2015 Informs Annual Meeting

MA34

INFORMS Philadelphia – 2015

MA34 34-Room 411, Marriott Managing Healthcare Services Sponsor: Health Applications Sponsored Session Chair: Vishal Ahuja, Southern Methodist University, P.O. Box 750333, Dallas, TX, United States of America, vahuja@smu.edu 1 - Coordination between Service Professionals in Health Care Delivery: A Multiple-case Study Claire Senot, Tulane University, 7 McAlister Dr., New Orleans, LA, United States of America, csenot@tulane.edu, Aravind Chandrasekaran, Peter T. Ward We investigate the specific coordination challenges faced by hospital’s caregivers (physicians and nurses) and the organizational mechanisms that allow them to combine their expertise. We employ a case study methodology that involves 49 semi-structured interviews from the heart-failure units of five U.S. acute care hospitals. 2 - Patient Portals in Primary Care: Impacts on Patient Health and Physician Productivity Hessam Bavafa, Assistant Professor, Wisconsin School of Business, Madison, WI, United States of America, hbavafa@bus.wisc.edu Interest in innovative healthcare delivery models has increased due to measures such as the Affordable Care Act, which is designed to expand insurance coverage and contain healthcare costs. One innovation that has been forwarded as a low- cost alternative to physician office visits is “e-visits,” or secure messaging between patients and physicians. We evaluate the effect of e-visit adoption on patient health and physician productivity using a panel dataset from a primary care provider in the US. 3 - Quantifying the Impact on Care Coordination on Health Outcomes Vishal Ahuja, Southern Methodist University, P.O. Box 750333, Dallas, TX, United States of America, vahuja@smu.edu, Hari Balasubramanian, Ian Mccarthy This paper quantifies the impact of care coordination on patient health outcomes, using data on outpatient health encounters for diabetes patients. Considering that a PCP’s task is to consciously facilitate the patient’s navigation of the health system, we use the number of PCP visits as a proxy for care coordination. We define new measures to capture the fragmentation of care. 4 - Does Medical Litigation Against Physicians Increase Inpatient Hospital Costs? Zeynal Karaca, Senior Economist, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD, United States of America, zeynal.karaca@ahrq.hhs.gov, Mehmet Ayvaci, Turgay Ayer, Herbert Wong We empirically assess the impact of medical litigations against physicians on hospital inpatient costs using Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases. We separately assess the cost impact on individual physicians facing the lawsuit and other physician colleagues (spillover effects). We find increased inpatient costs due to medical litigation and substantial variation in the degree of impact across board certified medical specialties.

2 - Mapping Chikungunya Disease Transmission and Implications for Surveillance

Elaine Nsoesie, Assistant Professor, IHME, University of Washington, 2301 5th Avenue Suite 600, Seattle, WA, United States of America, en22@uw.edu

A Chikungunya virus epidemic, which started in December 2013 in the Caribbean island of St. Martin has spread to several countries and islands in the Americas, affecting an estimated one million people within a year. We applied a comprehensive approach involving the integration of data from multiple sources to assess and map the global occurrence of Chikungunya. A thorough knowledge of Chikungunya transmission globally has significant implications for surveillance and burden estimation. 3 - Value of Perfect Information and Perfect Implementation: Anyi-VEGF Therapy for Ophthalmologic Use David Hutton, Assistant Professor, Department of Health Management and Policy, University of Michigan, 1420 Washington Heights, Ann Arbor, Mi, 48109, United States of America, dwhutton@umich.edu, Eric Ross, Joshua Stein We discuss differences between the value of information and value of implementation in the case of high-cost anti-VEGF therapy for ophthalmologic use. We review uncertainty in clinical trial data and discuss how it is used to create prior distributions necessary to ascertain value of information. We review Markov modeling and Monte Carlo methods for calculation, provide examples of these results for anti-VEGF therapy (billions of dollars), discuss next steps, and insights for other diseases. 4 - Data-driven Monitoring of Medical Recommendations for Breast Cancer Treatment Milton Soto, PhD Candidate, Western Michigan University, 4601 Campus Drive, Kalamazoo, MI, 49008, United States of America, miltonrene.sotoferrari@wmich.edu, Diana Prieto Medical recommendations for Breast Cancer healthcare may create overtreatment or undertreatment. Overtreatment may occur when aggressive courses are prescribed to patients with low risk of cancer spreading, while undertreatment may be generated by patients’ behaviors, as well as by social, economical or racial disparities. We describe techniques for the monitoring of over or undertreatment using data mining methods to identify possible mistreatment candidates. 5 - Performance of Machine Learning Models in Predicting Presence of BRCA Mutations Mehrnaz Abdollahian, University of South Florida, 4202 East Fowler Avenue, Tampa, FL, 33620, United States of America, mehrnaz@mail.usf.edu, Tapas K. Das BRCA1/2 gene mutations drastically increase chances of developing breast and ovarian cancers. These mutations are present in most hereditary breast and ovarian cancer patients. It is common practice for the physicians to require genetic BRCA testing for those that fit the rules of national cancer comprehensive network. However, historically 70% of tested are found negative. We have examined the power of predicting BRCA mutations using machine learning models on a nation-wide survey data.

MA36 36-Room 413, Marriott Resilient Public Health Supply Chains Sponsor: Public Sector OR Sponsored Session

MA35 35-Room 412, Marriott Health Policy Sponsor: Public Sector OR Sponsored Session

Chair: Jacqueline Griffin, Assistant Professor, Northeastern University, 334 Snell Engineering Center, 360 Huntington Ave, Boston, MA, 02125, United States of America, ja.griffin@neu.edu 1 - Minor Disruptions Lead to a Major Problem for the U.S. Saline Supply Chain Rana Azghandi, Northeastern University, 334 Snell Engineering Center, 360 Huntington Ave, Boston, MA, 02125, United States of America, rana.azghandi@gmail.com, Ozlem Ergun, Jacqueline Griffin In January 2014, FDA announced an ongoing national shortage of saline which has resulted in increased health risks for patients across the country. The underlying cause of this shortage has been the simultaneous occurrence of many small disruptions such as recalls and increased demand. A system dynamics model is used to analyze the saline supply chain network and to characterize how such a phenomenon results from minor supply disruptions due to feedback processes.

Chair: Diana Prieto, Assistant Professor, Western Michigan University, 1903 W. Michigan Ave., Kalamazoo, MI, United States of America, diana.prieto@wmich.edu 1 - A Bilevel Optimization Model for Health Information Exchange Policy Design Diego A. Martinez, Postdoctoral Fellow, Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD, 21205, United States of America, dmart101@jhmi.edu, Tapas K. Das, Jose L. Zayas-Castro, Felipe Feijoo Health information exchange (HIE) requires collaboration among competitors. While exceptions exist, reluctance to engage in information sharing is abundant from small medical practices to large hospital systems. To study the potential impact of federal policy stimulating HIE participation, we present a strategic gaming model formulated as a bilevel optimization program. Numerical examples from a hospital network in Florida are presented.

156