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© COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
An Enterprise Data Strategy for Powering Healthcare Modernization & Innovation MarkLogic Corporation & Intel Corporation
BILL GAYNOR
U.S. Healthcare Executive,
MarkLogic
MARCEE CHMAIT
Strategic Development &
Innovation, SCAN Health
Plan
DAVID E. DANHAUER,
MD, FAAP
System VP / CMIO,
Owensboro Health
DAVID DILORETO, MD,
FACS, MBA
HCEG Board Member
SVP, GE Healthcare
Camden Group
SLIDE: 2 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
“It ain’t what you don’t know that gets you into trouble.
It’s what you know for sure that just ain’t so.”
— The Big Short (2015)
SLIDE: 3 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Healthcare Organization Data Challenges HEALTHCARE IN 2017
50 LOWER
Compared to other service and
insurance industries … leveraging
unstructured data Satmetrix
High Price, High Volume FFS
Procedures Most Impacted,
Shift to Value-Based Models CMS
$355 per record, $158
average in other industries Ponemon Study
20 REDUCED
PAYMENTS
% MILLION PER
BREACH
$ 4 %
SATISFACTION
SLIDE: 4 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
The Massive Cost of Legacy Technology DATA CHALLENGES
60 % OF TIME
By data scientists just
wrangling data NYT
WASTED
In 2016 on data integration
software Gartner
Of data warehouse projects
is on ETL TDWI for Informatica
3.5 BILLION IN
SPENDING
$ % OF THE
COST 80
SLIDE: 5 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Healthcare’s Experts at Integrating Data From Silos
1,000+ global customers
Decade of customer success
250+ partners
525+ employees worldwide
Capitalized for success (lead
funding from Sequoia Capital
and Wellington)
CREDIBILITY MATURITY EXPERTISE
Consulting Services
Data integration experts
for payers, providers and HIT vendors
24x7 Expert Support
From true engineers
Online Community
Free dev software, collaborate with
tens of thousands of people
Free Training
Web-based and instructor-led
HEALTHCARE:
ICA
Healthcare.gov Aetna
AHA, American
Hospital
association,
Health Forum
AMA, American
Medical
Association
Wellcare
M Modal
SLIDE: 6 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Solving Enterprise Data Integration Challenges DATA CHALLENGES
Enterprise Data Hubs
Consumer360, Medicaid, Operational
Data, Metadata, Structured &
Unstructured Data, Real-time Delivery
at Scale … and Centers of Excellence
Data Services Hub & App Dev
Platform for Real-Time Enrollment
“The largest personal data integration
government project in the history of the
Republic.”
- STEPHEN PARENTE, PHD, MPH, MS
Dynamic Content Delivery at Scale
Integrated Data, Multi-Device Delivery Global Trade Store
Integrated Data, Integrated Post-Trade
Processing
3 Top 10 Payers
SLIDE: 7 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Popular Healthcare ―Next Gen‖ Data Projects DATA CHALLENGES
FLEXIBLE DATA MODEL
UNSTRUCTURED & STRUCTURED DATA
FAST INGEST, INDEX, SEARCH & ALERTING
ENTERPRISE RELIABILITY
Enterprise
Data Hub
IT Initiatives Business Initiatives
Master Data Management
Data Governance & Compliance /
Security
Cybersecurity
Metadata / Search
Hadoop ―Complement‖
Hadoop Alternative
Data Enrichment / Semantics
IoT – Health Device Data
Building Apps
Mergers & Acquisitions
Engagement & Service
360⁰ View & Search of ―Anything‖
Communications & Social Media
Payment Reform
ACO, MACRA, FWA
Quality & Outcomes
STARS, HEDIS
Real-time Alerts
Product / Plan Management
Clinically Integrated Networks (CIN)
SLIDE: 8 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Not Just a NoSQL Database … An Enterprise Platform Native advanced features add greater value and deliver a simplified enterprise architecture
SLIDE: 9
© COPYRIGHT 2016 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED. CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties
NoSQL DB Includes Native Search & App Server
KEY-
VALUE
COLUMN
DOCUMENT
GRAPH
A.I.
COGNITIVE
COMPUTING
PROPERTY
GRAPHS
TRIPLE
STORES
PREDICTIVE
ANALYTICS
NATURAL
LANGUAGE
PROCESSING
Data Platform vs. Standalone Tools
DATA
MINING
MACHINE
LEARNING ENTITY
EXTRACTION
KNOWLEDGE
GRAPHS
MarkLogic Native Capabilities
SLIDE: 11 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Owensboro Health
Owensboro Health is a nonprofit serving communities in Kentucky and Indiana with two hospitals, a
medical group comprising over 180 providers in 25 locations, a certified medical fitness facility and a
cancer center. Owensboro Health has been recognized for outstanding care, safety and clinical
excellence by The Joint Commission, U.S. News & World Report and Becker’s Hospital Review. As the
largest employer west of Louisville, Owensboro Health has 4,088 employees, and in FY 2015 saw
18,380 inpatient admissions and 823,072 outpatient encounters.
SLIDE: 12 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Physician Documentation Issues
Challenges in EMR versus paper
Patient story lost
Time-consuming and cumbersome
Limited Integration with transcription/voice recognition technology
―Note bloat‖
Copy/paste
Templating
Lost communication with Care Team
Coding issues
SLIDE: 13 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
The Quest for Innovation
Replace outdated legacy technology
Innovative technology
- Functional
- Easy to use
- Maintain workflows
- Integrated
- Improved quality of notes
- Transform unstructured data to discrete data
Metrics Driven - ROI
SLIDE: 14 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
The Process for Catalyzing Innovation
Search committee of key stakeholders
Delineation of problem and needs
Vendor search
Head-to-head business and technical evaluation
Formal ranking against needs
Selection of vendor
Project Development
- Scope, timeline, budget, etc.
- Metrics
SLIDE: 15 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Outcomes: Focusing on Physician Satisfaction
Physician Satisfaction
Ease of use
- 5 ways to document to help meet differing providers workflows
- Survey – 70% favorable, 41% above average or exceeds expectations
- No lost voice files due to cloud-based solution
- Mobile
Quality of notes – Provider reviewing provider notes
- Survey – 83% favorable, 37% above average or exceeds expectations
Turn-Arounds
All turn-around times well beyond HIM requirements
SLIDE: 16 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Outcomes: Leveraging Unstructured Data
Transform Unstructured Data to Discrete Data
CAPD
- 53% response to suggested documentation improvements
- Most alerts related to ICD-10 documentation
CDI
- Coding is current without backlog
Patient Safety/Quality
- Abdominal aortic aneurysms
- Lung nodules
SLIDE: 18 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Keeping Seniors Healthy and Independent
SCAN HEALTH PLAN
SCAN Health Plan is one of the nation’s largest
not-for-profit Medicare Advantage plans with nearly
180,000 members in California. Part of the SCAN
family, SCAN Health Plan is committed to keeping
seniors healthy and independent. In addition to
Medicare Advantage, SCAN Health Plan also offers
Special Needs Plans, including coverage for those
who are dually eligible for Medicare and Medi-Cal.
Our story…40 years of seniors serving seniors
SLIDE: 19 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Consumer Access to Healthcare Seems Impossible CARE CHALLENGES
Health Plan
Enterprise Systems
Medical Records
Cle
arin
gho
use
/Po
rtal
s
Serv
ice
Cen
ter/
Po
rtal
EOB, Claims, Bills
SLIDE: 20 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Innovation Requires a Leap Frog Approach CARE INNOVATION
Service & Data Model
Business Model
MA Plan
Senior Experience Company
SLIDE: 21 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Connecting the Consumer to Their Ecosystem GRAPH TECHNOLOGY
BBC: Storyline Graph
Facebook: Social Graph
Google’s Knowledge Graph CrunchBase: Business Graph
LinkedIn: Economic Graph Walmart: Loyalty Graph
CO
NS
UM
ER
-CE
NT
RIC
D
OM
AIN
-CE
NT
RIC
SLIDE: 22 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Our Independent Living Knowledge PERSONALIZED CARE
PREPARE to live
Independently
PLANNING
WHAT TO EXPECT
Senior-Specific
Planning:
For independent
living:
• Financial plan
• Legal plan
• Social support
BALANCE their caregiving
with life living
TRANSITIONING
PERSONAL NEEDS
Senior-Supporting
Services:
• Personal care
• Family connection
• Friendly visitors
• Geriatric case
management
SIMPLIFY your daily living
at home
SLOWING
LIVING NEEDS
Senior-Tailored
Services:
• Getting to
doctor appts.
• Transportation
• Eating well
• Housekeeping
• Yard work
• In-Home Tech
• Pet Care
ENGAGE in your local
community
RETIRING
SOCIAL NEEDS
Senior-Friendly
Places:
• Working
• Volunteering
• Interest Groups
• Local Events
• Learning Venues
ADAPT as your capabilities
change
DECLINING
ADAPTING NEEDS
Senior-Designed
Products/Services:
• Seeing
• Hearing
• Walking
• Talking
• Remembering
TR
IGG
ER
C
ON
TE
NT
E
XP
ER
IEN
CE
S
ST
AG
E
RISE TO INDEPENDENT LIVING Personal
Pathways
in a Graph
SLIDE: 23 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
The Independent Living Situation Using Graphs PERSONALIZED CARE
Proactive Education
Consumer Intent
Brand Innovations
Connected Life
Experience Content inspires a better way
Personalized
Content Streams
Family & Friend Circle plans for independence
Progressive
Profiles
Personal Assistant elevates results
Proactive
Conversations
Prescriptive
Algorithms
Senior-Tailored Services improves adoption
SLIDE: 24 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
The Independent Living Platform PERSONALIZED CARE
CONNECTED ECOSYSTEM
Client Team
Planning
& Partnership
Community
Education
& Onboarding
DIGITAL
ENGAGEMENT
GUIDED EXPERIENCE
Community
Insight
Consumer
Surveys and
Assessments
Business
Metrics
Employee
App
Rise
Advisors
Local
Service
Networks
Senior
Circle
Planning Needs
Social Needs
Home Needs
Capability Needs
Care Needs
Engage Simplify
Adapt Balance
Rise
Path Prepare
PERSONAL PATHS
• Assessed goals
• Guiding content
• Progressive solutions
• Assisted daily routine
COMMUNITY
EDUCATION
SLIDE: 26 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
The Healthcare Executive Group
The HealthCare Executive Group (HCEG) is a national network of executives representing the supply
side of healthcare: health plans, health systems, provider organizations and other health industry
participants coming together to continually learn, grow, share and reshape the industry.
HCEG’s members are executive leaders from some of the most dynamic health plans, health systems,
and provider organizations in the United States. The HealthCare Executive Group is supported by a
select network of sponsor partners, industry advisers and alumni. A single membership fee covers all
HCEG events and content including HCEG’s Annual Forum, Executive Leadership Forums, a wide
range of live and recorded education content and programming delivered via multiple channels, and
other benefits.
QUESTIONS [email protected]
Next Gen Data Tech in Healthcare Video:
Harness the Power of Modern, Innovative Healthcare With
MarkLogic and Intel (3:24) - http://bit.ly/2j6FW00
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© COPYRIGHT 2016 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED. CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties
APPENDIX A: Additional Solution Information
SLIDE: 30 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
The MarkLogic Alternative
An Operational and Transactional Enterprise NoSQL Database
Data ingested as is (no ETL)
Structured and unstructured data
Data and metadata together
Adapts to changing data
and changing data structures
EASY TO GET DATA IN Flexible Data Model
Index once and query endlessly
Real-time and lightning fast
Query across JSON, XML, text,
geospatial, and semantic triples
in one database
EASY TO GET DATA OUT Ask Anything Universal Index
Flexible cloud deployment
Enterprise-grade data security
Reliable data and transactions
(100% ACID compliant)
Out-of-the-box failover,
replication, and backup
TRUSTED TO RUN YOUR BUSINESS Enterprise Ready
SLIDE: 31
© COPYRIGHT 2016 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED. CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties
Flexible Deployment Run It Wherever You Want
Linux or Windows
On-premises (virtual or physical)
Private cloud, hybrid cloud, public cloud
AWS or Azure
Any storage architecture, including Hadoop
PHYSICAL
CLOUD
VIRTUAL
SLIDE: 32
© COPYRIGHT 2016 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED. CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties
How MarkLogic Data Hub Works ... Improved Agility & Time to Market
SLIDE: 33 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
MarkLogic 9 (early release phase)
DATA INTEGRATION
- SEMANTICS, QUERY, MOVEMENT
PRODUCT ROADMAP & INVESTMENT THEMES
CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties
SECURITY
ADVANCED ENCRYPTION, REDACTION, CERTIFICATION
MANAGEABILITY
OPS DIRECTORY, ROLLING UPGRADES, TELEMETRY
SLIDE: 34
© COPYRIGHT 2016 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED. CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties
How Does it Work?
Schema-agnostic design
Real-time indexing for search and query
Reverse queries for event processing and alerting
Scale-out shared-nothing cluster topology
Analytics and Visualization
Transactions
Bitemporal
SLIDE: 35 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Platform for building apps, analytics and running your business
Operational Data Hub Solution – Next Gen Enterprise Integration Pattern
Convergent: Operational & Analytical. Provides 2-
way interaction between users and data
Contextual: Data harmonized with semantic
metadata
Data-centric: Integrates at the data level, not just
functionally
Cost-effective: Minimizes ETL, data copying,
business silos, technical silos and people-centric
integration
Secure: Provides a platform for rich data
governance
Complementary: Leverages existing assets and
patterns
OPERATIONAL
APPLICATIONS MULTI-CHANNEL
DISTRIBUTION
BIDIRECTIONAL
ANALYSIS
OF ALL DATA
SSD, DAS, SAN, NAS,
S3, Hadoop/HDFS
JSON
XML
Data-Centric
Architectural
Pattern
CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties
SLIDE: 36 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
MarkLogic Data Hub
HA
RM
ON
IZE
ING
ES
T
Enveloped
Documents
(Entity 1)
SE
RV
E
Enveloped
Documents
(Entity 2)
RDBMS
Source 1
Documents
Message Bus
Content Feed
Staging Final Source
Systems
Consuming
Applications
Source 2
Documents
Source N
Documents
… …
Enveloped
Documents
(Entity N)
Operational Apps
Analysis/BI
Data Feeds
Indexes, Query, Scripts Indexes, Query, Scripts
Data Flow
SLIDE: 37
© COPYRIGHT 2016 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED. CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties
MARKLOGIC APPROACH TO
DATA INTEGRATION
2
3
1
4
1 Ingest Data As-Is
2 Access the Data
3 Harmonize & Enrich the Data
4 Operationalize
Better Data Ingest, Index, Search, Harmonization & Enrichment
SLIDE: 38 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Load Data As-Is
Load structured and unstructured data
Keep data and metadata together
Harmonize data in the database
Ability to skip:
– Upfront modeling
– ETL tools
HOW MARKLOGIC DELIVERS JSON
XML
SEMANTIC
DATA
GEOSPATIAL
DATA
MLCP
BINARY
OTHER METHODS
REST APIs, Java Client API, Node.js Client API, Java / .NET XCC
SLIDE: 39 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
Developer and User Access
Variety of Interfaces – Modern
programming languages familiar to
developers
Application Services – Simplifies
architecture and speeds up development
Developer Productivity – Tools and
frameworks to speed delivery
HOW MARKLOGIC DELIVERS
SEARCH APPS
JAVASCRIPT
XQUERY
SPARQL
REST API
JAVA API
SQL VIEWS
TRANSACTIONAL
APPS
ANALYTICAL
APPS
SLIDE: 40
© COPYRIGHT 2016 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED. CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties
Real-Time Analytics
Range indexes can be used for
Faceted search
Aggregation and visualization
Analytics…
…including custom user-defined functions
Co-occurrence
SQL, ODBC, and BI integration
ODBC
SQL
Range Indexes
SLIDE: 41 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
If You Have an EDW
MarkLogic Data Hub Enterprise Data Warehouse
Real-time interactive
Two-way analysis & operations
All of your data
Load data as-is, model
alongside discovery
Proactive, alert-capable at
massive scale
Batch-oriented
Analysis only
Structured data
ETL and model dependent
Reactive, query-based
SLIDE: 42 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.
If You Have a Data Lake
MarkLogic Data Hub Data Lake
Advanced data governance and
provenance features
Real-time
Two-way analysis & operations
Save and index everything for
sub-second processing
Mature and fine-grained security
model with redaction features
Advanced Semantics capability
for rich context
Multi-model capability eliminates
technical silos
Issues with data governance
and provenance
Batch-oriented
Analysis only
Save everything and process
with brute force
Simplified security model
Limited or no context
Multi-layered ecosystem
encourages technical silos