Abstract:Many organizations depend on human decision-makers to make subjective decisions, especially in settings where information is scarce. Although workers are often viewed as interchangeable, the specific individual assigned to a task can significantly impact outcomes due to their unique decision-making processes and risk tolerance. In this paper, we introduce a novel framework that utilizes machine learning to predict worker behavior and employs integer optimization to strategically assign workers to tasks. Unlike traditional methods that treat machine learning predictions as static inputs for optimization, in our approach, the optimal predictive model used to represent a worker's behavior is determined by how that worker is allocated within the optimization process. We present a decision-aware optimization framework that integrates predictive model selection with worker allocation. Collaborating with an auto-insurance provider and using real-world data, we evaluate the effectiveness of our proposed method by applying three different techniques to predict worker behavior. Our findings show the proposed decision-aware framework outperforms traditional methods and offers context-sensitive and data-responsive strategies for workforce management.
Abstract:Diabetes is a global health priority, especially in low- and-middle-income countries, where over 50% of premature deaths are attributed to high blood glucose. Several studies have demonstrated the feasibility of using Community Health Worker (CHW) programs to provide affordable and culturally tailored solutions for early detection and management of diabetes. Yet, scalable models to design and implement CHW programs while accounting for screening, management, and patient enrollment decisions have not been proposed. We introduce an optimization framework to determine personalized CHW visits that maximize glycemic control at a community-level. Our framework explicitly models the trade-off between screening new patients and providing management visits to individuals who are already enrolled in treatment. We account for patients' motivational states, which affect their decisions to enroll or drop out of treatment and, therefore, the effectiveness of the intervention. We incorporate these decisions by modeling patients as utility-maximizing agents within a bi-level provider problem that we solve using approximate dynamic programming. By estimating patients' health and motivational states, our model builds visit plans that account for patients' tradeoffs when deciding to enroll in treatment, leading to reduced dropout rates and improved resource allocation. We apply our approach to generate CHW visit plans using operational data from a social enterprise serving low-income neighborhoods in urban areas of India. Through extensive simulation experiments, we find that our framework requires up to 73.4% less capacity than the best naive policy to achieve the same performance in terms of glycemic control. Our experiments also show that our solution algorithm can improve upon naive policies by up to 124.5% using the same CHW capacity.
Abstract:Problem definition: Behavioral health interventions, delivered through digital platforms, have the potential to significantly improve health outcomes, through education, motivation, reminders, and outreach. We study the problem of optimizing personalized interventions for patients to maximize some long-term outcome, in a setting where interventions are costly and capacity-constrained. Methodology/results: This paper provides a model-free approach to solving this problem. We find that generic model-free approaches from the reinforcement learning literature are too data intensive for healthcare applications, while simpler bandit approaches make progress at the expense of ignoring long-term patient dynamics. We present a new algorithm we dub DecompPI that approximates one step of policy iteration. Implementing DecompPI simply consists of a prediction task from offline data, alleviating the need for online experimentation. Theoretically, we show that under a natural set of structural assumptions on patient dynamics, DecompPI surprisingly recovers at least 1/2 of the improvement possible between a naive baseline policy and the optimal policy. At the same time, DecompPI is both robust to estimation errors and interpretable. Through an empirical case study on a mobile health platform for improving treatment adherence for tuberculosis, we find that DecompPI can provide the same efficacy as the status quo with approximately half the capacity of interventions. Managerial implications: DecompPI is general and is easily implementable for organizations aiming to improve long-term behavior through targeted interventions. Our case study suggests that the platform's costs of deploying interventions can potentially be cut by 50%, which facilitates the ability to scale up the system in a cost-efficient fashion.