Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

6.3K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
6.3K
Health Information Technology and Healthcare Information System01:30

Health Information Technology and Healthcare Information System

3.5K
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
3.5K
Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

1.0K
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
1.0K
Integrated Healthcare System01:20

Integrated Healthcare System

2.5K
An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
2.5K
Preventive Healthcare Services01:30

Preventive Healthcare Services

2.3K
Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
2.3K
Standards of Care II01:19

Standards of Care II

1.2K
Nurses bear specific legal responsibilities under several federal statutes, including:
1.2K

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

An approach to the classification of COVID-19 based on CT scans using convolutional features and genetic algorithms.

Computers in biology and medicine·2021
Same author

Breast cancer diagnosis from histopathological images using textural features and CBIR.

Artificial intelligence in medicine·2020
Same author

Recent computational methods for white blood cell nuclei segmentation: A comparative study.

Computer methods and programs in biomedicine·2019
Same author

Deep learning for cell image segmentation and ranking.

Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society·2019
Same author

Blood serum acute phase proteins and iron dynamics during acute phase response of Salmonella enterica serotype Dublin experimentally infected buffalo calves.

Veterinary immunology and immunopathology·2018
Same author

Reference 1D and 2D electrophoresis maps for potential disease related proteins in milk whey from lactating buffaloes and blood serum from buffalo calves (Water buffalo, Bubalus bubalis).

Research in veterinary science·2018

Related Experiment Video

Updated: Mar 15, 2026

Predicting Treatment Response to Image-Guided Therapies Using Machine Learning: An Example for Trans-Arterial Treatment of Hepatocellular Carcinoma
04:09

Predicting Treatment Response to Image-Guided Therapies Using Machine Learning: An Example for Trans-Arterial Treatment of Hepatocellular Carcinoma

Published on: October 10, 2018

8.9K

Using machine learning to support healthcare professionals in making preauthorisation decisions.

Flávio H D Araújo1, André M Santana2, Pedro de A Santos Neto2

  • 1Campus Senador Helvídio Nunes de Barros, Federal University of Piauí, Picos, Piauí, Brazil.

International Journal of Medical Informatics
|August 31, 2016
PubMed
Summary

This study developed a computational tool to improve the preauthorization process for health insurance providers. The decision support mechanism achieved over 96% accuracy in evaluating dental procedure requests, reducing resource waste.

Keywords:
ClassificationData miningEnsembleMachine learningPrepaid health plans

More Related Videos

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
12:18

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

8.2K

Related Experiment Videos

Last Updated: Mar 15, 2026

Predicting Treatment Response to Image-Guided Therapies Using Machine Learning: An Example for Trans-Arterial Treatment of Hepatocellular Carcinoma
04:09

Predicting Treatment Response to Image-Guided Therapies Using Machine Learning: An Example for Trans-Arterial Treatment of Hepatocellular Carcinoma

Published on: October 10, 2018

8.9K
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
12:18

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

8.2K

Area of Science:

  • Health Informatics
  • Computational Intelligence
  • Machine Learning

Background:

  • Preauthorization by Health Insurance Providers (HIPs) controls resource waste by denying unnecessary procedures.
  • Current preauthorization requires constant reviewer presence, increasing HIP operational costs.

Purpose of the Study:

  • To develop a computational intelligence-based tool to learn and optimize the preauthorization process.
  • To utilize an existing database from a non-profit HIP for dental procedure preauthorization.

Main Methods:

  • Data pre-processing included filtering, random under-sampling, and imputation.
  • Evaluated classifiers (Random Tree, Naive Bayes, SVM, Nearest Neighbor) using the kappa index.
  • Ensemble methods combined the best-performing classifiers.

Main Results:

  • Reduced 164 attributes to 15, creating 12 new attributes from beneficiary history.
  • Developed a decision support mechanism with over 96% hit rate.
  • Demonstrated high accuracy in evaluating dental procedure requests.

Conclusions:

  • A tool using computational intelligence can accurately evaluate test/procedure requests.
  • This tool can support healthcare professionals by automating evaluations for less complex, non-life-threatening cases.