Optimum Healthcare ITA physician’s perspective on Big Data, Predictive Analytics & Business Intelligence (BI) tools

Optimum Healthcare ITA physician’s perspective on Big Data, Predictive Analytics &

Business Intelligence (BI) tools

Professor Steven BoyagesJCMIT 2013

TAIWAN

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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.

Bridging the Gap

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Objectives of Investment in IT• Improve patient experience• Improve patient safety• Improve provider experience• Create value for money

High TouchHighTech

Team and WorkflowPlatform

TechnologyPlatform

Health work matrix

New Technology TriggersThe Nexus of IT Forces:

Social, Mobile, Cloud & Big Data/Information

Source: Gartner, 2013

Nearly every transaction or interaction leaves a data signature

InformationSomeone somewhere is capturing and storing

Sheer scale has far exceeded human sense-making capabilities

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

the data

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

It helps us see the forest without getting lost in the trees

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©2011 Healthcare Information and Management Systems Society 16

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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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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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 flow04/08/2023

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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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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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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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USING DATAGoogle trends, Google analytics

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Google Trends Michael Jackson

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Facebook can predict your breakups

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Your personality can be predicted

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Eating Habits

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Google flu trends

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Health Intelligence:Keeping Score in Health

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Moving from Analogue to Digital Scoreboards

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The Next Level: Health Intelligence Systems

• Definition

Responsive Agile Available Flexible Timely

Real timeNear Real time

Capability

Patient Care Safety Decision support Outcomes Research Patient Logistics

Performance Management State Area based Hospital/cluster/network Modality (scheduling) Bedside

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• 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

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The Next Level: Health Intelligence Systems

Bed BoardWeb BasedDelivered by legacy PASReal TimePredictiveED performanceNetwork performance eg

cardiologyLoad ManagementPatient PlacementLength of Stay Features

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Bed Board: Length of Stay and Inter-hospital Transfer

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New methods of scientific inquiry

Big Data

Big Question

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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Patterns of care

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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

Google trends for vitamin D

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Google Analytics-Google Trends

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New Technology TriggersThe Nexus of IT Forces:

Social, Mobile, Cloud & Big Data/Information


We need to embrace social media

apps4nsw collaborativesolutions for Health

The Two Hype Cycle Viewsof the Electronic Health Record

Technology Trigger

Peak ofInflated Expectations

Trough of Disillusionment Slope of Enlightenment Plateau of

Productivity

time

expectations

PositiveHype

NegativeHype

UsabilityValue


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

EHRAdoption

Adoption framework for an effective HER

Source: The Lancet (DOI:10.1016/S0140-6736(10)61854-5)

Terms and Conditions

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 managersSource: Gartner, 2013

High Tech

HighTouch

Team and Workflow Platform

Education and Learning

People

Technology Platform

Communication and Connection

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.’ ”

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”

Health & Medicine

Optimum Healthcare ITA physician’s perspective on Big Data, Predictive Analytics & Business Intelligence (BI) tools