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Machine Learning for Prediction of Postoperative Surgical Site Infection, Venous Thromboembolism, and Respiratory Failure: A Systematic Review of Model Performance, External Validation, and Clinical Deployment
Postoperative complications including SSI (2–20%), VTE (1–5%), and respiratory failure (1–8%) significantly increase morbidity, mortality, length of stay, and readmissions. This systematic review assessed machine learning models predicting these outcomes, their performance, external validation, and clinical deployment. A PRISMA-based search (2017–2024) identified 32 eligible studies. Models such as random forest and XGBoost showed AUROC ranges of 0.70–0.85 for SSI, 0.75–0.90 for VTE (outperforming Caprini scores), and 0.75–0.88 for respiratory failure. However, fewer than 20% of studies included external validation and less than 5% reported clinical deployment. Overall, while machine learning models show strong retrospective performance, limited validation and minimal real-world implementation remain major barriers to clinical translation.
Journal of Artificial Intelligence for Healthcare Systems
Review | Open access | 20 January 2025 | Article: 98

Machine Learning for Suicidality and Depression Risk Prediction: A Systematic Review of Electronic Health Records, Social Media, and Wearable Sensors
Suicidality and depression are major global health burdens, with over 700,000 suicide deaths annually and ~280 million people affected by major depressive disorder. Early risk prediction could support prevention, but traditional methods show limited accuracy. This PRISMA-compliant systematic review evaluated machine learning models for predicting suicidality and depression across electronic health records, social media, and wearable sensor data, focusing on performance, unimodal vs multimodal approaches, and ethical reporting. Searches of PubMed, PsycINFO, IEEE Xplore, arXiv, and ACM Digital Library identified eligible studies. EHR-based models showed AUROC 0.70–0.85 for suicide attempt prediction, social media models 0.70–0.80 for suicidal ideation, and wearable sensor models lower performance (0.65–0.75). Multimodal approaches improved performance by 5–10% over unimodal models. However, fewer than 20% of studies reported ethical considerations such as privacy, bias, or deployment safeguards. Overall, machine learning shows moderate-to-good predictive performance, with multimodal models performing best, but ethical reporting remains critically insufficient for clinical translation.
Journal of Artificial Intelligence for Healthcare Systems
Review | Open access | 20 January 2025 | Article: 99

Supervised Machine Learning Model for Predicting Medication Administration Delays in General Medical Wards Using Electronic Medication Administration Records, Pharmacy Dispensing Timestamps, Nurse-to-Patient Ratios, and Shift-Level Workload Indicators
Medication administration delays are a persistent patient safety and workflow problem in general medical wards. They arise from interacting pressures across nursing workload, pharmacy processes, medication availability, and patient acuity. Current approaches often rely on retrospective incident review, audit reports, or rule-based thresholds after a delay has already occurred. These methods do not provide timely support for proactive workload redistribution or pharmacy escalation. This manuscript proposes a supervised machine learning model to predict the probability that an upcoming scheduled medication dose will be delayed. The model is designed for operational use in general medical ward settings. The proposed model integrates electronic medication administration records, pharmacy dispensing timestamps, nurse-to-patient ratios, and shift-level workload indicators. A gradient boosting framework is conceptually used to capture non-linear relationships among workflow, staffing, and medication availability factors. The model would be expected to identify scheduled doses at elevated risk of delay before the administration window closes. Its outputs could support risk stratification, targeted charge nurse review, and earlier pharmacy coordination. A supervised prediction model for medication administration delay could function as an early warning component within a ward operations dashboard. Such a tool could support proactive clinical operations without replacing nurse judgment.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 25 February 2021 | Article: 63

Artificial Intelligence for Hospital Workflow Analytics: A Systematic Review of Machine Learning Models for Patient Flow, Staff Scheduling, Resource Utilization, and Operational Delay Prediction
Hospital workflow analytics has become central to improving throughput, reducing operational cost, and strengthening patient experience. Artificial intelligence offers predictive capabilities for patient flow, staffing, resource use, and delay anticipation. This systematic review examined machine learning models applied to patient flow, staff scheduling, resource utilisation, and operational delay prediction in hospital settings. The review focused on model types, operational endpoints, data sources, validation methods, and implementation maturity. A PRISMA 2020-aligned search strategy was designed for PubMed, Scopus, IEEE Xplore, and Web of Science. Screening, extraction, risk-of-bias appraisal, and narrative synthesis were structured around hospital operations rather than clinical diagnosis. The literature was dominated by retrospective, single-centre studies focused on patient flow, especially length-of-stay, admission, discharge, and bed-use prediction. Staffing, resource utilisation, and operational delay prediction were less frequently studied, and prospective deployment remained uncommon. Machine learning for hospital operations is maturing technically but remains fragmented across isolated workflow domains. Integration across patient flow, staffing, resource utilisation, and delay management requires stronger prospective evaluation.
Journal of Health Informatics and Digital Systems
Review | Open access | 25 February 2021 | Article: 65

Probabilistic Record Linkage and Machine Learning Model for Detecting Duplicate Patient Records Using Demographic Similarity, Address Variation, Encounter History, Insurance Identifiers, and Clinical Pattern Matching
Duplicate patient records are a pervasive problem in electronic health records, endangering patient safety and inflating healthcare costs. In EHR-driven health systems, identity fragmentation can separate medications, allergies, diagnoses, laboratory results, and prior encounters across more than one record. Traditional probabilistic linkage relies on manual tuning of weights for demographic attributes and cannot fully exploit temporal address changes, insurance identifiers, or clinical patterns. These limitations become especially important when names are misspelled, addresses change, identifiers are missing, or patients receive care across multiple facilities. This article develops a conceptual model that combines probabilistic record linkage with machine learning to detect duplicate patient records. The model uses demographic similarity, address variation, encounter history, insurance identifiers, and clinical pattern matching as complementary evidence streams. The proposed model first applies probabilistic blocking to generate candidate record pairs, then uses a deep learning classifier, such as a Siamese network, to score pairs based on static and dynamic features. The output is a duplicate probability that can support automated ranking, human review, and master patient index maintenance. Conceptually, the model would be expected to improve duplicate detection compared with purely probabilistic linkage when demographic data are incomplete or unstable. Its main advantage is that it can anchor linkage decisions in more stable encounter patterns, longitudinal clinical trajectories, and repeated institutional contact signals. Such a hybrid model could enable a more accurate and self-maintaining master patient index while reducing the burden of manual record merging. It would also support safer registration workflows by identifying probable duplicates before identity fragmentation affects care delivery.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 25 February 2025 | Article: 103

Machine Learning for Patient Transfer and Discharge Planning: A Review of Predictive Models for Placement Delay, Discharge Readiness, Follow-Up Completion, and Post-Discharge Risk
Hospital patient flow depends on timely transfer decisions, accurate discharge planning, and reliable post-discharge coordination. Delays in placement, premature discharge, missed follow-up, and unrecognized post-discharge risk can increase avoidable utilization and compromise continuity of care. This systematic review examined machine learning models for predicting placement delay, discharge readiness, follow-up completion, and post-discharge risk from 2017 to 2024. The objective was to synthesize model purposes, data sources, validation practices, implementation maturity, and practical relevance for care transitions. A PRISMA 2020-compliant systematic review was conducted using PubMed, Scopus, IEEE Xplore, and Web of Science. Dual screening, structured data extraction, and narrative synthesis were used because heterogeneity in model objectives, predictors, settings, and outcomes prevented meta-analysis. The evidence base was largest for post-discharge readmission risk and discharge readiness prediction, while placement delay and follow-up completion received less focused attention. Prospective validation, workflow integration, and outcome-based implementation studies were uncommon across all four domains. Machine learning offers promising tools to support proactive discharge planning and transitional care, but the evidence remains dominated by retrospective model development. Translation into routine practice requires prospective testing, interpretability, equity assessment, and integration into multidisciplinary workflows.
Journal of Health Informatics and Digital Systems
Review | Open access | 25 February 2025 | Article: 105

Explainable Machine Learning Framework for Predicting Preventable Appointment Cancellations Using Scheduling Notes, Patient Communication History, Weather Conditions, Transportation Barriers, and Prior Attendance Behavior
Appointment cancellations undermine clinic efficiency, disrupt continuity of care, and reduce access for patients waiting for limited appointment slots. Many cancellations may be preventable when risk is recognized early enough for staff to intervene with reminders, rescheduling support, transportation assistance, or telemedicine conversion. Existing appointment-risk models often emphasize historical attendance and demographic information while underusing scheduling notes, patient communication history, weather conditions, and transportation barriers. They also frequently provide risk scores without patient-specific explanations that staff can translate into meaningful outreach. This article proposes an explainable machine learning framework for predicting preventable appointment cancellations before the appointment occurs. The framework is designed to identify not only which appointments may be at risk, but also why the cancellation risk is elevated. The proposed framework uses a gradient-boosted classification model trained on structured scheduling variables, prior attendance behavior, communication history, weather-linked features, transportation indicators, and natural language processing outputs from scheduling notes. SHAP-based explanation layers would decompose each prediction into interpretable drivers that can be reviewed by scheduling staff, clinic managers, and governance teams. Conceptually, the framework would output a cancellation risk score together with a natural-language explanation of the dominant drivers. These outputs could support targeted interventions such as reminder escalation, proactive rescheduling, transportation support, or conversion to a virtual visit when appropriate. An explainable framework for preventable appointment cancellation prediction could shift patient access management from reactive backfilling toward proactive retention. By combining heterogeneous access signals with transparent attribution, clinics could better align outreach resources with patient-specific barriers.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 20 July 2025 | Article: 110

Interpretable Machine Learning Model for Predicting Prior Authorization Approval Delays Using Payer-Specific Rules, Clinical Documentation Features, Procedure Type, Medical Necessity Indicators, and Historical Approval Timelines
Prior authorization delays impede timely patient care and contribute to administrative pressure across clinical and revenue cycle workflows. These delays can affect scheduling, medication access, procedural planning, and patient confidence in the care process. Current authorization management tools are largely reactive and often focus on tracking request status after submission. They rarely predict which requests are likely to experience approval delays or explain the operational, clinical, or payer-specific reasons behind those delays. This article proposes an interpretable machine learning model for predicting the likelihood of prior authorization approval delays. The model is designed to provide transparent, request-level explanations that can guide pre-submission correction and authorization preparation. The proposed framework uses a gradient-boosted tree model trained conceptually on historical authorization requests. Inputs include payer-specific rules, clinical documentation features, procedure type, medical necessity indicators, and historical approval timelines, with SHAP used to attribute predicted delay risk to individual features. Conceptually, the model would output a delay probability and an explanation of the dominant drivers of that prediction. These drivers could include incomplete documentation, mismatch with payer medical necessity criteria, procedure categories associated with additional review, or payer-procedure combinations with historically slow turnaround. An interpretable prior authorization delay model could support earlier correction of incomplete requests, reduce administrative waste, and improve patient access. By aligning predictive analytics with transparent explanations, the framework could make authorization preparation more proactive and accountable.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 20 July 2025 | Article: 115

Machine Learning Model for Forecasting Hospital Housekeeping Demand Using Discharge Predictions, Room Turnover History, Isolation Status, Environmental Cleaning Requirements, and Unit-Level Census Patterns
Hospital housekeeping demand is closely tied to bed turnover, discharge timing, isolation precautions, and unit-level patient movement. Delays in environmental services completion can slow bed availability and create downstream pressure on emergency departments, inpatient units, and procedural areas. Environmental services staffing is often managed through fixed shift patterns, current occupancy views, and reactive dispatch queues. These approaches may not anticipate cleaning surges caused by clustered discharges, isolation rooms, or changing census patterns. This manuscript proposes a predictive model for forecasting hospital housekeeping demand by combining discharge predictions, room turnover history, isolation status, environmental cleaning requirements, and unit-level census signals. The goal is to estimate the number, type, and timing of cleaning tasks needed across hospital units. The proposed model would use historical environmental services logs, admission-discharge-transfer data, bed management data, discharge prediction outputs, and infection-control status indicators. A supervised regression or time-series architecture could generate hourly unit-level demand forecasts for routine, terminal, and enhanced cleaning tasks. Conceptually, the model would be expected to identify upcoming cleaning pressure before it appears on the live dispatch board. For example, it could anticipate an afternoon surge in terminal cleans when several predicted discharges coincide with isolation rooms and high unit census. A forecasting model for housekeeping demand could support proactive environmental services staffing, reduce avoidable bed turnaround delays, and improve hospital throughput. Its value would depend on careful integration with existing bed management systems and prospective evaluation in operational settings.
Journal of Health Informatics and Digital Systems
Original Research | Open access | 20 July 2025 | Article: 117
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AI-driven Diagnostics Artificial Intelligence in Health Informatics Artificial Intelligence in Healthcare Big Data in Healthcare Clinical Data Mining Clinical Decision Support Systems Clinical Informatics Computer Vision Connected Health Systems Deep Learning Digital Health Digital Healthcare Innovation Digital Transformation in Healthcare Electronic Health Records Ethical AI in Healthcare Explainable AI Health Data Analytics Health Data Privacy Health Informatics Health Information Management Health Information Systems Health System Optimization Health Technology Assessment Healthcare Data Science Healthcare Informatics Healthcare Information Security Healthcare Management Healthcare Management Information Systems Intelligent Medical Systems Internet of Medical Things (IoMT) Interoperability in Healthcare Systems Machine Learning Medical Data Analytics Medical Data Management Medical Imaging Mobile Health (mHealth) Natural Language Processing Precision Medicine Predictive Analytics Remote Patient Monitoring Smart Healthcare Systems Telemedicine Wearable Health Technologies e-Health




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