3P-U - Prédiction du Parcours Patients aux Urgences

Background: During the coronavirus disease 2019 (COVID-19) pandemic, calculation of the number of emergency department (ED) beds required for patients with vs. without suspected COVID-19 represented a real public health problem. In France, Amiens Picardy University Hospital (APUH) developed an Artificial Intelligence (AI) project called "Prediction of the Patient Pathway in the Emergency Department" (3P-U) to predict patient outcomes. Materials: Using the 3P-U model, we performed a prospective, single-center study of patients attending APUH's ED in 2020 and 2021. The objective was to determine the minimum and maximum numbers of beds required in real-time, according to the 3P-U model. Results A total of 105,457 patients were included. The area under the receiver operating characteristic curve (AUROC) for the 3P-U was 0.82 for all of the patients and 0.90 for the unambiguous cases. Specifically, 38,353 (36.4%) patients were flagged as "likely to be discharged", 18,815 (17.8%) were flagged as "likely to be admitted", and 48,297 (45.8%) patients could not be flagged. Based on the predicted minimum number of beds (for unambiguous cases only) and the maximum number of beds (all patients), the hospital management coordinated the conversion of wards into dedicated COVID-19 units. Discussion and conclusions: The 3P-U model's AUROC is in the middle of range reported in the literature for similar classifiers. By considering the range of required bed numbers, the waste of resources (e.g., time and beds) could be reduced. The study concludes that the application of AI could help considerably improve the management of hospital resources during global pandemics, such as COVID-19.

Overcrowding in Emergency Departments (ED) is considered as an international issue, which could have adverse impacts on multiple care outcomes such as the length of stay for example. Part of the solution could lie in the early prediction of the patient outcome as discharge or hospitalization. This study applies Deep Learning to this end. A large-scale dataset of about 260K ED records was provided by the Amiens-Picardy University Hospital in France. In general, our approach is based on integrating structured data with unstructured textual notes recorded at the triage stage. The key idea is to apply a multi-input of mixed data for training a classification model to predict hospitalization. In a simultaneous manner, the model training utilizes the numeric features along with textual data. On one hand, a standard Multi-Layer Perceptron (MLP) model is used with the standard set of features (i.e. numeric and categorical). On the other hand, a Convolutional Neural Network (CNN) is used to operate over the textual data. The two components of learning are conducted independently in parallel. The empirical results demonstrated that the classifier could achieve a very good accuracy with ROC-AUC≈0.83. The study is conceived to contribute to the mounting efforts of applying Natural Language Processing in the healthcare domain.

The implementation of Data Analytics has achieved a significant momentum across a very wide range of domains. Part of that progress is directly linked to the implementation of Text Analytics solutions. Organisations increasingly seek to harness the power of Text Analytics to automate the process of gleaning insights from unstructured textual data. In this respect, this study aims to provide a meeting point for discussing the state-of-the-art applications of Text Analytics in the healthcare domain in particular. It is aimed to explore how healthcare providers could make use of Text Analytics for different purposes and contexts. To this end, the study reviews key studies published over the past 6 years in two major digital libraries including IEEE Xplore, and ScienceDirect. In general, the study provides a selective review that spans a broad spectrum of applications and use cases in healthcare. Further aspects are also discussed, which could help reinforce the utilisation of Text Analytics in the healthcare arena.