- Big data, predictive analytics, and business intelligence (BI) tools can help healthcare organizations address growing cost pressures and improve operational and financial efficiency. However, their benefits are often underappreciated in healthcare. - BI can be used for both clinical and non-clinical purposes to analyze large amounts of healthcare data and gain insights. When properly implemented and governed, it allows organizations to better understand variability and optimize performance. - The presentation will provide real-world examples of how BI is being used in healthcare to improve patient outcomes, safety, and experience as well as hospital operations and systems.

1. Optimum Healthcare IT
A physician’s perspective on Big Data, Predictive
Analytics &
Business Intelligence (BI) tools
Professor Steven Boyages
JCMIT 2013
TAIWAN

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4. Summary
• Healthcare organizations face growing, complex cost-containment pressures.
Increasing regulation, diminishing reimbursement, changes in the patient mix, and
other challenges mean providers must maximize operational and financial
efficiency through best practices and analytics-based decision making.
• A combination of insufficient information, poor incentives for cost control along
with deficient monitoring and inefficiencies in health care processes—all of those
factors have led to much waste of time and funds.
• The ability to contain costs while delivering quality healthcare outcomes is
eminently possible, but will require a better understanding of what today’s data
technologies can achieve. Most people in healthcare are aware of BI tools and
analytics but generally its benefits are under-appreciated. As a result, BI in
healthcare remains under-implemented.
• This presentation will outline uses of BI for clinical and non clinical purposes, how
to govern such activity using real world examples.
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7. Bridging the Gap

8. Objectives of Investment in IT
• Improve patient experience
• Improve patient safety
• Improve provider experience
• Create value for money
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9. High Touch
High
Tech
Team and
Workflow
Platform
Technology
Platform
Health work matrix

10. New Technology Triggers
The Nexus of IT Forces:
Social, Mobile, Cloud & Big Data/Information
Source: Gartner, 2013

11. Nearly every transaction or interaction leaves a
data signature

12. Information
Someone somewhere is capturing and storing

13. Sheer scale has far exceeded human sense-
making capabilities

14. At these scales patterns are often too subtle and relationships too
complex or multi dimensional to observe by simply looking at the data

15. Data mining is a means of automating the
process to detect interpretable patterns

16. It helps us see the forest without
getting lost in the trees
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17. Summary
• Big data describes the way we deal with the
astonishing accumulation of digital information
which is often stored in large unstructured data
repositories.
• New tools such as business intelligence (BI) have
emerged to organise and interpret this vast array
of information with benefits in public health,
research, patient care and hospital operational
systems.
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19. Looking for patterns
• The trend of looking for commonalities and
overlapping interests is emerging in many parts of both
academia and business
• At the ultra small nanoscale examination of a cell,
researchers say, the disciplines of biology, chemistry
and physics begin to collapse in on each other
• Online marketers look at your behaviour in a number
of contexts to sell you something you may not even
know you wanted.
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20. Algorithms
• When it comes to algorithms, “if I can do a power
grid, I can do water supply,” said Steve Mills,
I.B.M.’s senior vice president for software and
systems. Even traffic, which like water and
electricity has value when it flows effectively, can
reuse some of the same algorithms.
• “leveraging the cost structure of new
mathematics.”
• Patient flow
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21. Potential areas for use
• MGI studied big data in five domains—healthcare in the
United States, the public sector in Europe, retail in the
United States, and manufacturing and personal-location
data globally. Big data can generate value in each.
• If US healthcare were to use big data creatively and
effectively to drive efficiency and quality, the sector could
create more than $300 billion in value every year.
• Two-thirds of that would be in the form of reducing US
healthcare expenditure by about 8 percent.
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22. Five broad areas in which big data can
create value
• First, big data can unlock significant value by making
information transparent and usable at much higher frequency
• Secondly, as organizations create and store more transactional
data in digital form, they can collect more accurate and
detailed performance information on everything from product
inventories to sick days, and therefore expose variability and
boost performance.
• Using data for basic low-frequency forecasting to high-
frequency nowcasting to adjust their business levers just in
time.
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23. Five broad areas in which big data can
create value
• Third, big data allows ever-narrower segmentation of
customers and therefore much more precisely tailored
products or services
• Fourth, sophisticated analytics can substantially
improve decision-making
• Finally, big data can be used to improve the
development of the next generation of products and
services. Eg data obtained from sensors embedded in
products to create innovative after-sales service
offerings
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24. USING DATA
Google trends, Google analytics
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25. Google Trends Michael Jackson
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26. Facebook can predict your breakups
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27. Your personality can be predicted
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28. Eating Habits
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29. Google flu trends
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30. Health Intelligence:
Keeping Score in Health
30

31. Moving from Analogue to Digital
Scoreboards
31

32. The Next Level:
Health Intelligence Systems
• Definition
 Responsive
 Agile
 Available
 Flexible
 Timely
Real time
Near Real time
Capability
Patient Care
 Safety
 Decision support
 Outcomes Research
 Patient Logistics
Performance Management
 State
 Area based
 Hospital/cluster/network
 Modality (scheduling)
 Bedside
32

33. • Bed Board (including LOS
enhancements)
• Ward Activity and Nursing Display
(WAND)
• eConsults
• iHandover
• Transport booking
• Infectious Diseases Alerts
• Pharmtrack
• CareFirst meetings run 3 times per week with
all senior clinical management
• Uses up to date (near real time information)
through CareFirst Dashboard – which
includes:
• Subject Area Dashboards (Patient Safety,
Mental Health, Surgery, Nursing, Costing,
ED etc.)
• Links to hundreds of pre-populated
Business Objects Reports (no
performance issues)
(a) Patient Care (b) Performance Mgmt
Mix of Patient & Performance Management tools to support patient care / flow
33
The Next Level:
Health Intelligence Systems

34. Bed Board
Web Based
Delivered by legacy PAS
Real Time
Predictive
ED performance
Network performance eg
cardiology
Load Management
Patient Placement
Length of Stay Features
34

35. Bed Board: Length of Stay and Inter-hospital
Transfer
35

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38. New methods of scientific inquiry
Big Data
Big
Question
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39. New methods of scientific inquiry
• While it is attractive to contemplate the way
everything may become connected to everything
else, it presents a number of large challenges.
• The lab research model has been important for
over a century in both scientific advancement
and product development; soon it may also have
to accommodate a search for truth based only on
pattern-spotting.
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40. Patterns of care
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Year%
and%
Quarter
QLD,%
Queensland;%
NT,%
Northern%
Territory;%
NSW,%
New%
South%
Wales;%
ACT,%
Australian%
Capital%
Territory;%
WA,%
Western%
Australia;%
SA,%
South%
Australia;%
VIC,%
Victoria;%
TAS,%
Tasmania;%
FBC,%
Full%
blood%
count
Rate%
per%
100000%
individuals
Rate%
per%
100000%
individuals
Figure%
1:%
Rate%
of%
Services%
per%
100%
000%
for%
vitamin%
D%
(25?hydroxyvitamin%
D),%
full%
blood%
count%
(FBC)%
and%
bone%
densitometry%
by%
quarter%
between%
2000%
and%
2011

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Table 2: Annual benefit paid by Medicare for
25-hydroxyvitamin D testing and percentage
increase since 2000
Year Annual Benefit ($) % Increase
2000 1,021,784 100%
2001 1,670,597 163%
2002 2,318,770 227%
2003 3,216,543 315%
2004 5,269,951 516%
2005 7,592,467 743%
2006 12,149,112 1189%
2007 22,621,733 2214%
2008 42,358,509 4146%
2009 67,643,016 6620%
2010 96,746,203 9468%

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b) Frequency of testing in individuals with more than one test
Frequency
of testing
per
individual
Number of
individuals
Cumulative
Percentage
Frequency
of testing
per
individual
Number of
individuals
Cumulative
Percentage
2 1026483 49.5 41 12 100
3 496225 73.4 42 11 100
4 251306 85.5 43 11 100
5 132173 91.8 44 10 100
6 71534 95.3 45 8 100
7 39857 97.2 46 6 100
8 22717 98.3 47 5 100
9 13165 98.9 48 5 100
10 7790 99.3 49 5 100
11 4665 99.5 50 4 100
12 2881 99.7 51 3 100
13 1826 99.8 52 3 100
14 1196 99.8 53 3 100
15 809 99.9 54 3 100
16 555 99.9 55 3 100
17 390 99.9 56 3 100
18 288 99.9 57 3 100
19 221 99.9 58 3 100
20 176 99.9 59 2 100
21 145 100 60 2 100
22 126 100 61 2 100
23 106 100 62 2 100
24 93 100 63 2 100
25 79 100 64 2 100
26 65 100 65 2 100
27 55 100 66 2 100
28 47 100 67 2 100
29 43 100 68 2 100
30 37 100 69 2 100

46. Google trends for vitamin D
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47. Google Analytics-Google Trends
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48. New Technology Triggers
The Nexus of IT Forces:
Social, Mobile, Cloud & Big Data/Information
Source: Gartner, 2013

52. We need to embrace social media

53. apps4nsw collaborative
solutions for Health

54. The Two Hype Cycle Views
of the Electronic Health Record
Technology
Trigger
Peak of
Inflated
Expectations
Trough of
Disillusionment Slope of Enlightenment
Plateau of
Productivity
time
expectations
Positive
Hype
Negative
Hype
UsabilityValue
Source: Gartner, 2013

55. Needs
•Complexity
•Chronicity
•Severity
•Urgency
Benefits
•Improved experience
•Improved safety
•Improved clinical outcomes
Risks
•Increased clinical risk
•Privacy breach
Trust
•Design
•Credibility of information
•Security
•Privacy
•Ease of use
EHR
Adoption
Adoption framework for an effective HER

56. Source: The Lancet (DOI:10.1016/S0140-6736(10)61854-5)
Terms and Conditions

57. What Do We Need To Get There?
New-Style Leadership
New Skills
• Next Generation of ICT-engaged Clinical Leaders
• Executive Level-performing CIOs
• Medical/Clinical Informatics
• Patient Informatics
• Enterprise data warehouse architects/data modelers,
master data managers
• Data Scientists (epidemiologists are the “new cool”)
• Analysts - both business & clinical systems and clinical
data analysts
• Project managers
Source: Gartner, 2013

58. High
Tech
High
Touch

59. High Touch
• “I tell them that their first reflex should be to
look at the patient, not the computer,”
• Dr. Heineken said. And he tells the team to
return to each patient’s bedside at day’s end.
“I say, ‘Don’t go to a computer; go back to the
room, sit down and listen to them. And don’t
look like you’re in a hurry.’ ”

60. George Bernard Shaw
• “The reasonable man
adapts himself to the
world: the
unreasonable one
persists in trying to
adapt the world to
himself.
• Therefore all progress
depends on the
unreasonable man”