Putting Data Analytics to Work for Upstream Suicide Prevention
Using data analytics and specifically designed care programs to reach out to Veterans who are at high risk of suicide
We are working hard to provide earlier and better care and services to Veterans before they are in crisis. This goal has inspired and supported new partnerships that bring together public and private sectors, including VA clinicians and providers, data scientists, consultants, and epidemiologists. The result of one of these partnerships — one of many that are continuing to reshape and improve how the VA serves Veterans — is the Perceptive Reach Project, named for how data analytics can extend the insight and reach of VA providers and clinicians to identify Veterans who are at high-risk of suicide, and support delivery of high-quality and targeted care.
Perceptive Reach represents a paradigm shift in how to identify Veterans at high risk of suicide. Instead of solely relying on Veterans to seek out care or screenings to identify those at risk, Perceptive Reach uses big data, predictive analytics and specifically designed programs and a Perceptive Reach dashboard. The dashboard compiles data and analytics to guide VA providers, clinicians and caregivers in proactively reaching out and engaging Veterans who are at high risk of suicide that may have been missed or never or never considered by traditional screenings. Perceptive Reach allows providers, clinicians and caregivers to focus on the Veterans that need care by harnessing the power of large administrative data and advanced analytics to enhance detection of risk and support clinical decision making.
The project pulled together subject matter experts from across the VA and collaborative solutions and began with a team of VA researchers, epidemiologists and clinicians collaborating to develop a new analytical model. Instead of relying on traditional screenings for suicide risk, the model combined and evaluated over 380 different attributes to identify populations that were at the greatest risk of suicide. Rather than considering how individual risk factors could be identified, the innovative model considered how the combination of multiple factors influences an individual’s cumulative risk for suicide. The risk level generated by the predictive analytics risk model is not an absolute sign of an imminent threat but is, instead, one of many factors that may indicate the need for engaging directly with a Veteran through proactive, specialized attention and possibly, treatment. The initial predictive model, similar to other predictive models that have been designed to identify Veterans at risk of other adverse outcomes, such as hospitalizations and accidental overdoses, further extends how Perceptive Reach’s data analytics can improve Veterans’ care. By using analytics and evaluating new and previously untapped variables, Perceptive Reach illuminates those who may be in need, but might never have been considered at risk.
“If we can enhance our ability to identify Veterans who are at the greatest risk, then we can act to get them the help and services they need “— Dr. Robert Bossarte, Director of Epidemiology
Perceptive Reach is not just a predictive analytics model, but a new system and approach to preventing Veteran suicide and providing care, by using data and constantly refining and improving the care provided. The VA Medical Centers in Butler and Erie, Pennsylvania are currently testing a pilot software program called the Perceptive Reach Dashboard, which is a secure web-based tool that displays the results of the predictive risk model to care providers.
Using the Perceptive Reach Dashboard VA care teams have developed several early engagement and intervention strategies that are tailored to the specific needs of Veterans identified as higher risk. One intervention strategy includes a “Caring Communications” component that sends letters to at-risk patients expressing concern, care and directing the patient to VA community support resources. Another intervention strategy is a clinical decision support model that helps guide providers through the clinical decision making for at-risk patients at the point of care. Bolstered by identifying at-risk Veterans earlier, VA care teams work with communities to be proactive in their care, and engage Veterans before crisis.
“By being able to identify Veterans in need of care, and treating them as early as possible, it decreases the likelihood of more serious conditions developing down the road”— Dr. Caitlin Thompson, VA’s National Mental Health Director for Suicide Prevention and Community Engagement
The Perceptive Reach project is a key development in the broader conversation about Veterans’ access to mental healthcare services. The VA Center for Innovation went on the road and interviewed Veterans, VA employees, caregivers and providers, using human-centered design discovery methods to understand Veterans’ needs and experiences throughout their journey of accessing mental health services. The Veterans’ access to mental healthcare services report, focused on ‘turning point’ moments, when Veterans decide to seek care and their subsequent experiences seeking care to fit their needs. Perceptive Reach helps remove barriers to mental healthcare services by proactively reaching out to Veterans who are at higher risk of suicide and self-harm, and engaging them with care and services before they reach a crisis.
“Perceptive Reach would have been impossible alone. Without the vision and insight from our partners, combined with our expertise and data, we would have had the necessary pieces, but not the integrated solution we have developed together” — Dr. Robert Bossarte, Director of Epidemiology
Perceptive Reach is the product of partnerships across the private and public sector, mobilized by the VA Center for Innovation’s Industry Innovation Competition. The Competition is an opportunity for the private sector to help solve VA’s most pressing challenges; this year the competition focused on improving mental health care for Veterans. To tackle the complex problem of higher suicide rates for Veterans without evidence of access to health care services, the VA sought new, novel and upstream interventions and strategies that built upon existing knowledge of characteristics of risk and relationships between service use and risk.
Recently, the VHA Innovation Program’s Perceptive Reach project won a 2016 Federal Health IT (FHIT) award in the Data Solutions category. Perceptive Reach was recognized for combining technology, outreach and clinical support to deliver a data-driven early intervention and treatment solution aimed at Veteran suicide prevention.
What is the VA Center for Innovation?
The VA Center for Innovation (VACI) identifies, tests, and evaluates new approaches to efficiently and effectively meet the current and future needs of Veterans through innovations that are rooted in data, design-thinking, and agile development. VACI sources and supports innovations, such as Perceptive Reach, from VA employees and industry professionals to enhance Veterans care and experiences.
The Perceptive Reach project is sponsored by the VA Center for Innovation (VACI). The project is led by the US Department of Veterans Affairs Mental Health Team.