Improving Health Care Management Through Persistent Homology of Time-Varying Variability of Emergency Department Patient Flow

Excessive admissions at the emergency department (ED) is a phenomenon very closely linked to the propagation of viruses. It is a cause of overcrowding for EDs and a public health problem. The aim of this work is to give EDs' leaders more time for decision making during this period. Based on the admissions time series associated with specific clinical diagnoses, we will first perform a detrended fluctuation analysis to obtain the corresponding variability time series. Next, we will embed this time series on a manifold to obtain a point cloud representation and use topological data analysis through persistent homology technic to propose two early real-time indicators. One is the early indicator of abnormal arrivals at the ED whereas the second gives the information on the time index of the maximum number of arrivals. The performance of the detectors is parameter dependent and it can evolve each year. That is why we also propose to solve a biobjective optimization problem to track the variations of this parameter.