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HEALTH INTELLIGENCE SYSTEM · 2024

Chronic disease
prediction using
graph machine learning.

A graph-based risk stratification system that connects longitudinal health, claims and service-use data to identify patients who may benefit from earlier, better-targeted care.

Explore system ● CONFIDENTIAL DATASET

PROJECT TYPE

Predictive analytics
& clinical decision support

METHODS

Graph neural networks
Network representation learning

CLIENTS & COLLABORATORS

University of Sydney
CBHS

STATUS

PEER-REVIEWED
RESEARCH PROGRAM

Risk does not live
in a single record.

Chronic conditions emerge through patterns: diagnoses, medications, service utilisation, demographic context and the pathways patients take through care.

Conventional models usually treat each patient as an isolated row. This project reframed the data as a dynamic network, capturing relationships between patients, conditions, providers and episodes of care.

From fragmented records to an action-ready risk signal.

01

Ingest

Securely prepare longitudinal clinical, claims and service-use data.

02

Connect

Represent people, events and care relationships as a heterogeneous graph.

03

Learn

Train temporal graph models to surface emerging risk patterns.

04

Act

Route calibrated risk signals into prioritisation workflows.

Performance with
evidence.

Published evaluations compare network-informed models against established tabular baselines, with a focus on useful representation of comorbidity and patient similarity.

93.49%

accuracy for cardiovascular disease prediction

89.15%

accuracy for chronic pulmonary disease prediction

0.79–0.91

AUC range in the type 2 diabetes study

Reported results are drawn from the linked peer-reviewed studies. Production performance should be revalidated for each population, care setting and intended decision.

Built on a published
body of work.

Multiple peer-reviewed studies translate graph methods into practical risk-modelling capabilities. The program brings academic rigour and industry context together through collaboration between the University of Sydney and CBHS (Commonwealth Bank Health Society).

RISK STRATIFICATION / PROTOTYPE VIEWUPDATED 08:32

Make the next
patient review
count.

Rather than producing a black-box score, the interface surfaces a reviewable group of patients, the associated drivers and a practical route to action.

PATIENT CLUSTERRISKPRIMARY SIGNALPATHWAY
CLUSTER_102HIGHComorbidity + service useReview in 7 days
CLUSTER_247ELEVATEDMedication change patternCare outreach
CLUSTER_391ELEVATEDUnplanned admissionsClinical review
CLUSTER_456WATCHMissed follow-up eventMonitor
MODEL OUTPUTS ARE DESIGNED TO SUPPORT — NOT REPLACE — CLINICAL JUDGEMENT.
Better prediction is only useful when it makes the next decision clearer.
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