Clarity Healthcare Intelligence: population health management based on artificial intelligence - optimization in risk prediction and management of coronary artery disease and post-operative results

• Grant number: 19/09068-3
• Support Opportunities: Research Grants - Innovative Research in Small Business - PIPE
• Duration: June 01, 2021 - February 28, 2022
• Field of knowledge: Health Sciences - Collective Health - Preventive Medicine
• Principal Investigator: Luiz Sérgio Fernandes de Carvalho
• Grantee: Luiz Sérgio Fernandes de Carvalho
• Host Company: Clarity Healthcare Desenvolvimento de Software Ltda
• CNAE: Atividades de consultoria em gestão empresarial ; Atividades de serviços de complementação diagnóstica e terapêutica ; Atividades de apoio à gestão de saúde
• City: Jundiaí
• Pesquisadores principais: Marta Duran Fernandez
• Associated researchers: Bernardo Trindade ; Mauricio Daher Andrade Gomes ; Rebeca Gouget Sérgio Miranda
• Associated grant(s): 22/14190-5 - Brazilian Initiative for Population Health Management (Clarity:iGESTO): impact of active monitoring and health education on hospitalizations and control of cardiovascular risk factors, AP.PIPE
• Associated scholarship(s): 21/08602-6 - Population Health Management: Development of a Semi-Automated Computer Analysis System to Estimate Individual Health Risk and Its Future Costs, BP.TT; 21/08601-0 - Population Health Management: Development of a Semi-Automated Computer Analysis System to Estimate Individual Health Risk and Its Future Costs, BP.TT; 21/08970-5 - Population Health Management: Development of Semi-Automated Computer Analysis System to Estimate Individual Health Risk and Its Future Costs, BP.TT

Abstract

Faced with limited resource and the brutal dissipation of health-related expenditures (> 20 per cent of the volume of resources), population health management methods have become worldwide popular and are at the forefront of sustainable health care. Using predictive models for future costs based on clinical data, it is possible to identify the highest risk individuals and trigger intensive measures of prevention and health promotion, with the aim of reducing the chances of hospitalization, reducing costs and increasing longevity. More than 20 companies in the world have actions dedicated to the management of population health (Population Health Management [PHM]); however, its presence is very tenuous in Brazil. Despite the variety of predictive models of individual risks and future costs, the established models have low success rates (not higher than 78-82%). That is, ~ 20% of patients are inappropriately engaged in more intensive approaches or are not identified for such approaches, which reduces the efficiency of PHM actions. For preventive health strategies to produce cost-effective results, it is essential that they be sustained under three pillars: (i) segmentation / stratification; (ii) coordination of care; and (iii) analytical intelligence. Failures in any of the 3 pillars generate inefficiency and waste. Previous data from our group suggest that machine learning techniques not only stratify subpopulations of higher risk of becoming ill, but also point who are the patients with a high load of modifiable and uncontrolled risk factors. In order to anticipate the future costs and care needs of the most vulnerable individuals, we propose to study health determinants in two high-cost contexts: rehospitalization, dialysis and death in patients with (i) coronary artery disease (CAD); and in (ii) pre-operative care (PrOp). In patients with CAD we will analyze 4 Brazilian databases and for PrOp we will have access to a large national database. Using state-of-the-art tools in predictive statistics: (i) we will select predictors by supervised learning techniques; (ii) we will construct prediction models for risk of hospitalization, renal failure and death, (iii) we will establish predictive models for future costs. With this, we will produce the computer system prototype (Clarity HI Soft) that: (a) estimates risks in health in real time; (b) estimate future costs; (c) include visual analytics platforms for patients and managers. This system will be configured for use in other databases, such as community data from the Unified Health System (SUS) and data from private health plans. The proposed analyzes will contribute to a more precise diagnosis of population health, allowing to identify the individuals of greater health risk and those with greater chance of implying in increased costs in the future years. These estimates are the key link to delivering Population Health Management (PHM) services, Clarity Healthcare Intelligence's niche market. We also expect to produce a patent for Clarity HI Soft, establish governance strategies around the use of analytical data and results, as well as operationalize analyzes and incorporate lessons from the real world. Impacts on the company's business and the market. Innovative Research will enable Clarity Healthcare Intelligence to introduce a PHM model with high predictive accuracy, raising utility data on public health and chronic disease epidemiology. Optimizing the data analysis process will make the company highly competitive in the PHM market. The interaction with Brazilian data (an unprecedented fact) will put the company ahead of competitors in negotiations with health plans and SUS managers. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

DE CARVALHO, LUIZ SERGIO FERNANDES; STEPHANUS, ANDREA DIAS; PFITZNER, MARIANA SAVEDRA. When economy meets physiopathology: A novel cost-effectiveness model finally considers the cumulative effect of LDL cholesterol burden. ATHEROSCLEROSIS, v. 367, p. 3-pg., 2023-02-14. (19/09068-3)

ALEXIM, GUSTAVO DE ALMEIDA; ROCHA, LUIZA FERREIRA; DOBRI, GIOVANI PREDIGER; ROSA JR, ADAIR DA SILVA; REIS, RICARDO TORRES BISPO; NOGUEIRA, ANA CLAUDIA CAVALCANTE; SOARES, ALEXANDRE ANDERSON DE SOUZA MUNHOZ; SPOSITO, ANDREI CARVALHO; DE PAULA, ANA PATRICIA; DE CARVALHO, LUIZ SERGIO FERNANDES. Clinical and economic impact of coronary artery bypass graft and percutaneous coronary intervention in young individuals with acute coronary syndromes and multivessel disease: A real-world comparison in a middle-income country. FRONTIERS IN CARDIOVASCULAR MEDICINE, v. 9, p. 11-pg., 2022-11-10. (19/09068-3)

DE OLIVEIRA, ANA BEATRICE MAGALHAES; LUCHIARI, BEATRIZ; BONILHA, ISABELLA; BARRETO, JOAQUIM; NOGUEIRA, ANA CLAUDIA CAVALCANTE; CENICCOLA, GUILHERME DUPRAT; POLANCZYK, CARISI ANNE; SPOSITO, ANDREI CARVALHO; DE CARVALHO, LUIZ SERGIO FERNANDES. Aspirin in primary prevention and the risk of heart failure: a systematic review and meta-analysis of controlled trials. ESC HEART FAILURE, v. N/A, p. 4-pg., 2022-12-26. (19/09068-3)