Harnessing Machine Learning to Improve Palliative Care Access
The electronic medical record and its reams of data have become perceived as barriers to patient-clinician interactions. I want to improve access to palliative care by using machine leaning. In collaboration with Drs. Kenneth Jung and Nigam Shah at our Center for Biomedical Informatics Research, I have built a model that identifies patients at a high risk for mortality in the next year. We will use the risk estimated by the model to prompt timely palliative care screening and evaluation on the inpatient medicine services, with the goal of increasing access to basic palliative care and specialty palliative care services. We are examining the implementation lifecycle of a predictive model from its development as a research project to the design of a workflow for clinical use and its deployment in clinical practice at our academic medical center.
“Residency was the critical period when I discovered what moved me in medicine: the intersections of suffering, uncertainty, and hope in serious illness. On the wards, I cycled between feelings of frustration and fulfillment in the care of patients with serious illness: dismayed when doing treatments to patients that we knew would not work because it was the default or “out of courtesy,” and fulfilled when we could carry out the goals of patients on their terms. My teachers and mentors taught me how we can address the suffering of our patients and families—first and foremost, by the act of not looking away, and by engaging with our patients and their families in the process of hoping so that we “help illuminate the hopes that remain,” in the words of Dr. Chris Feudtner. My calling and my challenge is to lead a health system-wide palliative care program that harnesses data science methods to identify patients with palliative care needs to address their suffering and their goals and that deploys sound educational methods to equip frontline clinicians who care for patients with serious illness and their families. I will contribute to the field by developing and iterating a strategic model for larger-scale palliative care programming and collaborate with other palliative care programs to share educational resources and methods.”