Reducing preventable hospital readmissions is a national priority for payers, providers, and policymakers seeking to improve health care and lower costs. The rate of readmission is being used as a benchmark to determine the quality of healthcare provided by the hospitals. In thisproject, we have used machine learning techniques like Logistic Regression, Random Forest and Support Vector Machines to analyze the health claims data and identify demographic and medical factors that play a crucial role in predicting all-cause readmissions. As the health claims data is high dimensional, we have used Principal Component Analysis as a dimension reduction technique and used the results for building regression models. We compared and evaluated these models based on the Area Under Curve (AUC) metric. Random Forest model gave the highest performance followed by Logistic Regression and Support Vector Machine models. These models can be used to identify the crucial factors causing readmissions and help identify patients to focus on to reduce the chances of readmission, ultimately bringing down the cost and increasing the quality of healthcare provided to the patients.

High hospital readmission rates are associated with significant costs and health risks for patients. Therefore, it is critical to develop predictive models that can support clinicians to determine whether or not a patient will return to the hospital in a relatively short period of time (e.g, 30-days). Nowadays, it is possible to collect both structured (electronic health records - EHR) and unstructured information (clinical notes) about a patient hospital event, all potentially containing relevant information for a predictive model. However, their integration is challenging. In this work we explore the combination of clinical notes and EHRs to predict 30-day hospital readmissions. We address the representation of the various types of information available in the EHR data, as well as exploring LLMs to characterize the clinical notes. We collect both information sources as the nodes of a graph neural network (GNN). Our model achieves an AUROC of 0.72 and a balanced accuracy of 66.7\%, highlighting the importance of combining the multimodal information.

Hospital readmission prediction is critical for clinical decision support, aiming to identify patients at risk of returning within 30 days post-discharge. High readmission rates often indicate inadequate treatment or post-discharge care, making effective prediction models essential for optimizing resources and improving patient outcomes. We propose PT, a Transformer-based model that integrates Electronic Health Records (EHR), medical images, and clinical notes to predict 30-day all-cause hospital readmissions. PT extracts features from raw data and uses specialized Transformer blocks tailored to the data's complexity. Enhanced with Random Forest for EHR feature selection and test-time ensemble techniques, PT achieves superior accuracy, scalability, and robustness. It performs well even when temporal information is missing. Our main contributions are: (1)Simplicity: A powerful and efficient baseline model outperforming existing ones in prediction accuracy; (2)Scalability: Flexible handling of various features from different modalities, achieving high performance with just clinical notes or EHR data; (3)Robustness: Strong predictive performance even with missing or unclear temporal data.

Readmissions among Medicare beneficiaries are a major problem for the US healthcare system from a perspective of both healthcare operations and patient caregiving outcomes. Our study analyzes Medicare hospital readmissions using LSTM networks with feature engineering to assess feature contributions. We selected variables from admission-level data, inpatient medical history and patient demography. The LSTM model is designed to capture temporal dynamics from admission-level and patient-level data. On a case study on the MIMIC dataset, the LSTM model outperformed the logistic regression baseline, accurately leveraging temporal features to predict readmission. The major features were the Charlson Comorbidity Index, hospital length of stay, the hospital admissions over the past 6 months, while demographic variables were less impactful. This work suggests that LSTM networks offers a more promising approach to improve Medicare patient readmission prediction. It captures temporal interactions in patient databases, enhancing current prediction models for healthcare providers. Adoption of predictive models into clinical practice may be more effective in identifying Medicare patients to provide early and targeted interventions to improve patient outcomes.

Hospital readmission, defined as patients being re-hospitalized shortly after discharge, is a critical concern as it impacts patient outcomes and healthcare costs. Identifying patients at risk of readmission allows for timely interventions, reducing re-hospitalization rates and overall treatment costs. This study focuses on predicting patient readmission within less than 30 days using text mining techniques applied to discharge report texts from electronic health records (EHR). Various machine learning and deep learning methods were employed to develop a classification model for this purpose. A novel aspect of this research involves leveraging the Bio-Discharge Summary Bert (BDSS) model along with principal component analysis (PCA) feature extraction to preprocess data for deep learning model input. Our analysis of the MIMIC-III dataset indicates that our approach, which combines the BDSS model with a multilayer perceptron (MLP), outperforms state-of-the-art methods. This model achieved a recall of 94% and an area under the curve (AUC) of 75%, showcasing its effectiveness in predicting patient readmissions. This study contributes to the advancement of predictive modeling in healthcare by integrating text mining techniques with deep learning algorithms to improve patient outcomes and optimize resource allocation.

With the increasing availability of patients' data, modern medicine is shifting towards prospective healthcare. Electronic health records contain a variety of information useful for clinical patient description and can be exploited for the construction of predictive models, given that similar medical histories will likely lead to similar progressions. One example is unplanned hospital readmission prediction, an essential task for reducing hospital costs and improving patient health. Despite predictive models showing very good performances especially with deep-learning models, they are often criticized for the poor interpretability of their results, a fundamental characteristic in the medical field, where incorrect predictions might have serious consequences for the patient health. In this paper we propose a novel, interpretable deep-learning framework for predicting unplanned hospital readmissions, supported by NLP findings on word embeddings and by neural-network models (ConvLSTM) for better handling temporal data. We validate our system on the two predictive tasks of hospital readmission within 30 and 180 days, using real-world data. In addition, we introduce and test a model-dependent technique to make the representation of results easily interpretable by the medical staff. Our solution achieves better performances compared to traditional models based on machine learning, while providing at the same time more interpretable results.

Today, MLOps offers a fairly robust framework for operationalizing AI, says Zuccarelli, who's now innovation data scientist at CVS Health. By way of example, Zuccarelli points to a project he worked on previously to create an app that would predict adverse outcomes, such as hospital readmission or disease progression. That meant creating a mobile app that was reliable, fast, and stable, with a machine learning system on the back end connected via API. As MLOps platforms mature, they accelerate the entire model development process because companies don't have to reinvent the wheel with every project, he says. And this means developing expertise in a wide range of activities, says Meagan Gentry, national practice manager for the AI team at Insight, a Tempe-based technology consulting company.

Measures to predict 30-day readmission are considered an important quality factor for hospitals as accurate predictions can reduce the overall cost of care by identifying high risk patients before they are discharged. While recent deep learning-based studies have shown promising empirical results on readmission prediction, several limitations exist that may hinder widespread clinical utility, such as (a) only patients with certain conditions are considered, (b) existing approaches do not leverage data temporality, (c) individual admissions are assumed independent of each other, which is unrealistic, (d) prior studies are usually limited to single source of data and single center data. To address these limitations, we propose a multimodal, modality-agnostic spatiotemporal graph neural network (MM-STGNN) for prediction of 30-day all-cause hospital readmission that fuses multimodal in-patient longitudinal data. By training and evaluating our methods using longitudinal chest radiographs and electronic health records from two independent centers, we demonstrate that MM-STGNN achieves AUROC of 0.79 on both primary and external datasets. Furthermore, MM-STGNN significantly outperforms the current clinical reference standard, LACE+ score (AUROC=0.61), on the primary dataset. For subset populations of patients with heart and vascular disease, our model also outperforms baselines on predicting 30-day readmission (e.g., 3.7 point improvement in AUROC in patients with heart disease). Lastly, qualitative model interpretability analysis indicates that while patients' primary diagnoses were not explicitly used to train the model, node features crucial for model prediction directly reflect patients' primary diagnoses. Importantly, our MM-STGNN is agnostic to node feature modalities and could be utilized to integrate multimodal data for triaging patients in various downstream resource allocation tasks.

The development of neural networks for clinical artificial intelligence (AI) is reliant on interpretability, transparency, and performance. The need to delve into the black-box neural network and derive interpretable explanations of model output is paramount. A task of high clinical importance is predicting the likelihood of a patient being readmitted to hospital in the near future to enable efficient triage. With the increasing adoption of electronic health records (EHRs), there is great interest in applications of natural language processing (NLP) to clinical free-text contained within EHRs. In this work, we apply InfoCal, the current state-of-the-art model that produces extractive rationales for its predictions, to the task of predicting hospital readmission using hospital discharge notes. We compare extractive rationales produced by InfoCal to competitive transformer-based models pretrained on clinical text data and for which the attention mechanism can be used for interpretation. We find each presented model with selected interpretability or feature importance methods yield varying results, with clinical language domain expertise and pretraining critical to performance and subsequent interpretability.

Recent deep learning research based on Transformer model architectures has demonstrated state-of-the-art performance across a variety of domains and tasks, mostly within the computer vision and natural language processing domains. While some recent studies have implemented Transformers for clinical tasks using electronic health records data, they are limited in scope, flexibility, and comprehensiveness. In this study, we propose a flexible Transformer-based EHR embedding pipeline and predictive model framework that introduces several novel modifications of existing workflows that capitalize on data attributes unique to the healthcare domain. We showcase the feasibility of our flexible design in a case study in the intensive care unit, where our models accurately predict seven clinical outcomes pertaining to readmission and patient mortality over multiple future time horizons.