big data applications in healthcare

February 6, 2015

Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference

Big Data Applications

in Healthcare

Martin D. BrownPresident

PYA

Brian A. WorleyPresident and Chief Executive Officer

PYA Analytics

February 6, 2015


Outline of Presentation

• Case Studies

• Big Data and the Fourth Dimension

• Data Analytics in Science

• Data and US Healthcare

• PYA Analytics Applications

February 6, 2015


University of Kansas HospitalHays Medical Center

February 6, 2015


Healthcare Case Study 1:

Rural Clinically Integrated Network

Kansas Heart and Stroke Collaborative

• 3-year, $12.5 million award from the Center for Medicare and Medicaid Innovation led by the University of Kansas Hospital and a rural clinically integrated network including a rural regional referral center, 10 Critical Access Hospitals, primary care providers, and specialists

• Develop a care delivery and payment model to improve rural Kansans’ heart health and heart attack and stroke outcomes to reduce total cost of care for that population.

Goals

• Reduce total cost of care for target population by $13.8 million (1.9 % savings)

• Reduce deaths from heart and cerebrovascular disease by 20 %

February 6, 2015



Analytics’ Key Role

•Develop Shared Analytic Infrastructure (SAI) developed for CMS by computational scientists while at Oak Ridge National Laboratory

•Maintain an architecture for management and analysis of large volumes of disparate data

Summary:

Management of heterogeneous data sets; cloud-based infrastructure for dynamic and on-demand data; resource provisioning; innovative, and informal (ad-hoc) visualizations; Web-Oriented-Architecture application programing interface for remote access to data and analytic functions critical in a “virtual” model; and real-time claims and clinical data from diverse sources

Specifications:

February 6, 2015



Analytics’ Key Role

•Identify at-risk patients

•Facilitate interoperable use of population health IT solutions with KHSC staff and vendors

•Track total cost of care for the KHSC patient population

Functions:

•Conduct real-time analysis and predictive modeling to develop a transformational payment model that incentivizes and supports treating the target population

•Assist in conducting performance evaluations reported to CMS

Outcomes:

February 6, 2015



DOJ Investigation

…analyzed 9,426,517 lines of data. Each of

the 9,426,517 lines of data represented

7 years of data with one or more units of a

single service rendered and billed by

two disparate billing systems…

February 6, 2015


Example of

Healthcare Data Analytics Projects

Use CMS-established algorithms to calculate the

Hierarchical Condition Categories for qualifying

patients within the health provider network.

Building algorithms from published requirements

and performing analysis using the algorithms and

clinical data.

February 6, 2015


Example of

Healthcare Data Analytics Projects

Perform text analysis against contract documents to

identify the financial contract terms and compare with

actual invoicing costs.

Apply natural language processing to extract

contract terms from pdf documents and automate

the comparison of the terms against actual billing

from the financial system.

February 6, 2015


Business Problem

• Text-based data largely underutilized or ignored

• Lack of understanding as to the capabilities and possibilities

in text analysis

• Digital universe will total 35

zettabytes in 2020 (in 2011 it

was 1.8 zettabytes) [IDC 2011 Digital

Universe Study]

• 80% of digital data is

unstructured or text-based

data [2013 Forbes]

February 6, 2015


Text Analysis and Natural Language

Processing• Taking unstructured text-based data and deriving high-quality

structured information from it

• Types of information include:

– Linguistic metrics: e.g., total words, parts of speech, spelling errors

– Named entities: e.g., people, locations, organizations, dates

– Semantic

representations: concepts

contained in the data

– Similarity measures and

clustering

February 6, 2015


Use Cases and Current Projects• Healthcare

– Tennessee Department of Children’s Services (DCS)

– Centers for Medicare & Medicaid Services (CMS)

– Emergency room and doctors’ offices

• Legal space

– Legal invoicing

– Pre-discovery and discovery phase data processing

– Defense sector

– Condition-based maintenance

– Law enforcement support

• Business

– Email tracking

February 6, 2015


DCS Project Overview

• Project drivers

– Evaluate the quality of case notes (writing, information provided)

across the entire state; use findings to improve the training.

• Key idea

– Use essay auto-grading-like techniques, enhanced with PYA

Analytics proprietary algorithms for quantitative and qualitative

content analysis.

• Implementation

– Quantitative and qualitative analysis implemented as Python and

Java programs and deployable to DCS IT as an appliance.

February 6, 2015


Data Provided by DCS

• Narratives and metadata (description of the data

and cases)

– 5 gigabytes (GB) with over 11 million unique entries

• Good and bad tagged case notes

– Over 100 pre-classified examples with additional

comments concerning the reasoning behind the given

classification

• Keyword lists

February 6, 2015


CMS Measures Management System

• Develop automated system to conduct environmental

scan of available literature to support the new and

current CMS measures

• Provide unsupervised knowledge extraction and search

capabilities

– Support of other contractors’ work on semantic representations of

existing measures

• Develop conceptual representations for measure areas

that are lacking in evidentiary research

February 6, 2015


Legal Invoicing

• Develop software system that will facilitate and

automate the detection of rule violations in legal

invoices

• Implement optical character recognition (OCR) that will

convert paper documents to digital form

• Create logic-based set of rules and analyze text within

invoices to detect violations and anomalies

– E.g., Tasks designed for paralegal being billed at lawyer rates

February 6, 2015


Source: http://www.modernhealthcare.com, November 19, 2014

CMS names

First Chief

Data Officer…

“tasked with

overseeing

improvements in

data collection and

dissemination…”

February 6, 2015


The Business of Big Data

• $300 billion annual value of big data for the US healthcare

system, two-thirds of which would come in reduced

expenditures (McKinsey).

• $165 billion worth of value for big clinical data (McKinsey).

• 966 petabytes data stored by discrete manufacturing

companies in the US during 2009; 848 petabytes of data

stored by government in the same year (McKinsey).

• By 2020, IT departments will have 10 times more servers

and 50 times more data to look after than they do now.

February 6, 2015


Data Analytics Expertise

is in High Demand

• The US will face shortages of:

– between 140,000 and 190,000 individuals with “deep”

analytical skills capable of working with very large data

sets

– between 300,000 and 400,000 skilled technicians and

support staff

– about 1.5 million “data-savvy“ managers and analysts

(McKinsey)

February 6, 2015


Healthcare Analytics Will Reduce

Costs by Addressing Key Issues

• Unwarranted medical procedures

• Fraud, waste, and abuse

• Administrative costs

• Provider inefficiencies

• Coordinated care

• Preventable conditions

February 6, 2015


Healthcare Analytics for

Improving Care

• Ability to mine wide population data to

improve patients’ diagnosis and outcomes

• Reduction of medical errors

• More successful drug development

• Data-driven preventive care

• Consumers of healthcare, not just patients

February 6, 2015


Your Physician Can

Make Use of Data

Story Visualization Translate

February 6, 2015


Computerized Analytics May Perform Much of

the Initial Diagnosis and/or Inform the Physician

• Who has perfect memory and can read everything needed?

Analytics platforms such as IBM Watson

• Computers have the potential to assist/perform:

– Collecting patient symptoms

– Collecting patient history

– Comparing the two to a large data base

– Identify successful and poor outcomes of various treatments

– Provide informed recommendation of potential treatments with

probabilities of success

February 6, 2015


Coming Soon –

Genomic Data will be Added to your Health Records

February 6, 2015


Increasing Role of Social Media

February 6, 2015


Real-time Diagnostics from Sensors

February 6, 2015


Improved Emergency Care

Emergency room will know your

issues and history before you

arrive

Specialized field care can be

applied based on your history

February 6, 2015


Reduced Exposure

Data can be collected from

social media to track disease

spread

Tracking medical radiation

exposure more accurately in

real time

No child sick waiting rooms

February 6, 2015


Focus on Health

Use data to demonstrate

how you as individual can

maintain and improve health

Increased use of health

physicians versus care

physicians

February 6, 2015


PYA Analytics, LLC

• Headquartered in Knoxville, Tennessee

• Advanced Analytics Company

– Text Analysis and Natural Language Processing

– Statistics, Data Mining, and Predictive Analytics

– Geospatial/Temporal Analytics

– Information Visualization for Decision Support

– Big Data Architectures

February 6, 2015


PYA Analytics Applications

• Healthcare

• Food Industry

• University Academics and Operations

• State Social Services

• Legal – Compliance and Litigation

• Internet Radio

• Sports

• National Security

February 6, 2015


Food Industry

• What are the profit drivers across

the brand, franchises, and

individual stores?

• What are the influences of

demographics, weather, and

distance to critical infrastructure?

• What price bundling is predicted

to increase profit?

• Where is fraud taking place?

February 6, 2015


Contact Information

Martin D. Brown [email protected]

President http://www.linkedin.com/in/martybrowncpa

PYA http://twitter.com/healthcarecpa

(800) 270-9629 www.pyapc.com

Brian A. Worley [email protected]

President and CEO

PYA Analytics

(865) 862-4196 www.pyaanalytics.com

Amber McKenzie [email protected]

Data Scientist https://www.linkedin.com/in/ambermckenzie

PYA Analytics

(865) 862-4196 www.pyaanalytics.com

big data applications in healthcare

Healthcare

clinical data

lines of data

years of data

dimensiondata analytics

analytics key roledevelop

realtime analysis

financial contract terms

contract documents