An AI-Enabled Predictive Harm Response Management Algorithmic Tool to Reduce Adverse Events in Health Care Settings (PreHaRM): Protocol for a Three-Phase Model Development and Pilot-Testing Study

Clinical Snapshot

Key Findings

• P Value: Not applicable - protocol study

• Effect Size: Not applicable - protocol study

• Primary Outcome: Development of predictive harm algorithm - results pending

• Nnt Or Sensitivity: Sensitivity and specificity metrics planned but not yet available

• Confidence Interval: Not applicable - protocol study

Clinical Application

Requires significant IT infrastructure and data governance frameworks; implementation complexity high Designed specifically for Australian healthcare system with SA-NT DataLink integration; aligns with national digital health initiatives Nurses, midwives, and healthcare administrators in acute care settings

Abstract

BACKGROUND: Current data analysis and coordination methods do not effectively support nurses and midwives in risk reduction, as retrospective reporting does not allow real-time insights and precludes proactive, preventive care. Analysis of administrative data within Australia's health care sector to predict risk may help address this shortcoming. Predictive analytics can transform these data into meaningful insights, identifying harm risk profiles that benefit the performance of Australian and international clinical programs. Importantly, these tools may support nurses and midwives in preventing adverse events and predicting high-risk situations. Researchers, in collaboration with local health network staff, will develop a proof-of-concept predictive risk algorithm. The "predictive harm response management algorithmic tool to reduce adverse events in healthcare settings" program (project DHCRC-0156) will provide real-time insights via an interactive dashboard, enabling nurses, midwives, and health administration to assess risks and optimize resources in health care settings. This protocol details the algorithm development activities for subproject 1a, predictive risk model development, which aims to develop and pilot-test a predictive harm algorithm across 2 South Australian local health networks. OBJECTIVE: This study aims to identify the clinical harm outcome of interest and relevant data sources per site and build a suitable data solution to model predictors of harm risk and identify actionable clinical, workforce, and environmental factors that affect the harm outcome of interest. METHODS: This study design includes three phases: (1) model generation, (2) model evaluation, and (3) prototype development. Data linkage by SA-NT DataLink can only proceed following approval from each of the following: the South Australia Department for Health and Wellbeing Human Research Ethics Committee, the University of South Australia Human Research Ethics Committee, and hospital governance committees. The clinical dataset will be split into a training set, a validation set, and a test set. Exploratory data analysis will be undertaken to ascertain features and classify outcomes from the raw dataset. Derived features will be computed, feature correlations will be estimated, and initial feature selection will be performed. Iterative model development will occur over 3 stages, and a dashboard to display these results will be developed. RESULTS: The study commenced on July 19, 2021, and will conclude on December 31, 2025. Finalized results are expected in December 2025. CONCLUSIONS: This research will conclude with the development of the algorithm for transferability to health care environments. Research activities will be detailed in publicly available reports and manuscripts prepared for peer-reviewed journals that will be drafted in accordance with existing and appropriate checklists. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/75474.

References

1. 1.Eckert, M., Sharplin, G., Mayer, W., Grossmann, G., Stanek, J., Gupta, G., Darch, L., Stumptner, M., & Marlow, N. (2026). An AI-Enabled Predictive Harm Response Management Algorithmic Tool to Reduce Adverse Events in Health Care Settings (PreHaRM): Protocol for a Three-Phase Model Development and Pilot-Testing Study. JMIR Research Protocols. https://doi.org/10.2196/75474