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. 2021 Jun 10;4(1):97.
doi: 10.1038/s41746-021-00463-y.

Predictive analytics and tailored interventions improve clinical outcomes in older adults: a randomized controlled trial

Sara Bersche Golas  1 , Mariana Nikolova-Simons  2 , Ramya Palacholla  3   4   5   6 , Jorn Op den Buijs  2 , Gary Garberg  7 , Allison Orenstein  8 , Joseph Kvedar  3   4   5
Affiliations

Predictive analytics and tailored interventions improve clinical outcomes in older adults: a randomized controlled trial

Sara Bersche Golas et al. NPJ Digit Med. .

Abstract

This study explored the potential to improve clinical outcomes in patients at risk of moving to the top segment of the cost acuity pyramid. This randomized controlled trial evaluated the impact of a Stepped-Care approach (predictive analytics + tailored nurse-driven interventions) on healthcare utilization among 370 older adult patients enrolled in a homecare management program and using a Personal Emergency Response System. The Control group (CG) received care as usual, while the Intervention group (IG) received Stepped-Care during a 180-day intervention period. The primary outcome, decrease in emergency encounters, was not statistically significant (15%, p = 0.291). However, compared to the CG, the IG had significant reductions in total 90-day readmissions (68%, p = 0.007), patients with 90-day readmissions (76%, p = 0.011), total 180-day readmissions (53%, p = 0.020), and EMS encounters (49%, p = 0.006). Predictive analytics combined with tailored interventions could potentially improve clinical outcomes in older adults, supporting population health management in home or community settings.

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Conflict of interest statement

M.N.S., J.B. and A.O. are Philips Research employees. Philips funded the study. The remaining authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Participant flowchart.
Figure 1 summarizes the recruitment, randomization, and retention flow of patients in this study, leading to the final analyzed cohort.
Fig. 2
Fig. 2. Patients with single vs. multiple (a) EMS encounters and (b) 90-day readmissions.
Figure 2 summarizes between-groups differences in patients with 1 event versus those with multiple events for EMS encounter and 90-day readmission events.
Fig. 3
Fig. 3. Intervention design—Stepped-Care approach.
Figure 3 shows the (step one) predictive model ingesting data to calculate and generate risk scores, followed by (step two) nurse triage for patients flagged as high risk by the model. The figure also demonstrates how patients are regularly reassessed by the model.
Fig. 4
Fig. 4. Visualizing admissions and readmissions.
Figure 4 illustrates four patients’ examples on how admissions, 30-, 90-, and 180-day readmissions were counted in this study.
See this image and copyright information in PMC

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