Informs 2015

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INFORMS Philadelphia – 2015
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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,
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,
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,
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,
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, , 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.
MA35
35-Room 412, Marriott
Health Policy
Sponsor: Public Sector OR
Sponsored Session
Chair: Diana Prieto, Assistant Professor, Western Michigan University,
1903 W. Michigan Ave., Kalamazoo, MI, United States of America,
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, , 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.
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,
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, , 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,
, 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,
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
Chair: Jacqueline Griffin, Assistant Professor, Northeastern University,
334 Snell Engineering Center, 360 Huntington Ave, Boston, MA,
02125, United States of America,
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, , 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.
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