SNA TIG Week: Researchers making use of SNA in healthcare, care coordination and fraud investigations by Sophia Guevara

My name is Sophia Guevara, MLIS, MPA.  While conducting research for the Health Resources and Services Administration Maternal Child Health Bureau challenges, I came up with interesting research that provided information on how Social Network Analysis (SNA) is being used in healthcare.  Here are four papers that I came across in my research that might be of interest for those interested in learning how Social Network Analysis is being applied.

Rad Resource 1: Building Blocks for Measuring Care Coordination with Claims Data, published in 2014 in Population Health Management, took a look at the building blocks of “care coordination and corresponding measures” by conducting a literature review and the input of experts.  Within this document, the authors cite research that points to social network analysis increasingly being used to better understand the relationships in health services.

Rad Resource 2: The authors of, “Analysis of the Existence of Patient Care Team Using Social Network Methods in Physician Communities from Healthcare Insurance Companies,” used insurance claims to build the network.  This resource was published in 2017 took a look at social network analysis in physician-physician networks where the physicians share patients.  The aim of the research was “to explore whether it is possible to find care teams in networks of physicians from health insurance company claims and the possibility of using centrality metrics to analyze the interaction between these informal care team members.”

Rad Resource 3: This resource entitled, “Health care provider social network analysis: A systematic review”, was published in the September – October 2015 issue of Nursing Outlook.  The authors conducted a review of peer-reviewed SNA articles published up until April 2013 available in a variety of databases.

Rad Resource 4: Leveraging Social Network Analytics to Prevent Fraud and Improper Payments, a resource developed by LexisNexis, provided insight into a project they completed for the Office of the Medicaid Inspector General (OMIG) of a large Northeastern state.  Suspecting fraud among Medicaid recipients who were living in a million dollar condo complex, OMIG tasked the company with identifying the hidden relationships “between the condo dwellers and their assets, providers, medical facilities or other’s providing care to the state’s Medicaid recipients”.  However, the analysis turned up much more and included potential mortgage fraud and money laundering based on “deed flipping” volume.

The American Evaluation Association is celebrating Social Network Analysis TIG Week with our colleagues in the Social Network Analysis Topical Interest Group. The contributions all this week to aea365 come from our SNA TIG members. Do you have questions, concerns, kudos, or content to extend this aea365 contribution? Please add them in the comments section for this post on the aea365 webpage so that we may enrich our community of practice. Would you like to submit an aea365 Tip? Please send a note of interest to aea365 is sponsored by the American Evaluation Association and provides a Tip-a-Day by and for evaluators.


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