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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

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Leveraging Clinical Informatics to Address the Quintuple Aim for End-of-Life Care.

Amanda Zaleski¹, Kelly J Thomas Craig¹, Eamon Caddigan²

¹Clinical Evidence Development, Aetna Medical Affairs, CVS Health, Wellesley, MA, US.

AMIA ... Annual Symposium Proceedings. AMIA Symposium

|January 15, 2024

Summary

This summary is machine-generated.

This study introduces a data-driven Compassionate Care Program (CCP) to improve end-of-life care for older adults. The program successfully reduced hospital admissions and healthcare costs while ensuring equitable outcomes.

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Area of Science:

Gerontology and Palliative Care Informatics
Health Services Research
Machine Learning in Healthcare

Background:

Growing elderly population necessitates culturally tailored end-of-life care solutions.
Significant gap exists in providing specialized care management for patients with life-limiting illnesses.
The Quintuple Aim framework guides the development of healthcare improvements.

Purpose of the Study:

To describe a payor-led, informatics-based strategy for identifying Medicare beneficiaries eligible for a Compassionate Care Program (CCP).
To evaluate the impact of the CCP on end-of-life care experience, health outcomes, and healthcare expenditures.
To assess the program's effectiveness in addressing the Quintuple Aim.

Main Methods:

Utilized machine learning models to identify potential participants for the CCP among Medicare members.
Employed nurse care managers for personalized telephone outreach to identified individuals.
Conducted a retrospective, observational cohort analysis comparing propensity-weighted decedents with and without CCP participation.

Main Results:

The Compassionate Care Program (CCP) enhanced the end-of-life care experience for participants.
Equitable outcomes were observed across diverse demographics (age, gender, geography).
CCP participation led to a significant decrease in inpatient admissions (-37%) and medical spending (-59%) compared to non-participants.

Conclusions:

An informatics-based, payor-led approach can effectively identify and engage patients for specialized end-of-life care programs.
The Compassionate Care Program demonstrates significant benefits in improving care quality, reducing healthcare utilization, and lowering costs.
This model supports the Quintuple Aim by enhancing patient and caregiver experience, improving outcomes, and reducing costs.