5 Questions to Ask Before Building a Readmissions Model

Do you have access to the EMR data from the inpatient stay?At the time the prediction is made, at discharge, ABC Health has prescription claims, near real-time ADT feeds, and CMS blue-button patient history, but they do not have access to the EMR data from the hospital stay.

Also, their medical claims have a 3-month delay meaning all the medical claims they have for a patient would be from a previous admission — if there was one.

By answering these five questions, we’re able to define our model in much more detail than just predicting readmissions.

Let’s see how our model has evolved.

Initially: “I want to predict readmissions at ABC Health”After answering the 5 questions: “I want to optimize the in-home nurse visit intervention by predicting who will either get readmitted or have an adverse reaction like death within 45 days of discharge to home, but ignoring admissions related to pregnancy or cancer.

These predictions will be made every day starting when the patient is discharged until 45 days after the initial admission.

The machine learning model will be powered from prescription claims, ADT feeds, CMS blue-button data, and 3-month delayed medical claims.

”This framework is extremely effective and valuable for creating an AI model that provides a real return on investment because you’ve defined the model with your specific organization in mind.

Give it a try and let me know how it goes!Author: Megha Jain — Head of ProductMegha is a seasoned product manager with over 11 years of experience bringing software solutions to market.

Besides her deep experience in technology with a Masters in Computer Science Engineering from the University of Michigan, she also has a strong business foundation from her MBA at MIT Sloan School of Management.

She enjoys working on user-centric products and has a passion for using technology to help improve lives.

Originally published at https://closedloop.

ai on May 31, 2019.

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