Big data modeling to predict platelet usage and minimize wastage in a tertiary care system.

Leying Guan, Xiaoying Tian, Saurabh Gombar, Allison J Zemek, Gomathi Krishnan, Robert Scott, Balasubramanian Narasimhan, Robert J Tibshirani, Tho D Pham
Author Information
  1. Leying Guan: Department of Statistics, Stanford University, Stanford, CA 94305.
  2. Xiaoying Tian: Department of Statistics, Stanford University, Stanford, CA 94305.
  3. Saurabh Gombar: Department of Pathology, Stanford University, Stanford, CA 94305.
  4. Allison J Zemek: Department of Pathology, Stanford University, Stanford, CA 94305.
  5. Gomathi Krishnan: Stanford Center for Clinical Informatics, Stanford University, Stanford, CA 94305.
  6. Robert Scott: Stanford Hospital Transfusion Service, Stanford Medicine, Stanford, CA 94305.
  7. Balasubramanian Narasimhan: Department of Statistics, Stanford University, Stanford, CA 94305.
  8. Robert J Tibshirani: Department of Statistics, Stanford University, Stanford, CA 94305; tibs@stanford.edu thopham@stanford.edu.
  9. Tho D Pham: Department of Pathology, Stanford University, Stanford, CA 94305; tibs@stanford.edu thopham@stanford.edu.

Abstract

Maintaining a robust blood product supply is an essential requirement to guarantee optimal patient care in modern health care systems. However, daily blood product use is difficult to anticipate. Platelet products are the most variable in daily usage, have short shelf lives, and are also the most expensive to produce, test, and store. Due to the combination of absolute need, uncertain daily demand, and short shelf life, platelet products are frequently wasted due to expiration. Our aim is to build and validate a statistical model to forecast future platelet demand and thereby reduce wastage. We have investigated platelet usage patterns at our institution, and specifically interrogated the relationship between platelet usage and aggregated hospital-wide patient data over a recent consecutive 29-mo period. Using a convex statistical formulation, we have found that platelet usage is highly dependent on weekday/weekend pattern, number of patients with various abnormal complete blood count measurements, and location-specific hospital census data. We incorporated these relationships in a mathematical model to guide collection and ordering strategy. This model minimizes waste due to expiration while avoiding shortages; the number of remaining platelet units at the end of any day stays above 10 in our model during the same period. Compared with historical expiration rates during the same period, our model reduces the expiration rate from 10.5 to 3.2%. Extrapolating our results to the ∼2 million units of platelets transfused annually within the United States, if implemented successfully, our model can potentially save ∼80 million dollars in health care costs.

Keywords

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Grants

  1. N01HV28183/NHLBI NIH HHS

MeSH Term

California
Electronic Health Records
Health Care Costs
Humans
Models, Statistical
Platelet Transfusion
Tertiary Healthcare

Word Cloud

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