Reducing hospitalisations and arrests of mental health patients through the use of Analytics and

Care Co-ordinationSuzi Shaw LyonsIBM New Zealand

Watson Health

Mental health care challenges result in negative outcomes

Almost 10% individuals discharged from a state psychiatric hospital will be readmitted within 30 days; more than 20% will be readmitted within 180 days1

Total annual cost of mental illness in jails and prisons is estimated at $15 billion3

Hospitalization Reincarceration Homelessness

20% to 25% of the homeless population in the United States suffers from some form of severe mental illness5

U.S

. Nat

iona

l St

atis

tics

How do we break the cycle?

Keith SJ, Kane JM. J Clin Psychiatry. 2003;64(11):1308-1315.

Incompleterecovery

Symptomexacerbation

Relapses

Danger toself/others

Occasional Days Weeks Months

Loss of confidence

Loss of job

Loss of Social Support

Re-hospitalization

Danger toself/others

IMPA

CT O

N IL

LNES

S

DURATION OF NONADHERENCE

PATIENT IN CRISIS

Homelessness

HighCosts

The Stakeholders

Patient•Self managed•Better care•Complete and comprehensive evaluation

•No deterioration •Crisis Avoidance•Reduce burden to others

Government•Crime reduction•Improve public safety•Reduce cost of uncompensated care

•Effective jail capacity management

•Judicial system efficiency

Caregivers•Crisis Avoidance•Less demand/stress•More free time•Increase productivity•Peace of mind

Providers•Better outcomes•Cost savings•Care plan effectiveness•Crisis monitoring•Decision support•Complete and comprehensive view of patient history and status

Payer / System•Better Outcomes•New insights to manage risk•Work flow and administrative efficiencies•Regulatory and contract compliance•Complete and accurate clinical data• Reduce fraud

Care Coordination: Initial Scope

Improved Outcome and

Functional Recovery

Improve Appropriate

Use and Adherence

to Treatment

Improve continuity of

care

Provide Enhanced

Performance Reports

Identify High Risk/High

Cost Patients

Establish Common

Database of Assessment

and Treatment History

CoordinationEngage, convene, collaborate and cross boundaries to help deliver an integrated plan to achieve optimal outcomes and lower costs

Understand

Engage

FoundationKnow individuals and populations, and recognize intervention opportunities to apply evidence-based and standardized care planning

Know

WellnessD

ata-

driv

en in

sigh

ts

Expe

rien

tial i

nsig

htsAnalytics and cognitive computing

Gain understanding through data-driven insights that enable providers to act with greater visibility into outcomes and cost

Analytic Tools enable the analysis to develop the insights and objectives

Predictive Modeling Disease Onset& Progression

Predictive Analytics

Multimodal Longitudinal Patient Data (e.g. Structured +

Unstructured [text, image, genetics, …],

potentially social media)

Chance ofAdverse Event = 80%

X months

Hypothesis Testing

Cluster ProfilesPopulationClustering

Analytics Tools Insights

Crisis Prediction

Care Qualityand Outcome

Analysis

PopulationManagement

Foundation

Let’s meet David

David’s assessment and referral

Is David at risk?

David’s future

CoordinationEngage, convene, collaborate and cross boundaries to help deliver an integrated plan to achieve optimal outcomes and lower costs

Understand

Engage

FoundationKnow individuals and populations, and recognize intervention opportunities to apply evidence-based and standardized care planning

Know

WellnessD

ata-

driv

en in

sigh

ts

Expe

rien

tial i

nsig

htsAnalytics and cognitive computing

Gain understanding through data-driven insights that enable providers to act with greater visibility into outcomes and cost