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Presentation from Colin McNamara and Paul Caracchio at Chapman University on Big Data in Healthcare.
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www.Nexusis.com 877.286.3987 1
Applied Analytics in Health Care
Colin McNamara – Chief Cloud Architect Nexus IS Paul Caracciolo – Chief Healthcare Officer Nexus IS
4/5/2013
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Goal Today – Moving past correlation to predictive analytics
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Agenda – Trust me It’s exciting
! How Nexus is involved with High Tech and Health Care
! Data Science applied in enterprise compared to Health Care
! Big sexy data in healthcare
! Workflow integration – Making data count
! Perspectives from the Field
! Nexus Connected Healthcare
! Consumerization of Healthcare – Data Driven
! Call to Action - Opportunities
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Nexus – Technology Integration and Clinical Integration
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My Perspective on Applied Analytics
! Early employee at ID Analytics ! High Dimensional Analysis of Financial
transactions ! Creators of the FICO score ! Scientific team from MSDW ! Backend fraud analytics for
! Best Buy ! Amex ! Visa ! United Healthcare
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My Job – (And our biggest challenge)
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Real world application of Science
• Science Applied to Business
• Analytics at Scale Under
production loads
• Bridged the gap between research and business
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Key Challenge we face now
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Nexus – Applied Science in the technology side of our biz
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Analytics toolsets in the Enterprise – Not so long ago
• Hand Crafted
• Artisan Work
• Housed in Data Islands
• Hidden deep for specialized tasks
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Standard Analytics toolsets emerging
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Connections to backend processing standardizing
• HDFS Connectors
• Project R Interfaces
• SQL interfaces into HDFS
• Overlays of Overlays (ElasiticSearch – Logstash)
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Integrated Apps and Workflows
Standard Adapters
• Integrated applications
• Standard connections
• Batch and Real Time
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Results of standardization of connections – App Integration
Aggregate Normalize
Pull from biz Applications
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Point to Highlight – Move from Batch to Real Time
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Enabling real time feedback
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Mapping this to Clinical Care
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Three sides to healthcare
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Health Care Information Technology
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“Big Data” = Large Shelves
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New “Big Data” at Hospitals
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What is causing the change – Expand on Sources
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EHR Adoption
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2013 2014 2012
Industry Adoption Lifecycle Strategy
Meaningful Use
EMR
Ancillary Systems
Stage 2 ACO
Telemedicine
RTLS
Stage 1
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Lots of data
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Growth of Connected Devices – Tracks to Healthcare
Total 500 Million
2007 1/10th of a Device per
Person on Earth
Total 35 Billion
2010 5 Devices per
Person on Earth
Total 50 Billion
2013 7 Devices per
Person on Earth
Total 500 Billion~
2020 70~ Devices per Person on Earth
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Clinicians and mobile
• Clinicians driving adoption
• Mobile devices input and output data
• Integration into sensor nets
• Integration into alerting and workflow
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Me and Withings
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Larger data sources on the horizon
EHR Applications
Mobile Devices
Sensors Data Center
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Current Sensors – Just the start
Time series data Similar to Smart Grids
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Scientists Dream
Insert Dream Picture
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Challenges – Crossing the Gap
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Challenge - Understanding where data is being generating
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Challenge - Breaking the transcription barrier
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Challenge – Understand Clinical Workflow
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Challenge - Using data to impact clinical outcomes
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Results of standardization of connections – App Integration
Aggregate Normalize
Pull from biz Applications
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Call to action
! Understand the plethora of new data sources
! Partner with Clinicians and Health Care Chief Tech Officers
! Partner with Nexus to help make those connections
! Lets improve clinical outcomes together
! Come on up afterwards, Drop your card and location and let’s get you connected to relevant HealthCare CTO’s
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Nexus Healthcare Services
Connecting People, Process and Technology
to Improve Patient Care
Donn Wurts Director, Connected Healthcare Practice
[email protected] 925-324-0359
Paul Caracciolo Chief Healthcare Officer
[email protected] (303) 748-4402
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Agenda
! My Perspective, Where I’m Coming From
! Nexus Connected Healthcare
! Consumerization of Healthcare – Data Driven
! State of healthcare, analytics readiness – Reality Check
! Patient data is expanding with technology
! Call to Action - Opportunities
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My Perspective
Spent the last 14 years as an interim CTO in hospitals across the U.S.
! Stanford (adult hospital and Children’s hospital) ! Duke Medicine (CISO) ! Catholic Healthcare (Dignity Health’s 41 hospitals) ! City of Hope Hospital/Beckman Research Institute
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My Charge – Nexus Connected Healthcare
! Responsible for Nexus U.S. Healthcare Practice ! Strategic advisory and consulting services
! EMR selection, architecture, implementation, devices, app delivery
! Core services ! Managed services, data center, security, voice
! Introduction of new technologies into healthcare ! Cloud, Analytics, MDM ! Pilots, operational plans, value add
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Current Healthcare Projects at a Glance
! Managing the integration of acquired clinics and physician practices, into regional hospitals ! Technology diligence, connectivity, standardization, ambulatory EMR
! Integrating devices with EMR’s ! Patient monitoring and alerting (vitals, BP, lab results) ! Connecting 1,000’s of iPads/tablets/handhelds to EMR’s
! Architecting and implementing connectivity, servers and storage for hospital analytics
! Deploying Cloud applications securely
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Has Healthcare Been Customer Focused?
! Hospitals need customers, so the customer is #1
! WRONG !
! But that is changing
! Why?
! Availability of data to consumers coupled with the proliferation of mobile devices
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Consumerization of Healthcare
! For the first time, people are shopping around for their healthcare
! Hospital scores are available, physician scores, quality metrics for facilities, specialties, clinicians
! Recent survey, metropolitan area showed 40%+ of one children’s hospital patients/demographic do not use computers. Smartphones are the device of choice, and they are shopping healthcare via specialty health info sites, Yelp, hospital websites, search, etc.
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Healthcare Data for the Public/Customers
! Healthcare is getting competitive and marketing is becoming increasingly important (website analytics show lack of consumer interest in outdated hospital sites, no click through, abandonment)
! Social media, and leading edge technologies are the trend for getting data, communicating, decision making healthcare choices
! Healthcare websites need to have social integration, and backend data access to data sets for consumer search- clinician scores, hospital scores, outcomes, comforts, for care areas
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A Plea
! Be patient with us (healthcare), as an industry we’re typically 5+ years behind
! A large % of hospitals are just getting electronic medical records, some won’t for years still
! Most hospitals do not have an analytics program
! Most are understaffed/lean operations
! Shortage of physicians and nursing
! Not used to staffing for other than bare bones operations, patient handling
! Analytics is new and a new skill set, new way of thinking
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Healthcare Industry Challenges to Adoption
! “Keeping the lights on” is still priority #1 in hospitals across the U.S.
! EMR adoption is great, but we’re not there yet
! Analytics programs can be very expensive, and hospitals are struggling financially for years
! Not a core hospital competency, analytics represents a completely new skill set needed
! It’s complicated- even with a consolidated EMR, hospitals run 100’s of applications essential to the business-Analytics is competing with these
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Analytics Adoption in Hospitals
! Over 40% of hospitals in California responding to a recent survey, that are greater than 200+ beds, have either installed or plan to install clinical and/or financial decision support systems over the next couple of years (HIMSS)
! They’ll need help !
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Healthcare Data is Growing
! Note: data used in the care/diagnosis/decision making on a patient, will need to be included in the Electronic Medical Record
! Increase in devices being employed for care that are generating data, and will need to be included ! Patient monitoring, real time, alerting, WiFi/cellular to any device ! Telemedicine ! Home health monitoring, glucose, vitals, etc. ! RFID tracking (equipment, patients, staff) – meets FDA requirement ! Trend of consolidation of clinics and Physician practices with regional
hospitals (regional data) ! Imaging with phone’s, iPads, video cams, etc.
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Some New Rules for Data
! Data used in the care/diagnosis/decision making on a patient, needs to be
included in the Electronic Medical Record
! Very shortly, regulations will change so that, if a patient is readmitted for the same condition within 30 days, it is not a reimbursable event
New models are needed here, new protocols for managing patients that are data driven, home monitoring, patient education, discharge instruction reinforcement
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Technology is Enabling Consolidation-More Data Central
! Trend for hospitals to acquire clinics and physician practices regionally ! Extension of ambulatory EMR via Citrix, VDI ! Historical data being incorporated into central EMR’s ! Referrals on a regional basis, more concentrated care of
diseases
Bottom line- more data in one place for a region
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Real Time Communications – Alerting with Extension
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Opportunities/Call to Action
! Analytics in healthcare is still a “green field” opportunity - wide open
! Consumers are demanding access to healthcare data, what? How? Where? When? And email is too slow and cumbersome !
! There are new and evolving technologies such as Vertica, HANA and others, and the industry is willing to pilot/test
! Management and processing of new data sources on the horizon- clinical video, higher def imaging, home health monitoring, personalized medicine data, telemedicine consults
! Methodologies for standardizing and operationalizing analytics in healthcare are needed ! Systems (hardware, software, storage) ! Clinical operationalization
! Partnership needed with business, clinical, IT, research, consumer
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Nexus Collaboration
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! Thank You