Data Mining and Knowledge Discovery in Healthcare Organizations: A Decision-Tree Approach

Data Mining and Knowledge Discovery in Healthcare Organizations: A Decision-Tree Approach

Murat Caner Testik (Cukurova University, Turkey), George C. Runger (Arizona State University, USA), Bradford Kirkman-Liff (Arizona State University, USA) and Edward A. Smith (University of Arizona and Translational Genomics Research Institute, USA)
Copyright: © 2005 |Pages: 13
DOI: 10.4018/978-1-59140-459-0.ch007
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Health care organizations are struggling to find new ways to cut healthcare utilization and costs while improving quality and outcomes. Predictive models that have been developed to predict global utilization for a healthcare organization cannot be used to predict the behavior of individuals. On the other hand, massive amounts of healthcare data are available in databases that can be used for exploring patterns and therefore knowledge discovery. Diversity and complexity of the healthcare data requires attention to the use of statistical methods. By nature, healthcare data are multivariate, making the analysis difficult as well as interesting. In this chapter, our intention is to classify individuals that are future high-utilizers of healthcare. In particular, we answer the question of whether a mathematical model can be generated utilizing a large claims database that will predict which individuals who are not using a service in a yet untested database will be high utilizers of that health service in the future. For this purpose, an integrated dataset from enrollment, medical claims, and pharmacy databases containing more than 150 million medical and pharmacy claim line items and for over four million patients is analyzed for knowledge discovery. A modern data-mining tool, namely decision trees, which may have a broad range of applications in healthcare organizations, was used in our analyses and a discussion of this valuable tool is provided. The results and managerial aspects are discussed. Several approaches are proposed for the use of this technique depending on the health plan.

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Table of Contents
Elie Geisler
Nilmini Wickramasinghe, Jatinder N.D. Gupta, Sushil Sharma
Chapter 1
Sushil K. Sharma, Nilmini Wickramasinghe, Jatinder N.D. Gupta
Healthcare organizations are facing many challenges in the 21st Century due to changes taking place in global healthcare systems. Spiraling costs... Sample PDF
Knowledge Management in Healthcare
Chapter 2
Kevin C. Desouza
The medical field in recent years has been facing increasing pressures for lower cost and increased quality of healthcare. These two pressures are... Sample PDF
Knowledge Management in Hospitals
Chapter 3
A. E. Wahle, W. A. Groothuis
There are many arguments why healthcare organizations need knowledge management. In The Netherlands, there are some things going on, like a new... Sample PDF
How to Handle Knowledge Management in Healthcare: A Description of a Model to Deal with the Current and Ideal Situation
Chapter 4
A. H. Rubenstein, E. Geisler
One of the key factors that distinguishes enterprises of the 21st Century is the emphasis on knowledge and information. Knowledge management is an... Sample PDF
How to Start or Improve a KM System in a Hospital or Healthcare Organization
Chapter 5
Vidyaranya B. Gargeya, Deborah I. Sorrell
Healthcare organizations, like other information intensive organizations, cannot ignore the rapid progression to a digital network economy. While... Sample PDF
Moving Toward an e-Hospital
Chapter 6
Richard J. Puerzer
The management of patients in healthcare facilities, such as outpatient clinics and hospital emergency departments, is a significant hospital... Sample PDF
Applying Automatic Data Collection Tools for Real-Time Patient Management
Chapter 7
Murat Caner Testik, George C. Runger, Bradford Kirkman-Liff, Edward A. Smith
Health care organizations are struggling to find new ways to cut healthcare utilization and costs while improving quality and outcomes. Predictive... Sample PDF
Data Mining and Knowledge Discovery in Healthcare Organizations: A Decision-Tree Approach
Chapter 8
Khin Than Win, Peter Croll
Effective and appropriate implementation of health information systems assists with an organization’s knowledge management. To enhance a user’s... Sample PDF
Engineering Dependable Health Information Systems
Chapter 9
Sushil K. Sharma, Nilmini Wickramasinghe
The main purpose of this chapter is to bring out and discuss the central facts pertaining to the importance of incorporating knowledge management in... Sample PDF
e-Health with Knowledge Management: The Areas of Tomorrow
Chapter 10
Nilmini Wickramasinghe, Sushil K. Sharma, Harsha P. Reddy
The ongoing tension between certainty over uncertainty is the main force that is driving the evidence-based medicine movement. The central... Sample PDF
Evidence-Based Medicine: A New Approach in the Practice of Medicine
Chapter 11
Bruce Shadbolt, Rui Wang, Paul S. Craft
The acquisition of knowledge in healthcare is mostly piecemeal and irregular. Consequently, we believe that the integration of science and patient... Sample PDF
Moving to an Online Framework for Knowledge-Driven Healthcare
Chapter 12
Susan West Engelkemeyer, Sharon Muret-Wagstaff
Health care leaders face an intensifying array of changes and challenges that heighten the need for systematic approaches to knowledge management at... Sample PDF
Using the Malcolm Baldrige National Quality Award Criteria to Enable KM and Create a Systemic Organizational Perspective
Chapter 13
Adam Fadlalla, Nilmini Wickramasinghe
This chapter provides insight into various areas within the medical field that strive to take advantage of different data mining techniques in order... Sample PDF
Realizing Knowledge Assets in the Medical Sciences with Data Mining: An Overview
Chapter 14
M. Saito, H. Seki
Objectives: Improvement of service quality and security is required in any business area in society. The purposes of this chapter are to identify... Sample PDF
Organizational Control Mode, Cognitive Activity & Performance Reliability: The Case of a National Hospital in Japan
Chapter 15
Nabeel A.Y. Al-Qirim
This chapter reviews the strategic planning of health information systems in New Zealand. This step is deemed necessary to identify the main... Sample PDF
Tele-Medicine: Building Knowledge-Base Tele-Health Capability in New Zealand
Chapter 16
Tanya Castleman, Paul Swatman, Danielle Fowler
This chapter reports the results of a feasibility study into electronic collection of service data at “point of delivery” for disability programs.... Sample PDF
Aligning Multiple Knowledge Perspectives in a Health Services System: A Case Study
Chapter 17
Martin Hughes, William Golden
This chapter explores the role of intranet technology as an enabling technology for supporting the knowledge worker, knowledge work and various... Sample PDF
Knowing How Intranets Enable Knowledge Work: An Exploratory Study in Public Health
Chapter 18
John Gammack, Pranay Desai, Kuldeep Sandhu, Heidi Winklhofer
In this chapter we look at knowledge management in India with particular regard to the pharmaceutical industry. In India, changes in government... Sample PDF
Knowledge Management in Indian Companies: Benchmarking the Pharmaceutical Industry
Chapter 19
Nat Natarajan, Amanda H. Hoffmeister
The healthcare sector is a very important one in many countries and faces numerous quality and performance problems of great significance to all... Sample PDF
"Do No Harm": Can Healthcare Live Up to It?
Chapter 20
Graydon Davison
Research in Australia on the management of innovative practices in multidisciplinary palliative care teams reveals the central role of knowledge as... Sample PDF
Temporary Communication Infrastructures for Dynamic KM in the Complex and Innovative Environment of Palliative Care
Chapter 21
Jae-Hyeon Ahn, Suk-Gwon Chang
Understanding the contribution of knowledge to business performance is important for efficient resource allocations. It is very true for healthcare... Sample PDF
Managing Healthcare Organizations through the Knowledge Productivity Measurement
Chapter 22
Ana Karina Marimon da Cunha, Ely Laureano Paiva
This work examines the role of knowledge in the strategic process in the hospital industry. The research method consists of multiple case studies... Sample PDF
Knowledge Strategic Management in the Hospital Industry
Chapter 23
Darren Mundy, David W. Chadwick
As the healthcare industry enters the era of knowledge management it must place security at the foundation of the transition. Risks are pervasive to... Sample PDF
Secure Knowledge Management for Healthcare Organizations
Chapter 24
Twila Burdick, John Hensing, Bradford Kirkman-Liff, Pamela Nenaber, Howard Silverman, Maire Simington
In 2001 Banner Health launched Care Management and Organizational Performance as a system-wide, collaborative and team-based effort to improve the... Sample PDF
Managing Knowledge to Improve Healthcare Quality in Banner Health
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