The Adelaide Score: prospective implementation of an artificial intelligence system to improve hospital and cost efficiency

Joshua G Kovoor^{1

2}, Brandon Stretton^{2

3}, Aashray K Gupta^{2

4}, Alexander Beath¹, Mathew O Jacob¹, John M Kefalianos¹, Gavin J Carmichael^{1

5}, Ammar Zaka⁶, Gerry O'Callaghan^{2

3}, Shrirajh Satheakeerthy³, Andrew Booth³, Thomson Delloso³, Thomas J Hugh^{4

7}, Weng Onn Chan^{2

8}, Guy J Maddern^{2

8}, Eva Balan-Vnuk⁹, Michael Cusack⁹, Toby Gilbert^{2

10}, John Maddison^{2

10}, Stephen Bacchi^{10

11

12}; Adelaide Score Advisory Group

Collaborators, Affiliations

Collaborators

Adelaide Score Advisory Group:
Amal Abou-Hamden, Alex Al-Saffar, Annas Al-Sharea, Vasiliki Arachi, Yasser Arafat, Matthew Arnold, Karl Asmussen, Sara Ataie, Zahra Ataie, Zsolt Balogh, S George Barreto, Tarun Bastiampillai, John Beltrame, Jayme Bennetts, Taryn Bessen, Nazim Bhimani, Niranjan Bidargaddi, Joshua Blum, Riteesh Bookun, Martin Bruening, Ben Canny, Erick Chan, Justin Chan, Jacob Cherini, William Chik, Clara Chow, Edward Clarke, Jonathan Clarke, Robyn Clay-Williams, Elena Dicus, Christopher Dobbins, Francis Donnelly, Lukah Dykes, Suzanne Edwards, Aditya Eranki, Sarah Flint, Jason Flower, Kerrie Freeman, Tim French, Samuel Gluck, Harry Godber, Rudy Goh, Paul Gould, Amandeep Hansra, Peter Hewett, Russell Hodgson, Ashley Hopkins, Michael Horowitz, Sarah Howson, Mana Ittimani, Jonathan Henry Jacobsen, Alexander Jenkins, Hubertus Jersmann, Melinda Jiang, Karen Jones, Reto Kaepelli, Harish Kamalanathan, Billy Kennington, Emily Kirkpatrick, Pramesh Kovoor, Thiep Kuany, Antony Loan, Alasdair Leslie, Danny Liew, Peter Litwin, Yuchen Luo, Rajiv Mahajan, Jarrod Marks, Matthew Marshall-Webb, Daniel McIntyre, Ben Muston, Daud Mutahar, Silas Nann, Nasim Nematzadeh, Dominic Ng, Robert Padbury, Meet Patel, Henry Pleass, Anthony Porter, Peter Psaltis, Fabio Ramponi, Wendy Rogers, Alistair Royse, Margaret Schnitzler, Veronika Seda, Tony Sherbon, Rachel Short, Rajvinder Singh, Gopal Sivagangabalan, Harry Smallbone, Julian Smith, Peter Subramaniam, Liz Sutton, Ian Tan, Sheryn Tan, Melissa Teo, Aravinda Thiagalingam, David Tivey, Minh-Son To, Markus Trochsler, Richard Turner, Daksh Tyagi, Anton Van Den Hengel, Andrew Vanlint, Santosh Verghese, Leigh Warren, Ashley Wilson-Smith, Geoffrey Wong, Sarah Zaman, Andrew Zannettino, Kathryn Zeitz

Affiliations

¹ Ballarat Base Hospital, Ballarat, Victoria, Australia.
² University of Adelaide, Adelaide, South Australia, Australia.
³ Royal Adelaide Hospital, Adelaide, South Australia, Australia.
⁴ Royal North Shore Hospital, Adelaide, South Australia, Australia.
⁵ University of Melbourne, Ballarat, Victoria, Australia.
⁶ Gold Coast University Hospital, Gold Coast, Queensland, Australia.
⁷ University of Sydney, Sydney, New South Wales, Australia.
⁸ The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
⁹ SA Government, Adelaide, South Australia, Australia.
¹⁰ Lyell McEwin Hospital, Adelaide, South Australia, Australia.
¹¹ Massachusetts General Hospital, Boston, Massachusetts, USA.
¹² Harvard University, Boston, Massachusetts, USA.

PMID: 39754371
DOI: 10.1111/ans.19383

The Adelaide Score: prospective implementation of an artificial intelligence system to improve hospital and cost efficiency

Joshua G Kovoor et al. ANZ J Surg. 2025 Mar.

. 2025 Mar;95(3):342-349.

doi: 10.1111/ans.19383. Epub 2025 Jan 3.

Authors

Collaborators

Adelaide Score Advisory Group:
Amal Abou-Hamden, Alex Al-Saffar, Annas Al-Sharea, Vasiliki Arachi, Yasser Arafat, Matthew Arnold, Karl Asmussen, Sara Ataie, Zahra Ataie, Zsolt Balogh, S George Barreto, Tarun Bastiampillai, John Beltrame, Jayme Bennetts, Taryn Bessen, Nazim Bhimani, Niranjan Bidargaddi, Joshua Blum, Riteesh Bookun, Martin Bruening, Ben Canny, Erick Chan, Justin Chan, Jacob Cherini, William Chik, Clara Chow, Edward Clarke, Jonathan Clarke, Robyn Clay-Williams, Elena Dicus, Christopher Dobbins, Francis Donnelly, Lukah Dykes, Suzanne Edwards, Aditya Eranki, Sarah Flint, Jason Flower, Kerrie Freeman, Tim French, Samuel Gluck, Harry Godber, Rudy Goh, Paul Gould, Amandeep Hansra, Peter Hewett, Russell Hodgson, Ashley Hopkins, Michael Horowitz, Sarah Howson, Mana Ittimani, Jonathan Henry Jacobsen, Alexander Jenkins, Hubertus Jersmann, Melinda Jiang, Karen Jones, Reto Kaepelli, Harish Kamalanathan, Billy Kennington, Emily Kirkpatrick, Pramesh Kovoor, Thiep Kuany, Antony Loan, Alasdair Leslie, Danny Liew, Peter Litwin, Yuchen Luo, Rajiv Mahajan, Jarrod Marks, Matthew Marshall-Webb, Daniel McIntyre, Ben Muston, Daud Mutahar, Silas Nann, Nasim Nematzadeh, Dominic Ng, Robert Padbury, Meet Patel, Henry Pleass, Anthony Porter, Peter Psaltis, Fabio Ramponi, Wendy Rogers, Alistair Royse, Margaret Schnitzler, Veronika Seda, Tony Sherbon, Rachel Short, Rajvinder Singh, Gopal Sivagangabalan, Harry Smallbone, Julian Smith, Peter Subramaniam, Liz Sutton, Ian Tan, Sheryn Tan, Melissa Teo, Aravinda Thiagalingam, David Tivey, Minh-Son To, Markus Trochsler, Richard Turner, Daksh Tyagi, Anton Van Den Hengel, Andrew Vanlint, Santosh Verghese, Leigh Warren, Ashley Wilson-Smith, Geoffrey Wong, Sarah Zaman, Andrew Zannettino, Kathryn Zeitz

Affiliations

¹ Ballarat Base Hospital, Ballarat, Victoria, Australia.
² University of Adelaide, Adelaide, South Australia, Australia.
³ Royal Adelaide Hospital, Adelaide, South Australia, Australia.
⁴ Royal North Shore Hospital, Adelaide, South Australia, Australia.
⁵ University of Melbourne, Ballarat, Victoria, Australia.
⁶ Gold Coast University Hospital, Gold Coast, Queensland, Australia.
⁷ University of Sydney, Sydney, New South Wales, Australia.
⁸ The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
⁹ SA Government, Adelaide, South Australia, Australia.
¹⁰ Lyell McEwin Hospital, Adelaide, South Australia, Australia.
¹¹ Massachusetts General Hospital, Boston, Massachusetts, USA.
¹² Harvard University, Boston, Massachusetts, USA.

PMID: 39754371
DOI: 10.1111/ans.19383

Abstract

Background: The Adelaide Score is an artificial intelligence system that integrates objective vital signs and laboratory tests to predict likelihood of hospital discharge.

Methods: A prospective implementation trial was conducted at the Lyell McEwin Hospital in South Australia. The Adelaide Score was added to existing human, artificial intelligence, and other technological infrastructure for the first 28 days of April 2024 (intervention), and outcomes were compared using parametric, non-parametric and health economic analyses, to those in the first 28 days of April 2023 (control). Artificial intelligence evaluated inpatients admitted under 18 surgical and medical teams, and patients of high likelihood of discharge were provided, on working shifts between Thursday to Sunday, to the Supportive Weekend Interprofessional Flow Team (SWIFT) comprising a senior nurse and pharmacist.

Results: Two thousand nine hundred and sixty-eight admissions were included across intervention and control periods. Relative to the control group, use of the Adelaide Score in the intervention group resulted in significantly shorter median length of stay (3.1 versus 2.9 days, P = 0.028) and significantly lower seven-day readmission rate (7.1 versus 5.0%, p = 0.02). The 0.2 bed-day reduction in median length of stay produced a cost saving of $735 708.60 across the 28-day period, or $9 564 211.80 across a 52-week year. There was no significant difference between intervention and control groups in median length of stay for patients discharged on weekends, in-hospital mortality, or discharge to non-home destinations.

Conclusions: The prospective implementation of the Adelaide Score was associated with improved hospital and cost efficiency, alongside lower readmissions, for patients across surgical and medical services.

Keywords: artificial intelligence; cost saving; efficiency; the Adelaide score.

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References

1. Boyle LM, Mackay M, Stockman K. Ambulance ramping, system pressure, and hospitals in crisis: what do the data tell us? Med. J. Aust. 2021; 215: 526–527.
1. Boscaini J. SA ambulance ramping hits near‐record levels amid ‘extreme’ pressure on the system: ABC News; 2024. Available from URL: https://www.abc.net.au/news/2024-04-02/south-australia-ambulance-ramping....
1. Cook B, Evenden J, Genborg R et al. A brief history of ramping. Intern. Med. J. 2024;54: 1577–1580.
1. Queensland Government. Putting Patients First: Further action to tackle ramping and healthcare pressures 2024 Available from URL: https://www.health.qld.gov.au/__data/assets/pdf_file/0031/1236739/Puttin....
1. Queensland Health. 2023–2024 budget; 2024. Available from URL: https://www.health.qld.gov.au/system‐governance/health‐system/managing/b....

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Grants and funding

Dr Joshua Kovoor and A/Prof Stephen Bacchi are Fulbright Future Scholars, supported by the Australian-American Fulbright Commission.

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The Adelaide Score: prospective implementation of an artificial intelligence system to improve hospital and cost efficiency

Collaborators

Affiliations

The Adelaide Score: prospective implementation of an artificial intelligence system to improve hospital and cost efficiency

Authors

Collaborators

Affiliations

Abstract

References

MeSH terms

Grants and funding

LinkOut - more resources

Miscellaneous