Xinxin Zhu

Information technology for healthcare transformation

Rising costs, decreasing quality of care, diminishing productivity, and increasing complexity have all contributed to the present state of the healthcare industry. The interactions between payers (e.g., insurance companies and health plans) and providers (e.g., hospitals and laboratories) are growing and are becoming more complicated. The constant upsurge in and enhanced complexity of diagnostic and treatment information has made the clinical decision-making process more difficult. Medical transaction charges are greater than ever. Population-specific financial requirements are increasing the economic burden on the entire system. Medical insurance and identity theft frauds are on the rise. The current lack of comparative cost analytics hampers systematic efficiency. Redundant and unnecessary interventions add to medical expenditures that add no value. Contemporary payment models are antithetic to outcome-driven medicine. The rate of medical errors and mistakes is high. Slow inefficient processes and the lack of best practice support for care delivery do not create productive settings. Information technology has an important role to play in approaching these problems. This paper describes IBM Researchs approach to helping address these issues, i.e., the evidence-based healthcare platform.

DYNAMIC AND ACCRETIVE COMPOSITION OF PATIENT ENGAGEMENT INSTRUMENTS FOR PERSONALIZED PLAN GENERATION

Patient engagement is important to help patients become more informed and active in managing their health. Effective patient engagement demands short, yet valid instruments for measuring self-efficacy in various care dimensions. However, the static instruments are often too lengthy to be effective for assessment purposes. Furthermore, these tests could neither account for the dynamicity of measurements over time, nor differentiate care dimensions that are more critical to certain sub-populations. To remedy these disadvantages, we devise a dynamic instrument composition approach that can model the measurement of patient self-efficacy over time and iteratively select critical care dimensions and appropriate assessment questions based on dynamic user categorization. The dynamically composed instruments are expected to guide patients through self-management reinforcement cycles within or across care dimensions, while tightly integrated into clinical workflow and standard care processes.

Automatic summarization of risk factors preceding disease progression an insight-driven healthcare service case study on using medical records of diabetic patients

In this study we consider the problem of how to derive insight from medical records to define and improve healthcare services. As noted in many guidelines, risk factors are important to determining the care plan of chronic disease patients, e.g., pre-diabetic or diabetic patients who have started on hemoglobin A1c (HbA1c) control medications. Whereas the traditional management of chronic disease relies on a predetermined set of risk factors, without regard to patient-specific status, literature and recently released guidelines have suggested a less-prescriptive approach that allows flexibility in disease management plans to account for patient-centric information shown in medical records. However, methods of systematically summarizing medical records into risk factors have not been evaluated to support such a patient-centric focus in healthcare services. In this study, we evaluated automatic methods that can identify risk factors important for classifying Diabetic patients at risk of worsen disease progression. In particular, we used the prescription of cardiovascular disease (CVD) medication as the indicator of CVD co-morbidity development in Diabetic patients. We evaluated the summaries obtained with different sources of health information on the risk stratification task and examined the quality of the generated summaries using various proposed intrinsic metrics. In addition, we evaluated to what extent we can reduce the whole medical records into a small set of risk factors. The evaluation illustrates the potential of risk factor summarization and hints on how it can be used to enable practitioners in care planning and to support complex follow-up services at both the point of care and the extended care settings.

cHRV uncovering daily stress dynamics using bio-signal from consumer wearables

Knowing the dynamics of ones daily stress is essential to effective stress management in the context of smart and connected health. However, there lacks a practical and unobtrusive means to obtain real-time and longitudinal stress information. In this paper, we attempt to derive a convenient HRV-based (heart rate variability) biomarker named cHRV, which can be used to reliably reflect stress dynamics. cHRVs key advantage lies in its low maintenance and high practicality. It can be efficiently calculated only using data from photoplethysmography (PPG) sensors, the mainstream heart rate sensor embedded in most of the consumer wearables like Apple Watch. Benefiting from the proliferation of wearables, cHRV is ideal for day-to-day stress monitoring. To evaluate its feasibility and performance, we have conducted 14 in-lab controlled experiments. The result shows that the proposed cHRV has strong correlation with the stress dynamics (r > 0.95), therefore exhibits great potential for continuous stress assessment.