NSF Awards Balasubramanian $502,159 to Improve the Healthcare of Patients with Complex Medical and Social Needs
Associate Professor Hari Balasubramanian of the Mechanical and Industrial Engineering (MIE) Department is the principal investigator on a three-year, $502,159 grant from the National Science Foundation (NSF) to support his research on the impact of care interventions for patients who experience significant medical, behavioral-health, and social problems.
The NSF project comprises a collaboration between UMass Amherst and New Jersey’s Camden Coalition of Healthcare Providers, an organization with significant experience in care interventions for patients with complex medical and social needs. The Camden Coalition has worked with thousands of people from the Camden region struggling with chronic health issues, addiction, mental health challenges, poverty, unemployment, and housing instability. The co-principal investigator is Aaron Truchil of the Camden Coalition.
According to Balasubramanian, patients struggling in such ways require specialized healthcare and can account for 25 to 50 percent of national healthcare costs even though they represent less than five percent of the population.
Balasubramanian explains that “Holistic, person-centered, care interventions – often led by a multidisciplinary team consisting of nurses, community health workers, and social workers – have emerged as a strategy to engage with and help improve the health and wellbeing of such patients."
During such interventions, members of the care team repeatedly visit patients’ homes, cultivating authentic healing relationships, managing comorbidities, helping reconcile their medications, arranging primary and specialty care visits, accompanying patients to those visits, arranging for transportation, procuring medical equipment, and more.
Social workers and community health workers in the care team also address issues such as lack of housing, employment, legal services, insurance, mental health, and addictions.
Balasubramanian adds that “Such interventions are a still-emerging field of research, and the project will study several open questions, including longitudinal patterns of healthcare use among patients, the role of specific combinations of medical and social factors, and the impact of the time spent by the care team on patient outcomes.”
The primary contribution of this research, as Balasubramanian notes, is the adaptation of probability models to patient-level longitudinal data spanning multiple parts of health and social services systems. This approach includes the data obtained from Camden Coalition’s multi-year randomized controlled trial, which tested the impact of the care intervention on patients with complex medical and social needs
Balasubramanian concludes that “The [NSF] project aims to bring together a unique mix of data-driven probability models, optimization, and statistical learning methodologies informed by longitudinal data to a vital yet under-explored domain of healthcare.”
In general, Balasubramanian’s research team in the MIE department studies operations research applied to healthcare delivery. Some examples include: improving the ability of patients to see their primary care physicians in a timely manner; scheduling and staffing in hospitals to meet care needs without delays; and using publicly available datasets to identify patterns among patients with multiple chronic conditions.
In addressing these problems, Balasubramanian has worked with a number of national and local healthcare facilities beyond the Camden Coalition of Healthcare Providers. They include the renowned Mayo Clinic in Rochester, Minnesota, and Massachusetts General Hospital in Boston. (July 2022)