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Applied Analytics in Health Care

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

4/5/2013

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Goal Today – Moving past correlation to predictive analytics

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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

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Nexus – Technology Integration and Clinical Integration

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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

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My Job – (And our biggest challenge)

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Real world application of Science

•  Science Applied to Business

•  Analytics at Scale Under

production loads

•  Bridged the gap between research and business

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Key Challenge we face now

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Nexus – Applied Science in the technology side of our biz

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Analytics toolsets in the Enterprise – Not so long ago

•  Hand Crafted

•  Artisan Work

•  Housed in Data Islands

•  Hidden deep for specialized tasks

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Standard Analytics toolsets emerging

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Connections to backend processing standardizing

•  HDFS Connectors

•  Project R Interfaces

•  SQL interfaces into HDFS

•  Overlays of Overlays (ElasiticSearch – Logstash)

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Integrated Apps and Workflows

Standard Adapters

•  Integrated applications

•  Standard connections

•  Batch and Real Time

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Results of standardization of connections – App Integration

Aggregate Normalize

Pull from biz Applications

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Point to Highlight – Move from Batch to Real Time

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Enabling real time feedback

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Mapping this to Clinical Care

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Three sides to healthcare

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Health Care Information Technology

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“Big Data” = Large Shelves

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New “Big Data” at Hospitals

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What is causing the change – Expand on Sources

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EHR Adoption

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2013 2014 2012

Industry Adoption Lifecycle Strategy

Meaningful Use

EMR

Ancillary Systems

Stage 2 ACO

Telemedicine

RTLS

Stage 1

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Lots of data

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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

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Clinicians and mobile

•  Clinicians driving adoption

•  Mobile devices input and output data

•  Integration into sensor nets

•  Integration into alerting and workflow

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Me and Withings

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Larger data sources on the horizon

EHR Applications

Mobile Devices

Sensors Data Center

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Current Sensors – Just the start

Time series data Similar to Smart Grids

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Scientists Dream

Insert Dream Picture

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Challenges – Crossing the Gap

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Challenge - Understanding where data is being generating

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Challenge - Breaking the transcription barrier

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Challenge – Understand Clinical Workflow

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Challenge - Using data to impact clinical outcomes

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Results of standardization of connections – App Integration

Aggregate Normalize

Pull from biz Applications

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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

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Nexus Healthcare Services

Connecting People, Process and Technology

to Improve Patient Care

Donn Wurts Director, Connected Healthcare Practice

donn.wurts@nexusis.com 925-324-0359

Paul Caracciolo Chief Healthcare Officer

Paul.caracciolo@nexusis.com (303) 748-4402

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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

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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

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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

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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

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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

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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.

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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

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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

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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

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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 !

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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.

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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

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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

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Real Time Communications – Alerting with Extension

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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

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Nexus Collaboration

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! Thank You