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Similar to Big Data Expo 2015 - IBM Big Data in de Wereld van Healthcare
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Big Data Expo 2015 - IBM Big Data in de Wereld van Healthcare
- 1. © 2015 International Business Machines Corporation Big Data in de Wereld van Healthcare en Lifesciences Computing Yesterday, today, tomorrow and beyond 30 September 2015
- 2. 2 Dr N.S. Hekster Technical Leader Healthcare & LifeSciences IBM Nederland BV Johan Huizingalaan 765 1066 VH Amsterdam Mobile: +31620303371 n.s.hekster@nl.ibm.com Introductie Spreker
- 3. 3© 2015 International Business Machines Corporation De groei van de data in de wereld 2015 VolumeinZettabytes 2020 44 Zettabyte Bron: IBM Global Technology Outlook - 2012 We staan hier 2010 Percentage onzekere data Gat Tekst Enterprise Data Beelden Multimedia Sensors & Apparaten IoT Traditioneel
- 4. 4© 2015 International Business Machines Corporation Het volume, de verscheidenheid en snelheid van data opent ongekende mogelijkheden 2.5MTerabytes worden elke dag gegenereerd, 80% ervan is ongestructureerd.
- 5. 5© 2015 International Business Machines Corporation IBM BlueGene
- 6. 6© 2015 International Business Machines Corporation Single-cell metabolic pathways Source: Roche http://biochemical-pathways.com/#/map/1
- 7. 7© 2015 International Business Machines Corporation Van Gegevens naar Inzichten m.b.v. Healthcare Analytics Verbetering van het klinisch proces Bevolkings gezondheid Reductie van wachttijden Optimalisatie van zorgpaden en logistiek Nauwkeurige voorspelling van te gebruiken middelen Identificatie van patiënten met een hoog risico Definitie van doelmatige behandelplannen (EBM) Voorspelling toekomstige aandoeningen en behandeling Inschatten van zorgtrends Surveillance van ziekten Preventie Effectiviteit en efficiëntie
- 8. 8© 2015 International Business Machines Corporation Analytics in de Zorgsector BI Rapportage en ad hoc Analyse • Wat gebeurde er? • Wanneer en waar? • Hoeveel? Voorspellen • Wat gaat er gebeuren? • Wat zal het gevolg zijn? Optimalisatie • Wat is de beste keuze? • Gepersonaliseerde zorg • Dynamische fraudedetectie • Patiëntgedrag • Beheersing epidemieën • Ziekenhuisbrede analytics • Evidence-based medicine • Clinical outcomes analytics • Clinical Decision Support • Dashboards • Klinische data repositories • Afdeling data marts • Basale rapportage • Spreadsheets Huidige analytics niveau Data-integratie Data warehouse Transactionele rapportage Decision support analytics Voorspellende analyses We staan hier
- 9. 9© 2015 International Business Machines Corporation 9 Zorg op het lijf geschreven - realiteit vereist betere registratie, toegang tot en analyse van relevante patiëntinformatie en klinische kennis Toegang tot klinische kennis (e.g. Diagnostische hulpmiddelen, kennis van de oorzaken van ziekten, empirisch bewijs of vergelijkende effectiviteit) Toegang tot relevante patiëntinformatie Matig Matig Goed Goed Proefondervindelijk (Gebaseerd op expertise en ervaring) Voorspellend en Evidence-based (Gebaseerd op patiëntencohorts) Gepersonaliseerd (Gebaseerd op mensen zoals ik) Waarde Intuïtief en volgens klinische consensus (Op basis van partiële toegang tot beschikbare patiëntinformatie en klinische kennis) Meer kunst dan wetenschap Meer wetenschap dan kunst Bron: IBM Global Business Services and IBM Institute for Business Value
- 10. 10© 2015 International Business Machines Corporation Watson karakteristieken Begrijpt natuurlijke taal en menselijke communicatie Past zich aan en leert van de keuzen en antwoorden van zijn gebruikers Genereert, evalueert en verklaart gefundeerde hypothesen Gebaseerd op UIMA, DeepNLP, DeepQA, honderden annotatoren, neurale networken, en massively parallel processing (MPP – o.a. Hadoop, HPC)
- 11. 11© 2015 International Business Machines Corporation 14 februari 2011
- 12. 12© 2015 International Business Machines Corporation Enkele Jeopardy! Voorbeelden Zie ook J-Archive.com This word for a massive explosion is Latin for "new“ (Category: Boom!) wordpress.com bills itself as "a better way to keep one of these Internet diaries” (Category: dot.com) The animal for which this computer program is named is actually a red panda. (Category: The Internet) In 1966 this company produced 706 million elements of its product; in 2011, it produced 36 billion. (Category: Toy Brands)
- 13. 13© 2015 International Business Machines Corporation
- 14. 14© 2015 International Business Machines Corporation Watson in de Gezondheidszorg en Levenswetenschappen Department of Veterans Affairs Selected Watson to analyze EMRs in a demo project MD Anderson Introduced proprietary solution with Watson for clinical use for Leukemia and Molecular Targeted Therapies Baylor College of Medicine Published results of use with Watson Discovery Advisor – identified 7 targets for P53 activation within weeks Watson Genomics Advisor Secured 13 Cancer and Academic medical centers for beta testing Watson for Oncology, trained by Memorial Sloan Kettering available in clinical use in lung, breast, colon and rectal cancer Ongoing Training Partner Mayo Clinic Selected Watson to analyze EMRs for Clinical Efficiency and Effectiveness Program Mayo Clinic Completed testing with Clinical Trial Matching for lung, breast, colon and rectal cancer Bumrungrad International Hospital 5 year agreement for Watson for Oncology
- 15. 15© 2015 International Business Machines Corporation Health apps
- 16. 16© 2015 International Business Machines Corporation Wearables, swallowables, implantables …
- 17. 17© 2015 International Business Machines Corporation 6 Terabytes Per mensenleven Volume, Variety, Velocity, Veracity 60% Exogene Factoren 1100 Terabytes Gegeneerd per mensenlven 0.4 Terabytes Per mensenleven 30% Genetische Factoren 10% Klinische Factoren Een grote hoeveelheid onaangeboorde data heft invloed op gezondheid en welbevinden. Maar het grootste gedeelte bevindt zich buiten de traditionele medische systemen! J.M. McGinnis et al., “The Case for More Active Policy Attention to Health Promotion,” Health Affairs 21, no. 2 (2002):78–93
- 18. 18© 2015 International Business Machines Corporation
- 19. 19© 2015 International Business Machines Corporation Crowd-sourced spiegelinformatie
- 20. 20© 2015 International Business Machines Corporation Wat kunnen we nú doen? Governance – Geef sturing en voer de regie over het genereren, vergaren en vastleggen van data – Markeer data als “most valuable asset”. – Maak een Data MRI van het ziekenhuis, bedrijf etc. Maak ruimte voor innovatie – Creëer of werk met/als een start-up – Lees het succes niet af aan een traditionele KPI’s – Erken falen als onderdeel van het proces – Partner met clinical data scientists, neem ze in dienst, of leidt ze op Denk na over een open datainfrastructuur – Hardware, software, standaarden – Vindbaar, benaderbaar, integreerbaar, herbruikbaar, combineerbaar
- 21. 21© 2015 International Business Machines Corporation Chef Watson
- 22. 22© 2015 International Business Machines Corporation Met dank voor uw aandacht
Editor's Notes
- What is bringing about the need for a new era of computing. In large part it is because of the explosion of data. And not just the typical structured data we find in computer databases, but through voice, social media, and sensors throughout the world. Up to 80 percent of this data is projected to be unstructured data by 2015. As you can see, data is just beginning its rapid growth. We’re still on the blade part of the hockey stick. Started back in 2010 – IBM had just launched the fastest supercomputer, a 1 Petaflops calculator – only addresses the lower part of the curve. Even we go a 1000 times faster (you need nuclear power plants for that), you only addressing a fraction the total curve. And it is stuctured data! There is an explosion of unstructured. So do something entirely different. Starting in 2007 with Text (IBM has a history in NLP) and then make a dent into the curve – scaling up to IOT.
- Key messages: + This abundance of new data presents an enormous opportunity for companies to address the shifting needs and expectations of their customers and employees.
- In biochemistry, a metabolic pathway is a series of chemical reactions occurring within a cell. In a pathway, the initial chemical (metabolite) is modified by a sequence of chemical reactions. These reactions are catalyzed by enzymes, where the product of one enzyme acts as the substrate for the next. These enzymes often require dietary minerals, vitamins, and other cofactors to function. Pathways are required for the maintenance of homeostasis within an organism and the flux of metabolites through a pathway is regulated depending on the needs of the cell and the availability of the substrate. The end product of a pathway may be used immediately, initiate another metabolic pathway or be stored for later use. The metabolism of a cell consists of an elaborate network of interconnected pathways that enable the synthesis and breakdown of molecules (anabolism and catabolism)
- However, current medical practice does not consider to provide for the collection and access to patient “health-related” data that would be required for personalized medicine. This is a natural progression along the path to better, more scientific and data-driven care. The large arrow shows a progression from practicing medicine based on individual knowledge and experience, through intuitive or consensus-based approaches when evidence is sparse, to evidence based on populations and ultimately to the holy grail of personalized health promotion and care delivery with evidence based on patients like me. Currently, too much care today is “trial and error”, meaning that it is based on individual clinician expertise and knowledge, all-to-frequently with limited access to relevant patient information and clinical knowledge. Healthcare is too complex and changing too fast to base care only on what an individual clinician can learn and retain. In 1975 there were about 200 clinical trials published. By 2005, the number had grown to over 30,000. Add to that all the industry knowledge generated outside of clinical trials… In short, we have increasing complexity of intervention options, increasing insights into patient heterogeneity and an expanding scope of potential services for prevention, chronic care, etc. It is no longer possible to practice medicine “with the knowledge in a clinician’s head.” We don’t have complete knowledge today of all diseases – at it is unlikely that we ever will have complete knowledge. If a physician has access to more complete patient information and clinical knowledge, but knowledge of the disease, interaction of multiple diseases, etc. does not exist then the physician must depend upon his / her intuition to diagnose and determine the best treatment approaches, prognosis, etc. Evidence based approaches can represent a huge step forward. The problem with evidence based on populations is called heterogeneity of treatment effects, which describes the variation in treatment results from the same treatment in different patients. For example, some may respond well to a drug, some may respond but poorly, some may have an adverse reaction and some may have no response. Also, what we think are similar diseases based on symptoms may in fact be quite different diseases. For example, we now know that there are over 90 different types of lymphoma and leukemia. Experts today suggest that we have evidence for only about ¼ to 1/3 of what we do. Also we have been remarkably uncurious regarding what works, why it works and for whom it works. The share of US health expenses devoted to determining what works best is about one-tenth of one percent. Personalized healthcare, in the upper right hand corner, uses more complete information (for example, about the patient, disease states or responses to treatments) to help predict, prevent and aid in early detection of diseases. Then it uses the patient’s unique physiology – and patient preferences, where appropriate – to help determine the best preventive or therapeutic approaches. Regarding the axes, note the reference to diagnostic tools. An incorrect or incomplete diagnosis occurs all too frequently – in up to 50% of cases according to some studies. In a recent report, researchers state that the rate of diagnostic error is up to 15% and that the cases physicians see as routine and unchallenging are often the ones that end up being misdiagnosed. May 2, 2008 in Medscape. Also, autopsies suggest that as many as 20% of fatal illnesses are misdiagnosed. Jerome Groopman, MD and author of “How Doctors Think” suggests that patient pose 3 questions to their doctor when he or she suggests a diagnosis: What else could it be? There are over 10,000 diseases and the biggest diagnostic error is premature closure. Computerized diagnostic tools such as Isabel can help. It is now being interfaced to NextGen. Could two things be going on that would explain my symptoms? Is there anything in my history, physical examination, laboratory findings or other tests that seems not to fit with the diagnosis? Regarding the cause of the disease, we need to know the exact cause, not just the symptoms. A lot of diseases with different causes (and requiring different treatments) share similar symptoms. Regarding comparative effectiveness, we need better information about benefits, risks and costs (for cost effectiveness) for different interventions for different conditions (or multiple conditions) for different patient populations and subpopulations. Also, for the vertical axis, the definition of relevant patient information will expand in a more patient-centric, value-based healthcare system. Clinicians will need to know a lot more about a patient for prevention, prediction, early detection, chronic care coordination, patient compliance and behavior modification than is needed for a specific acute intervention.“
- De Watson machine die destijds aan the Jeopardy Quiz meedeed was een MPP (massively parallel proceesing) machine gebaseerd op 90 IBM POWER7 750, in standaard rekconfiguraties. Deze Watson draaide op Novell's SUSE Linux Enterprise Server. Het totale systeem beschikte over 16 Terabytes centraal geheugen en 4 Terabytes aan geclusterde dataopslag. Elk van de 90 POWER7 systemen had 4 POWER7 processoren lopende op 3.55 GHz, elk met 8 cores. Dat bracht het totaal op 2880 POWER7 cores. Today, Watson is delivered as a cloud service - Watson also is 90 percent smaller, 24 times faster and smarter with a 2,400 percent improvement in performance. Since Jeopardy!, IBM has shrunk Watson from the size of a master bedroom to three stacked pizza boxes.
- Main Idea: While Watson’s victory on “Jeopardy!” was a stunning feat, it was just the beginning of a new way of thinking about ways that computers can help us live and work better. Further speaking points: Watson is more than an incremental evolution in computing. It is a new class of industry specific analytic solutions. Beating the greatest players ever to compete on the American quiz show, “Jeopardy!” was a “Grand Challenge” that seemed impossible at the beginning of the project five years ago based on technology available at the time. Doing so captured the imagination of tens of millions but it was only a proof of concept into something much larger: a new generation of technology to help people live and work better. Additional Information: The numbers speak for themselves; interest in Watson goes far beyond quiz show enthusiasts or computer science majors. Watson struck a nerve in the popular imagination. And it continues to do so with an ongoing social media conversation of people reimagining the possibilities of ways to put Watson to work.
- What is Nova? What is a (we)blog? What is a firefox? What is Lego?
- Marketplace momentum demonstrates the promise of Watson in healthcare: 1. Watson for Oncology trained by Memorial Sloan Kettering: MSK is a World Leading Cancer Center, and the solution is available for clinical use. 2. Bumrungrad: Entered into a 5-year agreement for Watson for Oncology before it was generally available. They saw a single presentation and said, “I’m in” 3. MD Anderson: World Leading Cancer Center, this custom solution is LIVE and they are using it within the MD Anderson network. (Definition of Molecular Targeted Therapies: very precise treatments designed to effect tumors) 4. Watson CTM: Mayo Clinic will be using this clinically in 1Q 2015, and their doctors love it. We will be expanding into other cancers (in the GI area) later on in 2015. 5. Baylor: Within a research context, we’ve been working with Baylor and have achieved remarkable results The entire industry (not an average) identified a single target per year for the past 10-20 years. With Watson Discovery Advisor, we identified 7 targets for P53 activation within weeks. P53 protein is extremely important in Oncology related research because it controls the proliferation of cells. Some consider it the “cancer-killing protein”, because if you can activate it correctly, you can actually kill a tumor. In PubMed alone, there’s 70,000 research articles on p53 protein, 6-8K created each year. What Baylor said is, we aren’t going to have people memorize all these articles. We’ll have a collective intelligence (Watson) which will do the memorization, and let the researcher engage with Watson to not just understand one research journal, but to understand the collective insight that spans that literature. That’s how they identify all those targets. 6. Watson Genomics Advisor has secured Beta testing relationships with 13 Cancer and Academic medical centers 7. Veterans Health Administration selected Watson to analyze Electronic Medical Records (EMRs) pre and post patient visits in a demonstration project 8. Mayo EMRA: The number one hospital system in the world said, can we use Watson to improve the effectiveness of our clinical processes.
- J.M. McGinnis et al., “The Case for More Active Policy Attention to Health Promotion,” Health Affairs 21, no. 2 (2002):78–93
- Nog gehad over de DiabetesApp