chapman university-big-data-healthcare-final

www.Nexusis.com 877.286.3987 1

Applied Analytics in Health Care

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

4/5/2013

www.Nexusis.com 877.286.3987 2 2

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

www.Nexusis.com 877.286.3987 10 10

Analytics toolsets in the Enterprise – Not so long ago

•  Hand Crafted

•  Artisan Work

•  Housed in Data Islands

•  Hidden deep for specialized tasks

www.Nexusis.com 877.286.3987 11 11

Standard Analytics toolsets emerging

www.Nexusis.com 877.286.3987 12 12

Connections to backend processing standardizing

•  HDFS Connectors

•  Project R Interfaces

•  SQL interfaces into HDFS

•  Overlays of Overlays (ElasiticSearch – Logstash)

www.Nexusis.com 877.286.3987 13 13

Integrated Apps and Workflows

Standard Adapters

•  Integrated applications

•  Standard connections

•  Batch and Real Time

www.Nexusis.com 877.286.3987 14 14

Results of standardization of connections – App Integration

Aggregate Normalize

Pull from biz Applications

www.Nexusis.com 877.286.3987 15 15

Point to Highlight – Move from Batch to Real Time

www.Nexusis.com 877.286.3987 16 16

Enabling real time feedback

www.Nexusis.com 877.286.3987 17 17

Mapping this to Clinical Care

www.Nexusis.com 877.286.3987 18 18

Three sides to healthcare

www.Nexusis.com 877.286.3987 19 19

Health Care Information Technology

www.Nexusis.com 877.286.3987 20 20

“Big Data” = Large Shelves

www.Nexusis.com 877.286.3987 21 21

New “Big Data” at Hospitals

www.Nexusis.com 877.286.3987 22 22

What is causing the change – Expand on Sources

www.Nexusis.com 877.286.3987 23 23

EHR Adoption

www.Nexusis.com 877.286.3987 24 24

2013 2014 2012

Industry Adoption Lifecycle Strategy

Meaningful Use

EMR

Ancillary Systems

Stage 2 ACO

Telemedicine

RTLS

Stage 1

www.Nexusis.com 877.286.3987 25 25

Lots of data

www.Nexusis.com 877.286.3987 26 26

Growth of Connected Devices – Tracks to Healthcare

Total 500 Million

2007 1/10th of a Device per

Person on Earth

Total 35 Billion

2010 5 Devices per

Person on Earth

Total 50 Billion

2013 7 Devices per

Person on Earth

Total 500 Billion~

2020 70~ Devices per Person on Earth

www.Nexusis.com 877.286.3987 27 27

Clinicians and mobile

•  Clinicians driving adoption

•  Mobile devices input and output data

•  Integration into sensor nets

•  Integration into alerting and workflow

www.Nexusis.com 877.286.3987 28 28

Me and Withings

www.Nexusis.com 877.286.3987 29 29

Larger data sources on the horizon

EHR Applications

Mobile Devices

Sensors Data Center

www.Nexusis.com 877.286.3987 30 30

Current Sensors – Just the start

Time series data Similar to Smart Grids

www.Nexusis.com 877.286.3987 31 31

Scientists Dream

Insert Dream Picture

www.Nexusis.com 877.286.3987 32 32

Challenges – Crossing the Gap

www.Nexusis.com 877.286.3987 33 33

Challenge - Understanding where data is being generating

www.Nexusis.com 877.286.3987 34 34

Challenge - Breaking the transcription barrier

www.Nexusis.com 877.286.3987 35 35

Challenge – Understand Clinical Workflow

www.Nexusis.com 877.286.3987 36 36

Challenge - Using data to impact clinical outcomes

www.Nexusis.com 877.286.3987 37 37

Results of standardization of connections – App Integration

Aggregate Normalize

Pull from biz Applications

www.Nexusis.com 877.286.3987 38 38

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

www.Nexusis.com 877.286.3987 39

Nexus Healthcare Services

Connecting People, Process and Technology

to Improve Patient Care

Donn Wurts Director, Connected Healthcare Practice

[email protected] 925-324-0359

Paul Caracciolo Chief Healthcare Officer

[email protected] (303) 748-4402

www.Nexusis.com 877.286.3987 40 40

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

www.Nexusis.com 877.286.3987 41 41

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

www.Nexusis.com 877.286.3987 42 42

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

www.Nexusis.com 877.286.3987 43 43

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

www.Nexusis.com 877.286.3987 44 44

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

www.Nexusis.com 877.286.3987 45 45

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.

www.Nexusis.com 877.286.3987 46 46

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

www.Nexusis.com 877.286.3987 47 47

www.Nexusis.com 877.286.3987 48 48

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

www.Nexusis.com 877.286.3987 49 49

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

www.Nexusis.com 877.286.3987 50 50

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 !

www.Nexusis.com 877.286.3987 51 51

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.

www.Nexusis.com 877.286.3987 52 52

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

www.Nexusis.com 877.286.3987 53 53

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

www.Nexusis.com 877.286.3987 54 54

Real Time Communications – Alerting with Extension

www.Nexusis.com 877.286.3987 55 55

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

www.Nexusis.com 877.286.3987 56 56

Nexus Collaboration

www.Nexusis.com 877.286.3987 57 57

! Thank You

chapman university-big-data-healthcare-final

Education