Predicting Inpatient Flow at a Major Hospital Using Interpretable Analytics

Problem definition: Translate data from electronic health records (EHR) into accurate predictions on patient flows and inform daily decision making at a major hospital. Academic/practical relevance: In a constrained hospital environment, forecasts on patient demand patterns could help match capacity and demand and improve hospital operations. Methodology: We use data from 63,432 admissions at a large academic hospital (50% female, median age 64 years old, median length of stay 3.12 days). We construct an expertise-driven patient representation on top of their EHR data and apply a broad class of machine learning methods to predict several aspects of patient flows. Results: With a unique patient representation, we estimate short-term discharges, identify long-stay patients, predict discharge destination, and anticipate flows in and out of intensive care units with accuracy in the 80%+ range. More importantly, we implement this machine learning pipeline into the EHR system of the hospital and construct prediction-informed dashboards to support daily bed placement decisions. Managerial implications: Our study demonstrates that interpretable machine learning techniques combined with EHR data can be used to provide visibility on patient flows. Our approach provides an alternative to deep learning techniques that is equally accurate, interpretable, frugal in data and computational power, and production ready.

History: This paper has been accepted for the Manufacturing & Service Operations Management Special Section on Responsible Research in Operations Management.

Funding: The research was funded by Beth Israel Deaconess Medical Center.

Supplemental Material: The e-companion is available at https://doi.org/10.1287/msom.2021.0971.