New Grant: Predicting, Preventing Surgery Cancellations with Machine Learning

September 09, 2016

Nick Pratap, MB, BChir, of Cincinnati Children’s Department of Anesthesia and the Heart Institute and Yizhao Ni, PhD, of the Division of Biomedical Informatics have received a $300,000, two-year grant from the Agency for Healthcare Research and Quality that aims to use electronic health records (EHRs) to identify children likely to suffer last-minute surgery cancellation. Their efforts will contribute to other initiatives across the hospital already aiming to reduce such cancellations.

Every year, between two and twenty percent of surgical procedures are cancelled at the last minute in America, wasting thousands of dollars per procedure. In addition, the cancellation of a procedure creates psychological stress and financial hardships for patient and family alike.

Already Pratap has led quality improvement efforts at Cincinnati Children’s to reduce cancellation by about 16% through use of text-message reminders and clearer pre-operative instructions for families. Now, only about four percent of surgery procedures at Children’s are cancelled last minute.

However, the potential lost revenue for even this small proportion is about $3,000 per hour for operating room time alone, equating to around $5 million each year. In addition, patient families are faced with avoidable stress, wasted journeys and missed work, often unpaid, leading to frustration, disappointment and anger.

Pratap and Ni aim to reduce surgery cancellations further by using machine learning technology to identify potential predictors.

Information that EHRs can provide about a patient has the potential to reduce health care costs and improve efficiency. The researchers plan to use EHRs and public data resources to identify key predictors of last-minute cancellation of surgery. They expect that by successfully developing computerized models for prediction, they will be able to deliver support to families who need it most. 

Ultimately the number of last-minute surgery cancellations will decrease, leading to more timely surgeries, higher patient and family satisfaction, and lower costs. It is their goal that this approach will be used clinically to assist the surgery team in real time, improving overall efficiency.

The AHRQ R21 grant is provided by the Agency for Healthcare Research Quality to support researchers as they explore a developing area of research.