© 2009 IBM Corporation0

Public Health Informatics: Opportunity in an Era of Change

Public Health Informatics ConferenceAtlanta, Georgia

April 29, 2014M-J. Sepúlveda, MD FACPIBM Fellow & Vice President

© 2009 IBM Corporation1

Business and Government Structure Modernization

Information Readiness and Analytics

Big DataCities Cognitive Computing

Transformation is accelerating in societies driven by economic, demographic, technological,

environmental and legislative forces.

© 2009 IBM CorporationPhoto: Luca Bruno / AP

2005

© 2009 IBM CorporationPhoto: Michael Sohn / AP

2013

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2008

© 2009 IBM Corporation5 IBM Confidential Photo: Reuters

2014

© 2009 IBM Corporation

1990

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2010

© 2009 IBM Corporation

Urban and rural populations by development group, 1950-2050

Less Developed Urban

Less Developed Rural

More Developed Rural

More Developed Urban

Less Developed Rural to Urban Transition

Global Rural toUrban Transition

© 2009 IBM Corporation

Cities are focal points of economic activity

Bangalore

New Delhi

Beijing

Guangzhou

Shanghai

Johannesburg

Cape Town

SydneyMexico

Paris

Lisbon

Brussels

Seoul

-10

0

10

20

30

-5 5 15 25 35 45 55

Top cities act as economic activity hubs

(Size of the bubble – ratio of city share of national GDP to its share of national population, 2009)

48% Global GDP in 2012 from top 300 cities with 19% worldwide population.

Talent Cities contain an increasingly large share of the world's highly skilled, educated, and entrepreneurial population

Innovation Cities support large-scale business networks that absorb and extend innovation

City

sha

re o

f cou

ntry

pop

ulat

ion,

%

City share of country GDP, %9

Source: UN Habitat 2010, and IBM Global Center for Economics Development analysis

%Pop”n = % GDP

© 2009 IBM Corporation10

Current programs, agencies & transactions in health and social services are not sustainable

SOCIALENTERPRISES

CBO’s

GovernmentAgencies

Law Enforcement

HealthcareProviders

Courts

EducationProviders

AdvocacyGroups

Employers

EarlyIntervention

AdultProtection

WorkersComp.

UnemploymentInsurance

Employment

Management

JuvenileJustice

Child Care

ChildSupport

Income Assistance

Medical Assistance

Child ServicesNEEDS

Education

Safety

Health

Financial

Shelter

Food

FAMILY

Abuse

LIFE EVENTS

Neglect

Counseling

Loss of JobMarriage

Injury

Foster Care

Substance Abuse

FAMILY

Environmental

Transportation

Energy and Water

Government and Agency Administration

Urban Planning

Planning and Management

Public Safety

Social and Health

Human

Education

Infrastructure

© 2009 IBM Corporation11

State and Local

Public Welfare and Health Costs

2012

$721B

States$541B

MunicipalGovernments

$180B

© 2010 IBM Corporation1212

Local governments debt ridden

DTR Debt to Revenue

Ratio

All Local Governments in 19 states

Revenue Debt

All Local Governments

DTR >1DTR = 1.1

US Census 2012 Annual Survey State Government

$1.67 Trillion $1.75 Trillion

$1.75 Trillion$0.6-$93.6 Billion

© 2011 IBM Corporation13

Water & Industrial

Water and Wastewater Flood Management Utilities Grid Mgmt Oil Platform Mgmt Usage Analytics Leak Detection Contamination Mgmt Predictive Maintenance Asset Management Smart Metering

Public Safety & Fraud

Fusion Centers Fraud Analytics Video Analytics Crime Information Predictive Policing Border Security Emergency Response Terrorism Cyber Security

Planning & Operations

City Planning Airport Cockpit Smarter Retail Operation Integr Supply Chain Mgmt Investment Coordination Budget Management Business Licensing Social Programs Outcome Management

Stadiums & Events

Fan Experience Command Center Sales Optimization Physical Security Emergency Mgmt Sentiment Analysis Traffic and Crowd Flow Parking optimization Strategic Planning

AnalyzePredictive Systems

Modelling & Simulation

Archive

VisualizeDashboards

AlarmingReports / Analysis

Visualization

Data-IntegrationWeather / Citizens / Taxes / Healthcare /

…

Alarms KPI’s Guidelines

Service Bus

Standard-based Interfaces

Domain specific Interfaces

Gateway Gateway Gateway Gateway Gateway

Traffic Water Public Safety Energy Buildings/

Stadiums

Traffic & Transportation

Multi-modal Mobility Traffic Prediction Smarter Parking Bus Arrival Prediction Fleet Optimization Data Integration Planning and Simulation Road User Charging Connected Car Electric Vehicle Mgmt

Municipal IT systems to manage, monitor processes, Analyze, consolidate events and initiate responses!

1 2 3 4 5

Intelligent Operations Center

Event Rules WorkflowsSemantic Models

© 2011 IBM Corporation

Intelligent Operations

Water quality Conservation /leakage/flood Use and Waste Flood Management:

Water & Wastewater

Water Infrastructure

Weather & External data

Flood prediction & Emergency

Water

TODAY

Observe and

react

TOMORROWAnticipateand avoid

Road traffic

Bus / Coach

Electric vehicles

FretCar parkingTaxis Tram / train Bikes

INTEGRATION & DATA PROCESSING

Intelligent Transportation

++

PREDICTIVE

MULTIMODAL

REAL TIME

Smarter Mobility

Optimal way to destination Help citizens to avoid

incidents Awareness &

recognition of criticalsituations

Traffic and incident management

Predictive analytics Supervise traffic control Collaboration of

concerned agencies

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Rio de Janeiro IOC

15

© 2009 IBM Corporation

Big Dataand Internet of Things

16

Data in Doubt

VeracityVolume Velocity Variety

Data in Motion Data in Many FormsData at Rest

© 2009 IBM Corporation4/6/201

What can we do with big data for PH?

17

SurveillanceResponse, Mobilization Social media/

Geospatial analysis Physical, Chemical, Biologic Climactic , Environmental Events, Incidents Risk Factors, Conditions Epidemic early warning system Video analysis Audio analysis

Smart Grid management Multimodal surveillance Real-time promotions Cyber security ICU monitoring Options trading Click-stream analysis CDR processing IT log analysis RFID tracking & analysis

Assessment , Prediction, Forecasting Transaction analysis to create insight-based

product/service offerings Fraud modeling & detection Risk modeling & management Social media/sentiment analysis Environmental analysis

Discovery & Experimentation Surveillance Modeling and Simulation Sentiment analysis Scientific research Ad-hoc analysis Model development Hypothesis testing Transaction analysis to create insight-

based product/service offeringsManage and Plan Operational analytics – BI reporting Planning and forecasting analysis Predictive analysis

© 2009 IBM Corporation

Capacity

Product

Services Payment

MeasurementTechnology

People

Culture

Process

18

EthicsLaws

Liabilities

Work Organization Partnerships

Supply Chain, Capital/Equipt.

Operations and

Budgets

PerformanceAssessment

TrainingSkills

Communication

Leadership

PayRewards

StandardsInteroperability

Privacy, Security

LearningImprovementCollaborationTransparency

Modified after P. Gabow MD; Ret. CEO Denver Health

Many Challenges

© 2009 IBM Corporation

Danah Boyd, 2010

“Just Because It is Accessible Doesn’t Mean Using It is Ethical”

http://www.danah.org/papers/talks/2010/WWW2010.html

“Bigger Data are Not Always Better Data”

“Not All Data are Created Equal”

“ “What and Why are Different Questions”

“Be Careful of Your Interpretations”

© 2009 IBM Corporation

Sponsors: Orange, University of Leuven, MIT Objective: use massive data sets mobile phone to improve well-being populations Target: Cote D’Ivoire, 4 months; 4 data sets Orange mobile subscribers;

encouraged use other data sets; public, private research institutions Projects

– Tourism and events analysis: better organization, economic impacts.– Population statistics: poverty maps with poverty/GDP development index – Health improvement : correlating mobility with data on spread of disease,.– Economic Indicators: correlating calling/mobility patterns with economic

activities– Alerting/Preventing violence: violent events to improve population’s security– Improving privacy: Exploring large data sets, crossing them to help improve the

knowledge on how to make better Safe open Data.

PPP: Data for Development Challenge (D4D) 2012

© 2009 IBM Corporation4/6/201

PPP: Smart Cities Dubuque Iowa

City in Motion: Making sense of billions of telco events in conjunction with transportation data

Smart Water Meter Analytics: Analyzing smart meter data for leaks, anomalies, and consumption patterns

Sensing(Active & Passive Sensing)

Dynamic & Static Data

Spatio- Single & multi-domainAnalytics & Modeling

Impacting(Inform, Actuate, Respond, Control,

Influence)

Dynamic &

Impacting Supply

(Inform, Actuate, Respond, Control,

Insights)

Sensors, Cell Phones, People,

temporal & SocialInformation Management

Sensing

Analytics & Modeling

& Influencing DemandInfluence via Social Computing)

(Demand Models, Behavior Models,

Models

Smart Electric Meter Analytics: Analyzing smart meter data for anomalies, and consumption patterns and sharing information

Citizen Engagement Platform: Coupling social profiles (Lotus Connections) with Spatial data (IOC) in a 2-way city-citizen communication platform

Static Data

© 2009 IBM Corporation

Continuing evolution of computing: new “learning” systems are required, ushering a new era of computing

Systemintelligence

Tabulating Systems Era

Programmable Computing Era

Cognitive Systems Era

DiscoveryProbabilisticIntelligent optionsBig Data (i.e. 4 “V’s”)Natural language

1900 1950 2011

4V’s = Volume + Variety + Velocity + Voracity

1

1

SearchDeterministicSimple outputs“Enterprise” dataMachine language

. . . enabling new opportunities and outcomes

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Cognitive computing

© 2012 International Business Machines Corporation24

Watson paths

24

© 2012 International Business Machines Corporation2525

Watson Oncology

© 2009 IBM Corporation

Big data challenges for cognitive computing

Volume:storage

technologies

Velocity:analyzing

data in motion

Veracity:uncertainty,

data in doubt

Computer architecture:

CPU centric

© 2010 IBM Corporation

Speed of change & data create great PH/PHI opportunities

Culture of partnership outside PH/PHI needed, make it happen

Multi-sectoral data literacy is essential for multi-sectoral collaboration

27

© 2009 IBM Corporation28

Transformation is a journey

Single view of the problem/case

Population health systems analytics

Pop. health optimization

Population health information exchange

Population health practitioner portal

IT optimization

Digitize information for relevant sectorsImpacting health

View andexchange of

multi-sectoral and health

related data via

customizableuser interface

Exchange population

health-related data within

and betweenenterprises

Derive valueand intelligence

to improve population

health outcomes and curb costs

Healthy citizens in healthy communities

Smarter Health Systems

Popu

latio

n he

alth

val

ue

Maturity over time