Big Data and Smart Healthcare
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Sujan PereraKno.e.sis Center, Wright State University
Big Data and Smart Healthcare Wright State Honors Institute Symposium
Healthcare is Changing
• Introduction of new federal rules and incentive programs• Hospitals are forced to change the process (30-day
readmission, ICD10 adaptation, quality measures) • Free and Open health information• Rise of discussions/forums/social media• 70-75% Americans online have used internet to find
health information1
• Rapid growth of health related devices• Variety of cheap sensors for health status/activity
monitoring• IBM Watson• Adaptation of Watson technology to Healthcare
1 http://www.additiveanalytics.com/blog/infographic-healthcare-social-media
Challenges on the way
• Huge amount of data being generated• Scientific knowledge, social forums, patient records
• Variety of data formats (text, images, videos)• Find the signal from noise (actionable information)• Expert can’t keep up with the new information• Need expert knowledge to interpret data (esp.
combination of observations)• Trustworthiness• Especially on social forums
• Privacy
It is clear that we need mechanisms to automate some parts of data processing and help humans in decision
making.
This talk will concentrate on how to improve the machine understanding of unstructured data
Structured vs Unstructured Data
Patient Disorders ICD-9 Code
Patient1 Hypertension 401
Patient2 Atrial fibrillation 427.31
Patient1 Pulmonary hypertension 416
Patient3 Edema 782.3
Patient4 hyperthyroidism 242.9
Coronary artery disease, status post four-vessel coronary artery bypass graft surgery on , by Dr. X with a left internal mammary artery to the left anterior descending artery, sequential vein graft to the ramus and first diagonal, and a vein graft to the posterior descending artery. He had normal left ventricular function. He is having some symptoms that are unclear if they are angina or not. I am therefore going to get him scheduled for an exercise Cardiolite stress test.
VS
• Structured data is incomplete and not accurate2,3
• 80% of patient data is unstructured1
• Stake holders interested in unstructured data• Medical professionals• Scientists• Insurance Companies• Policy makers
• Interesting Applications• Search• Prediction• Applications like CAC and CDI• Data and knowledge mining• Decision Support
Unstructured Data
1 http://www.zdnet.com/within-two-years-80-percent-of-medical-data-will-be-unstructured-70000137072Strengths and Limitations of CMS Administrative Data in Research3Comparison of clinical and administrative data sources for hospital coronary artery bypass graft surgery report cards
• Key indicators for readmission prediction reside in unstructured patient notes• facilities
• “Holter monitor was ordered by Lisa. She failed to get this because she did not have transportation”
• non-compliance• “Atrial fibrillation with poorly controlled ventricular rate due
to noncompliance.”• financial status
• “The patient mentioned that Bystolic is expensive and cannot afford it now.”
How Important is Unstructured Data
• ICD10 adaptation – need to understand the relationships E08 - Diabetes mellitus due to underlying condition
E08.0 - Diabetes mellitus due to underlying condition with hyperosmolarity E08.00 - without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) E08.01 - with coma
E08.1 - Diabetes mellitus due to underlying condition with ketoacidosis E08.10 - without coma E08.11 – with coma
• The underlying condition can be congenital rubella, Cushing's syndrome, cystic fibrosis, malignant neoplasm, malnutrition, pancreatitis
How Important is Unstructured Data
• Semantic Web– Provides a common framework that allows data to
be shared and reused across application, enterprise, and community boundaries
– Offers mechanisms to query data and reason over them
• Natural Language Processing– Enable computers to understand natural language
input
The Solution
An Example
He is off both Diovan and Lotrel. I am unsure if it is due to underlying renal insufficiency. He has actually been on atenolol alone for his hypertension.
Raw Text
Concepts
Knowledge
Inference
diovan lotrel renal insufficiency atenolol hypertension
diovanvaltuna
valsartan
antihypertensive agent
atenolol
tenominatenix kidney failure
renal insufficiency
kidney disease
disorder
blood pressure disorder
hypertension
systoloc hypertension
pulmonary hypertension
Patient taking diovan for hypertension
Patient has kidney disease
Patient is on antihypertensive drugs
is used to treat
is a
drug
disorder
cTAKESezNLP
ezKB<problem value="Asthma" cui="C0004096"/><med value="Losartan" code="52175:RXNORM" /><med value="Spiriva" code="274535:RXNORM" /><procedure value="EKG" cui="C1623258" />
ezFIND ezMeasure ezCDIezCAC
www.ezdi.us
ezHealth Platform