超越基于时间的计费:一个人工智能支持的复杂性模型,用于安全的消息报销
Dong-Gil Ko1, Umberto Tachinardi2,3, Eric J Warm4
1Department of Operations, Business Analytics & Information Systems, Carl H. Lindner College of Business, University of Cincinnati, Cincinnati, Ohio, USA.
概括
目前的远程医疗计费没有考虑到临床复杂性. 一个使用消息内容和电子健康记录参与的新AI模型,而不仅仅是时间,提供了一种更公平的方式来偿还提供者安全的患者信息.
科学领域:
- 医疗信息学 医疗信息学
- 人工智能在医学中的应用
- 医疗保健管理局的管理.
背景情况:
- 目前的远程医疗报销依赖于评估和管理的持续时间,这并不准确地反映了医疗服务提供者对保护患者信息的复杂性.
- 需要更好地反映异步远程医疗临床护理复杂性质的报销模式.
- 现有的框架无法捕捉数字患者沟通所涉及的认知努力和临床判断.
研究的目的:
- 开发和验证一个人工智能支持的远程医疗报销模型,以量化临床复杂性.
- 根据提供者的认知努力和临床内容,为异步远程医疗服务创建更准确的计费框架.
- 建立改革远程医疗补偿的基础,以确保提供者获得公平的补偿.
主要方法:
- 分析来自大型卫生系统的149,499条安全患者信息 (2023-2024年).
- 在消息子集上使用监督伪标签与严格的注释准则 (Cohen's κ = 0.816).
- 开发了一个渐变增强分类器,使用电子健康记录参与 (域参与) 和语言复杂性 (认知判断) 的特征,通过交叉验证和离开一个提供商的测试进行验证.
主要成果:
- 基于复杂性的模型实现了曲线下的面积 (AUC) 约为0.82,显著优于基于时间的模型 (AUC~0.57).
- 复杂性的关键预测因素包括独特的医疗概念,临床内容的广度和情感紧迫性,而不是消息长度或持续时间.
- 可计费线程显示了更高的医疗密度和情绪强度,验证了域参与和认知判断指标.
结论:
- 人工智能驱动的复杂度指标比基于时间的指标更准确地代表了提供者在远程医疗中的认知努力.
- 开发的模型为远程医疗计费改革提供了一种实用,准确和可解释的方法.
- 这一框架支持更公平的提供者补偿,并增强远程医疗服务的可持续性.
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