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New	Business	Capabilities	through	
Streaming	Data	Architectures
A	Case	Study	from	EVŌ	– Paul	Boal,	Amitech	Solutions
July	25,	2017
Paul	Boal
paul.boal@amitechsolutions.com
@paulboal
Paul	has	been	architecting	healthcare	analytics	solutions	for	
over	15	years,	implementing	a	range	of	technologies	from	
traditional	data	warehouses	to	Hadoop-based	solutions,	
advanced	analytics,	and	real-time	clinical	data	integration.	
Paul	is	now	Vice	President	of	Delivery	with Amitech Solutions,	
where	he	helps	teams	deliver	big	data	solutions	for	
healthcare.
2
Starting	from	batch
3
• Those	systems	sync	once	a	day.
• CMS	sends	us	claim	files	every	30	days.
• We	get	new	benchmarks	ratings	annually.
• Our	vendor	sends	updated	prices	lists	quarterly.
• We	balance	that	process	at	the	end	of	the	month.
• We	run	weekly	extracts	to	send	to	that	partner.
• We	load	and	aggregate	the	data	warehouse	daily.
The	results	of	batch
4
• The	average	person	should	drink	8	glasses	of	water	a	day.
• The	average	person	should	take	10,000	steps	per	day.
• The	average	person	should	get	6-8	hours	of	sleep	per	night.
• The	average	person	should…
Getting	healthcare	right
Have	the	right	
information	at	the	
right	time,	and	deliver	
it	to	the	right	person	in	
the	right	way	in	the	
right	moment.
5
The	EVŌ	Concept
Wellness	is	a	
personal	journey
6
7
Have	the	right	
information	at	the	
right	time,	and	deliver	
it	to	the	right	person	in	
the	right	way	in	the	
right	moment.
Right	Information:	Multiple	Sources
• Consumer-grade	reliability
• As	much	insight	as	possible	
from	as	little	information	as	
possible
• Accelerometer
• Heartrate
• Steps
• Activity
• Sleep
• Augment	device	data	with	
personal	feedback
• Benchmark	against	population
8
Right	Time:	Data	Acquisition
• Data	integration	models
• Device	à Vendor	Mobile	App	à Vendor	Cloud	à EVŌ	Cloud
• Device	à EVŌ	App																					à EVŌ	Cloud
• Device	EVŌ	App	à Vendor	Mobile	SDK										à EVŌ	Cloud
9
Right	Time:	Data	Acquisition
• Data	integration	models
• Device	à Vendor	Mobile	App	à Vendor	Cloud	à EVŌ	Cloud
• Device	à EVŌ	App																					à EVŌ	Cloud
• Device	EVŌ	App	à Vendor	Mobile	SDK										à EVŌ	Cloud
10
Right	Time:	Data	Acquisition
• Data	integration	models
• Device	à Vendor	Mobile	App	à Vendor	Cloud	à EVŌ	Cloud
• Device	à EVŌ	App																					à EVŌ	Cloud
• Device	EVŌ	App	à Vendor	Mobile	SDK										à EVŌ	Cloud
11
Right	Time:	Data	Processing
• Processing	is	primarily	data-driven	rather	than	clock-driven
• Processing	intensive	because	the	engine	does	“something”	on	every	data	entry
• Take	care	not	to	create	infinite	loops
• Use	clock-based	processing	to	look	for	missing	data
12
Web	Services NoSQL	DB	w/	Message	Queue Streaming	Data	Processing	Engine
Missing
Data
Check
Right	Person
13
Family	&
Friends
Individual
AdministratorsCare	Managers
• Push	notifications
• Mobile	app
• Encouragement
• Motivation
• Warnings
• Alerts
• Promote	positive	
reinforcement
• Outreach
• Monitor	progress
• Identify	risks
• Referrals
• Engagement
• Program	value
• Cost	savings
• Adjust	program
Right	Way
• Psychographic	questions	to	understand
how	best	to	interact	with	a	user.
• Personalize notification	rules	based	on	
user	persona.
• Create	custom	messages	that	use	
language	and	tone	that	will	persuade	
this	particular	user.
• Monitor	interaction	with	messaging	to	
notice	what	has	an	impact	and	what	is	
ignored.
• Adapt	to	persona	changes over	time.
14
Right	Moment
• Push	Notification	
• Rules	Engine
• Range	of	times	when	
each	message	can	be	
delivered
• Message	timeout	limit
• Persona	Specific
• How	many	notifications
• How	much	detail
• Calendar	Integration
• Wait	until	after	meetings
15
EVŌEVŌ
Your	house	is	in	sleep	mode.	Time	for	you	to	start	
powering	down,	too.
Press	for	details.
Good	morning!		Here’s	how	you	slept	last	night
4.5hrs	deep	/	7hrs	total
Press	for	details.
9:00Thursday,	December	15
6:00Thursday,	December	15
Right	
Moment
Right	Way
Right	Time
Right	Person
Right	
Information
The	Right	Architecture	for	EVŌ
16
The	Right	Technologies	for	EVŌ
17
Technical	Lessons:	Data	Capture
• Technologies:
• Java	web	services	API	(Swagger)
• AWS	DynamoDB	(NoSQL,	wide,	dynamic	columns)
• JSON	data	structures
• Light-weight	source	data	capture	– let	clients	get	in	and	out	quickly.
• Flexible	data	model
• Allow	clients	to	change	without	backend	dependency.
• Add	new	clients	without	impacts	to	existing	clients.
• Defer	data	mapping	– back-end	data	integration	and	standardization.
18
"key" = "identifiers",
"datetime" = YYYYMMDDhhmmss,
"data" = { JSON LOB }
Technical	Tips:	Data	Streaming
• Technologies:
• AWS	DynamoDB	Streams	/	Kinesis
• Apache	Flume	
• Light-weight	ledger
• Guaranteed	to	be	first-in	first-out	within	a	shard.
• Consuming	process	is	responsible	for	check-pointing.
• Data-driven
• Consuming	process	defines	the	processes.
• Consuming	processes	have	to	consume	data	in	a	timely	fashion.
• Built-in	to	database	– every	write	creates	a	message.
19
Technical	Tips:	Data	Processing
• Technologies:
• AWS	EMR	/	Apache	Spark
• RedHat	/	JBoss	Drools	
• Responsible	for	queue	management
• Spark	is	a	micro-batch	model,	not	single	transaction.
• Consuming	process	has	to	checkpoint	what	has	been	processed.
• Watch	out	for	infinite	loops
• If	a	process	writes	back	to	it’s	own	data	source,	filter!
• Quickly	filter	records	that	don’t	need	to	be	processed.
• Break	up	components	– Not	one	monolithic	process	/	not	microservices.
• Integrate	with	other	tools	– e.g.	Drools 20
21
1 Right	Information • What	information	do	you	have	access	to?
• What	would	it	take	to	get	more	information?
• What	is	the	best	balance	of	effort	to	value?
2 Right	Time • How	soon	can	each	data	source	be	available?
• What	are	your	options	for	where	to	process	data?
• Which	processes	are	data-driven,	user-driven,	and	clock-driven?
3 Right	Person • Think	about	what	role	each	possible	user	plays	in	the	process.
• What	does	each	user	need	do	their	job?
• Are	there	secondary	users	who	might	need	information,	too?
4 Right	Way • What	do	I	know	about	how	this	user	would	like	to	get	information?
• What	words	and	images	will	this	user	respond	to?
• Leave	reports	and	information	access	to	secondary	screens.
5 Right	Moment • Can	you	provide	timely	feedback	to	this	user?
• What	happens	to	information	you	want	to	communicate	but	can’t?
• What	information	can	wait	for	another	time?
What	can	you	
make	right?
22

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