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J Med Syst. 2019 Jan 17;43(3):44. doi: 10.1007/s10916-019-1160-5.

Machine Learning Can Improve Estimation of Surgical Case Duration: A Pilot Study.

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Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.
Leap Rail Inc, Houston, TX, USA.
NorthBay Healthcare, Fairfield, CA, USA.
Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.
Center for Perioperative Research, Brigham and Women's Hospital, Boston, MA, USA.


Operating room (OR) utilization is a significant determinant of hospital profitability. One aspect of this is surgical scheduling, which depends on accurate predictions of case duration. This has been done historically by either the surgeon based on personal experience, or by an electronic health record (EHR) based on averaged historical means for case duration. Here, we compare the predicted case duration (pCD) accuracy of a novel machine-learning algorithm over a 3-month period. A proprietary machine learning algorithm was applied utilizing operating room factors such as patient demographic data, pre-surgical milestones, and hospital logistics and compared to that of a conventional EHR. Actual case duration and pCD (Leap Rail vs EHR) was obtained at one institution over the span of 3 months. Actual case duration was defined as time between patient entry into an OR and time of exit. pCD was defined as case time allotted by either Leap Rail or EHR. Cases where Leap Rail was unable to generate a pCD were excluded. A total of 1059 surgical cases were performed during the study period, with 990 cases being eligible for the study. Over all sub-specialties, Leap Rail showed a 7 min improvement in absolute difference between pCD and actual case duration when compared to conventional EHR (p < 0.0001). In aggregate, the Leap Rail method resulted in a 70% reduction in overall scheduling inaccuracy. Machine-learning algorithms are a promising method of increasing pCD accuracy and represent one means of improving OR planning and efficiency.


Case duration; Efficiency; Model; Natural language processing; Operating room; Prediction

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