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The Unseen Labor of Maintaining Predictive Models for MSK Care Cost Reduction: A Comprehensive Guide for Decision-Makers

October 16, 2023

In a healthcare environment increasingly influenced by data analytics, predictive models are invaluable for managing musculoskeletal (MSK) care costs, such as surgeries, imaging, and injections. However, these models are not self-sustaining; they require ongoing, rigorous maintenance. The aim of this article is to illuminate the sheer complexity and depth of work involved in this critical task.

Why Maintenance is Indispensable

Predictive models are designed to anticipate and guide care decisions that can significantly impact MSK care costs. Ineffective maintenance can lead to skewed predictions, missed cost-saving opportunities, and compromised patient outcomes.

The Labor-Intensive Aspects of Model Maintenance

Data Collection & Cleaning

A predictive model is only as good as the data feeding it. For MSK-focused models, this requires a continuous inflow of healthcare claims and lab results. Data must be meticulously cleaned and verified, involving significant labor from data engineers and clinical experts.

Model Re-calibration

Algorithms can become outdated quickly. Regular recalibration, involving a deep review of coefficients, thresholds, and parameters, demands focused effort from skilled data scientists.

Quality Assurance

To ensure that the model’s recommendations remain accurate and actionable, periodic quality checks are critical. This involves benchmarking the model's predictions against real-world outcomes, particularly after healthcare policy changes or system upgrades.

External Factors Analysis

Monitoring seasonal fluctuations in MSK issues or the impact of emerging medical research is essential. This activity requires additional labor to adjust the model in response to these external influences.

Feedback Loop with Care Managers and Physicians

Effective models are iterative, incorporating feedback from care managers and physicians to refine the model’s suggestions. This is an ongoing dialogue that involves data collection and analysis.

Documentation

Both technical and user-facing documentation must be kept up-to-date. This ensures that end-users are effectively guided and also meets the need for transparency.

Stakeholder Communication

Regular briefings and updates must be communicated to all stakeholders, including healthcare providers and payers. This laborious process is critical for trust and buy-in.

Audit Trails

Maintaining a detailed audit log serves multiple purposes: troubleshooting, compliance, and transparency. This is an ongoing task requiring attention to detail.

Training and Upskilling

The rapidly evolving tech landscape necessitates ongoing training for staff responsible for model maintenance, taking focus away from other high-value areas.

Performance Monitoring

Key performance indicators (KPIs) must be periodically evaluated to measure the model's success in achieving its objectives. This requires both time and expertise in data analytics.

Time and Cost Estimates for Model Maintenance (Excluding Data Collection & Cleaning)

Maintaining a predictive healthcare model focused on MSK care costs demands significant time and financial investment. Below are rough estimates for various tasks:

Model Re-calibration

- Time: 20 hours quarterly

- Cost: $20,000 - $30,000 annually (data scientist involvement)

Quality Assurance

- Time: 10 hours monthly

- Cost: $15,000 - $25,000 annually

External Factors Analysis

- Time: 5-10 hours quarterly

- Cost: $5,000 - $10,000 annually

Feedback Loop with Care Managers and Physicians

- Time: 5 hours monthly

- Cost: $12,000 - $20,000 annually

Documentation

- Time: 2-4 hours monthly

- Cost: $3,000 - $6,000 annually

Stakeholder Communication

- Time: 2 hours monthly

- Cost: $4,000 - $8,000 annually

Audit Trails

- Time: 2 hours weekly

- Cost: $10,000 - $15,000 annually

Training and Upskilling

- Time: 10 hours quarterly

- Cost: $8,000 - $12,000 annually

Performance Monitoring

- Time: 5 hours monthly

- Cost: $12,000 - $20,000 annually

Total Estimated Annual Cost: $89,000 - $154,000

Total Estimated Annual Time: 720 - 1,200 hours

Conclusion

The maintenance of a predictive model aimed at reducing MSK care costs is far from straightforward. It is a multifaceted, labor-intensive undertaking that demands ongoing investment in both resources and expertise. The choice to neglect this could be costly in terms of both finances and patient care quality.

The decision-makers in healthcare should view the rigorous upkeep of these models not merely as a technical necessity but as a business imperative.

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