Decision Support ◽  
Decision Support Systems ◽  
Clinical Decision Support ◽  
Clinical Decision Making ◽  
Support Systems ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Classification Framework

Clinical decision support systems are meant to improve the quality of decision-making in healthcare. Artificial intelligence is the science of creating intelligent systems that solve complex problems at the level of or better than human experts. Combining artificial intelligence methods into clinical decision support will enable the utilization of large quantities of data to produce relevant decision-making information to practitioners. This article examines various artificial intelligence methodologies and shows how they may be incorporated into clinical decision-making systems. A framework for describing artificial intelligence applications in clinical decision support systems is presented.

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