“ high precision analytics for healthcare: promises and challenges” by sriram vishwanath

High Precision Analytics for Healthcare: Promises and Challenges

Sriram VishwanathProfessor, UT Austin

Cofounder, Accordion HealthPresident, Brilliant.MD

Problems with Predictive Analytics

Where Are My Actionable Insights?

“… Software X is a black box. I put my data, and it gives me some sort of risk scores. I know that high risk scores are bad. So, what should I do next? …”

“… I purchased Software Y, and it gives me a report that there have been thirty preventable readmissions in the last month. But I want to know what to do to prevent them in the future … “

Wait!All those people said that they do “predictive” analytics

A Good Approach• Population Health Personalized Health• Identify High Risk Patients Predict Change of Risk• I can Predict it all Based on Measured Precision

Key InsightProvider is as critical as patient in determining outcomes

The Importance of Right Methodology

Claims

Rx

Labs

EHR

transforminto

tensorsfeature

extraction

apply algorithms(ML and traditional)

blend

ing

model

Input

ActionableInsight

Intervention

feedback

feedback

GLM

kNN

RF

*courtesy Accordion Health

Forecast the Future

Example – Joe S.

• 69 y/o man with COPD & h/o acute exacerbations• Tend to occur annually with seasonal

triggers• Also has DM, HTN which are relatively

poorly-controlled• He does not always take his COPD meds• PCP: Dr. Alvarez (and other members of

healthcare ecosystem)• Risk score: Medium

Example – Joe S.

Joe had a COPD exacerbation last spring…

So, it’s not surprising that he will likely have another exacerbation next spring

Difficulty in Prediction : EasyAssociated Costs: High

Intervention: Medication Reminder Intervention: Home-visitEfficacy: Low

Efficacy: High

Example – Linda R. • 76 y/o woman with h/o well-

controlled Hypertension• Family h/o of CVD• Recently seen for palpitations, but

otherwise asymptomatic• Mostly adherent to medication• PCP: Dr. Lin• Risk score: Low

Example – Linda R.

Although palpitations are asymptomatic

We predict severe cardiac dysrhythmia, like atrial fibrillation And the likelihood

of a stroke is highDifficulty in Prediction : Hard

Associated Costs: Extremely HighIntervention: PCP-visit, additional medication prescribed

Efficacy: High

Measured Precision

*courtesy Accordion Health

Predicted Superutilizers

Alice S.Bob W.Cindy N.Doug D.Eve A.Frank L.George B.

Hank T.Ivana M.Jack K.

Alice S.

Cindy N.

Keith L.Larry L.Mary W.Nancy S.Olivia Z.

Patrick W.Quincy A.

Robert S.

13

POST-ACUTE RISK PREDICTION

Case Study

BUNDLING: POST-ACUTE RISK PREDICTIONPost Acute Pathways

Discharge Date Day 0

CJR PeriodDay 90

Home Health

SNF

Inpatient

Good Decision: Patient A (blue) placed in a Skilled Nursing Facility (SNF), then goes home.

Bad Decision: Patient B (red) placed in (HHA) after discharge, resulting in readmission due to surgical complications.

Patient A

Patient B

*courtesy Accordion Health

Post Discharge Facilities Determine Overall Costs

*courtesy Accordion Health

Micro Targeting and Forecasting for Care Intervention

*courtesy Accordion Health

Targeted Predictive Prescriptive

Sriram Vishwanathsriram@utexas.edu