Saturday, February 10, 2018

Brilliant Lecture on Healthcare and Operations Research by Dr. Hari Balasubramanian

Yesterday, Professor Hari Balasubramanian of the Mechanical and Industrial Engineering Department at UMass Amherst kicked off our Spring 2018 UMass Amherst INFORMS Speaker Series.  His lecture: Care Coordination for Complex, High-Utilizing Patients: The Camden Coalition Experience was brilliant.
The announcement for his talk even made the UMass Amherst homepage!
The UMass Amherst INFORMS Student Chapter President, Deniz Besik, introduced him, although to many he did not need an introduction given his renown as an educator and also as a researcher, having received an NSF CAREER Award. Before joining the faculty at UMass Amherst in 2008, Dr. Balasubramanian spent two years as a postdoc at the Mayo Clinic in Minnesota.
Dr. Balasubramanian began his talk with excellent motivation including that he first became familiar with the Camden Coalition project through a video report by Dr. Atul Gawande (I am a huge fan of his books) on doctor hotspots, which is a must see. Dr. Balasubramanian contacted the Coalition and then began working with them and using what is being called the most detailed dataset in healthcare. The data is granular, time data. He shared with us that 1% of the top "spending" patients account for 25-30% of the total costs. There is a very skewed structure - a minority of the patients experience multiple hospitalizations - higher hospitalizations account for higher costs. He spoke about patients being on 17 different medicines and how the outcome for many of these patients does not improve. Some of this is due to poor coordination of care and after care. Their care is fragmented and there had not been enough studies done on the associated time effort.

Dr. Balasubramanian's lecture was in three parts: patient trajectories, learning and prediction, and workload and staffing (perfect for operations research to address via queuing and capacity planning). The Camden Coalition consists of nurses as well as social workers and community health workers. The dataset has data on 531 patients and 331 have "graduated" from this program. The patient's trajectory begins when the patient agrees to an "intervention" and the trajectories are also mapped and time stamped (with icons that were very effective). A patient "graduates" when he/she is "self-reliant".

Dr. Balasubramanian detailed numerous research questions, such as what are the links between workload of the providers and the high-utilizing care patient outcomes. He also described some of the approaches to investigation, including the use of machine learning, and decision trees and random forests (which generated a lot of questions from the audience), and, of course, beautiful classical and advanced queuing theory! The work is with partners at the Camden Coalition and his doctoral student, Ekin Koker, a very active UMass Amherst INFORMS Student Chapter member and former Webmaster!
His talk was an exemplar of Doing Good with Great Operations Research. He is also working now in Holyoke, Massachusetts, which has some of the healthcare shortcomings as Camden had and still has.

We had a lovely lunch at the UMass Amherst University Club after his lecture.
To celebrate his great talk the group of six shared four desserts, including the one below.
Afterwards, Dr. Balasubramanian was interviewed in the Supernetworks Lab at the Isenberg School for a video that the chapter will be positing on its youtube channel soon, a fabulous initiative begun this year. See the interview with Dr. Renata Konrad by Deniz Besik here. Also, see the interview with Dr. Dmytro Matsypura by Pritha Dutta.

A HUGE thanks to Professor Balsubramanian for all his time and efforts for speaking to us and from the great work that he and his team are doing in Operations Research and Healthcare!