DeGroote School of Business, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S4M4, Canada.
Artif Intell Med. 2012 Oct;56(2):123-35. doi: 10.1016/j.artmed.2012.08.001. Epub 2012 Sep 8.
To develop and explore the predictability of patient perceptions of satisfaction through the hospital adoption of health information technology (HIT), leading to a better understanding of the benefits of increased HIT investment.
The solution proposed is based on comparing the predictive capability of artificial neural networks (ANNs) with the adaptive neuro-fuzzy inference system (ANFIS). The latter integrates artificial neural networks and fuzzy logic and can handle certain complex problems that include fuzziness in human perception, and non-normal and non-linear data. Secondary data from two surveys were combined to develop the model. Hospital HIT adoption capability and use indicators in the Canadian province of Ontario were used as inputs, while patient satisfaction indicators of healthcare services in acute hospitals were used as outputs.
Eight different types of models were trained and tested for each of four patient satisfaction dimensions. The accuracy of each predictive model was evaluated through statistical performance measures, including root mean square error (RMSE), and adjusted coefficient of determination R(2)(Adjusted). For all four patient satisfaction indicators, the performance of ANFIS was found to be more effective (R(Adjusted)(2)=0.99) when compared with the results of ANN modeling in predicting the impact of HIT adoption on patient satisfaction (R(Adjusted)(2)=0.86-0.88).
The impact of HIT adoption on patient satisfaction was obtained for different HIT adoption scenarios using ANFIS simulations. The results through simulation scenarios revealed that full implementation of HIT in hospitals can lead to significant improvement in patient satisfaction. We conclude that the proposed ANFIS modeling technique can be used as a decision support mechanism to assist government and policy makers in predicting patient satisfaction resulting from the implementation of HIT in hospitals.
通过医院采用健康信息技术(HIT)来开发和探索患者满意度的可预测性,从而更好地理解增加 HIT 投资的好处。
所提出的解决方案基于比较人工神经网络(ANNs)和自适应神经模糊推理系统(ANFIS)的预测能力。后者集成了人工神经网络和模糊逻辑,可以处理包括人类感知中的模糊性、非正态和非线性数据在内的某些复杂问题。将来自两个调查的二级数据合并来开发模型。安大略省加拿大医院的 HIT 采用能力和使用指标被用作输入,而急性医院医疗服务的患者满意度指标被用作输出。
针对四个患者满意度维度中的每一个,分别训练和测试了八种不同类型的模型。通过统计性能指标,包括均方根误差(RMSE)和调整后的确定系数 R(2)(Adjusted),评估每个预测模型的准确性。对于所有四个患者满意度指标,与 ANN 建模相比,ANFIS 的性能(R(Adjusted)(2)=0.99)被发现更有效(R(Adjusted)(2)=0.86-0.88),可以预测 HIT 采用对患者满意度的影响。
使用 ANFIS 模拟获得了不同 HIT 采用场景下的 HIT 采用对患者满意度的影响。通过模拟场景的结果表明,医院全面实施 HIT 可以显著提高患者满意度。我们得出结论,所提出的 ANFIS 建模技术可以用作决策支持机制,以协助政府和决策者预测医院实施 HIT 后患者满意度的变化。