Designing a Consumer-centric Care Management Program by Prioritizing Interventions Using Deep Learning Causal Inference.

Tianhao Li, Haoyun Feng, Vikram Bandugula, Ying Ding
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Abstract

Care management is a team-based and patient-centered approach to reduce health risks and improve outcomes for managed populations. Post Discharge Management (PDM) is an important care management program at Elevance Health, which is aimed at reducing 30-day readmission risk for recently discharged patients. The current PDM program suffers from low engagement. When assigning interventions to patients, case managers choose the interventions to be conducted in each call only based on their limited personal experiences. In this work, we use deep learning causal inference to analyze the impact of interventions conducted on the first call on consumer engagement in the PDM program, which provides a reliable reference for case managers to select interventions to promote consumer engagement. With three experiments cross-validating the results, our results show that consumers will engage more in the program if the case manager conducts interventions that require more nurse-patient interactions on the first call. On the other hand, conducting less interactive and more technical interventions on the first call leads to relatively poor consumer engagement. These findings correspond to the clinical sense of experienced nurses and are consistent with previous findings in patient engagement in hospital settings.

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利用深度学习因果推理确定干预措施的优先次序,设计以消费者为中心的护理管理计划。
护理管理是一种以团队为基础、以患者为中心的方法,旨在降低健康风险并改善受管理人群的治疗效果。出院后管理(PDM)是 Elevance Health 的一项重要护理管理计划,旨在降低近期出院患者的 30 天再入院风险。目前的 PDM 计划参与度不高。在为患者分配干预措施时,病例管理人员仅根据其有限的个人经验选择每次呼叫中要进行的干预措施。在这项工作中,我们利用深度学习因果推理分析了第一次呼叫中进行的干预对 PDM 项目中消费者参与度的影响,这为个案经理选择干预措施以促进消费者参与度提供了可靠的参考。通过三个实验的交叉验证,我们的结果表明,如果个案管理者在首次呼叫时进行需要更多护士与患者互动的干预,消费者会更多地参与到项目中来。另一方面,在首次呼叫中进行互动较少、技术性较强的干预会导致消费者参与度相对较低。这些发现与经验丰富的护士的临床感觉相吻合,也与之前在医院环境中患者参与度的研究结果相一致。
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