# Learning Bundled Care Opportunities from Electronic Medical Records

## TL;DR

This study presents a data-driven method to identify groups of health conditions from electronic medical records that could be managed together in bundled care programs, potentially improving healthcare efficiency.

## Contribution

The paper introduces a novel framework for inferring condition clusters from EMR data and validates their plausibility for bundled care through expert surveys.

## Key findings

- Identified four plausible condition clusters for bundled care.
- Healthcare experts found the clusters suitable for bundled management.
- EMR data can inform new bundled care strategies.

## Abstract

Objectives: The fee-for-service approach to healthcare leads to the management of a patient's conditions in an independent manner, inducing various negative consequences. It is recognized that a bundled care approach to healthcare-one that manages a collection of health conditions together-may enable greater efficacy and cost savings. However, it is not always evident which sets of conditions should be managed in a bundled program. Study Design: Retrospective inference of clusters of health conditions from an electronic medical record (EMR) system. A survey of healthcare experts to ascertain the plausibility of the clusters for bundled care programs. Methods: We designed a data-driven framework to infer clusters of health conditions via their shared clinical workflows according to EMR utilization by healthcare employees. We evaluated the framework with approximately 16,500 inpatient stays from a large medical center. The plausibility of the clusters for bundled care was assessed through a survey of a panel of healthcare experts using an analysis of variance (ANOVA) under a 95% confidence interval. Results: The framework inferred four condition clusters: 1) fetal abnormalities, 2) late pregnancies, 3) prostate problems, and 4) chronic diseases (with congestive heart failure featuring prominently). Each cluster was deemed plausible by the experts for bundled care. Conclusions: The findings suggest that data from EMRs may provide a basis for discovering new directions in bundled care. Still, translating such findings into actual care management will require further refinement, implementation, and evaluation.

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Source: https://tomesphere.com/paper/1706.00487