SBIR Phase I: Combining Machine Learning with Clinical Expertise to Assess and Mitigate Risk in Healthcare

Presaj, Inc., Cedar Rapids IA

Investigators

Abstract

The broader impact/commercial potential of this Small Business Innovation Research (SBIR) Phase I project will improve health care outcomes associated with complex procedures. Approximately 1 in 7 major surgical procedures in the US is associated with a medical complication, totaling more than 4 million complications and $80 billion in costs per year. Many more complications occur in non-surgical settings. This project will use machine learning to combine proven engineering principles with clinical expertise to identify and address specific risks for each procedure, care facility, and patient (accounting for high-impact risk factors ranging from diabetes to social determinants of health). This technology will augment existing standardized, outcome-oriented quality-improvement tools with cost-effective customized, process-oriented tools in a novel way, with an envisioned initial application for the ~5,100 community hospitals in the US. A modest improvement of 1% of complications would annually reduce costs by nearly $1 billion and will save 4,500+ lives. This Small Business Innovation Research (SBIR) Phase I project will use a systems-based approach to examine process-level risk in healthcare. Big data in healthcare is inconsistently structured and not optimized to directly improve patient outcomes. The large datasets for most procedures provide only high-level conclusions regarding risk; they do not pinpoint the specific steps in provider workflow with high risk or the role of external factors, such as comorbidities or facility age. This project will determine the feasibility of using machine learning supervised by experienced clinicians to assess risk using principles from Failure Modes and Effects Analysis. The project will develop a proof-of-concept machine-learning system that uses a proprietary risk taxonomy and modifiers to combine national, state, facility, and actuarial datasets to generate risk priority numbers for each step for a service line. This system will then be applied to coronary artery bypass graft surgery to assess its validity and clinical value. Monte Carlo simulations and clinician focus groups using a Likert scale will determine the significance of the results. This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.