Chapman university-big-data-healthcare-final

Applied Analytics in Health Care

Colin McNamara – Chief Cloud Architect Nexus IS
Paul Caracciolo – Chief Healthcare Officer Nexus IS

4/5/2013
1 www.Nexusis.com 877.286.3987

Goal Today – Moving past correlation to predictive
analytics


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

Nexus – Technology Integration and Clinical Integration


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


My Job – (And our biggest challenge)


Real world application of Science

•  Science Applied to
Business

•  Analytics at Scale Under
production loads

•  Bridged the gap between
research and business


Key Challenge we face now


Nexus – Applied Science in the technology side of our biz


Analytics toolsets in the Enterprise – Not so long ago

•  Hand Crafted

•  Artisan Work

•  Housed in Data Islands

•  Hidden deep for
specialized tasks


Standard Analytics toolsets emerging


Connections to backend processing standardizing

•  HDFS Connectors

•  Project R Interfaces

•  SQL interfaces into HDFS

•  Overlays of Overlays
(ElasiticSearch – Logstash)


Integrated Apps and Workflows

•  Integrated applications

•  Standard connections

•  Batch and Real Time
Standard
Adapters


Results of standardization of connections – App Integration

Aggregate Pull from biz
Normalize Applications


Point to Highlight – Move from Batch to Real Time


Enabling real time feedback


Mapping this to Clinical Care


Three sides to healthcare


Health Care Information Technology


“Big Data” = Large Shelves


New “Big Data” at Hospitals


What is causing the change – Expand on Sources


EHR Adoption


Industry Adoption Lifecycle Strategy
2012 2013 2014

RTLS

Ancillary
Systems Telemedicine
EMR

Meaningful Use Stage 1 Stage 2 ACO


Lots of data


Growth of Connected Devices – Tracks to Healthcare

Total 500 Million Total 35 Billion Total 50 Billion Total 500 Billion~

1/10th of a Device per 5 Devices per 7 Devices per 70~ Devices per
Person on Earth Person on Earth Person on Earth Person on Earth
2007 2010 2013 2020

Clinicians and mobile

•  Clinicians driving adoption

•  Mobile devices input and
output data

•  Integration into sensor nets

•  Integration into alerting and
workflow


Me and Withings


Larger data sources on the horizon
EHR Applications

Mobile Devices

Data Center Sensors


Current Sensors – Just the start

Time series data

Similar to Smart Grids


Scientists Dream

Insert Dream Picture


Challenges – Crossing the Gap


Challenge - Understanding where data is being generating


Challenge - Breaking the transcription barrier


Challenge – Understand Clinical Workflow


Challenge - Using data to impact clinical outcomes


Results of standardization of connections – App Integration

Aggregate Pull from biz
Normalize Applications


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


Nexus Healthcare Services

Paul Caracciolo
Chief Healthcare Officer
Paul.caracciolo@nexusis.com
(303) 748-4402
Donn Wurts
Director, Connected Healthcare Practice
donn.wurts@nexusis.com
925-324-0359 Connecting People, Process and Technology
39 www.Nexusis.com 877.286.3987 to Improve Patient Care

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


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


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


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


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

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.

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


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

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

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 !


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.

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


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


Real Time Communications – Alerting with Extension


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


Nexus Collaboration


! Thank You


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