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Big Data Analytics in Health Care Making Sense and Getting Value from the “Tsunami” of Health Data Presented by: Alex J Mair, Director, Architecture Mark Nenadovic, Group Director Emerging Technology Group, Canada Health Infoway eHealth 2013 Conference Copyright © 2013 Canada Health Infoway May 27, 2013 Faculty/Presenter Disclosure • Presenters: Alex J Mair, Mark Nenadovic • Relationships with commercial interests: − Nothing to disclose ©2013 Canada Infoway © 2012 CanadaHealth Health Infoway Inc.Inc. 2 Agenda Big Data Analytics in Health Care • Setting the context • Introduction to Big Data Analytics • Enablers for Success • Call to Action ©2013 Canada Infoway © 2012 CanadaHealth Health Infoway Inc.Inc. 3 Data Never Sleeps • Consider that the average GP must stay on top of: − 10,000+ diseases & syndromes − 3,000+ Rx − 1,100+ lab tests • PubMed has over 22.6 million records − 500K added each year ©2013 Canada Infoway © 2012 CanadaHealth Health Infoway Inc.Inc. 4 Problem? - “Practice of medicine” vs. the “science of medicine” • Promise? - Technology... - − − mitigates human deficiencies; amplifies strengths increases access to complete, current and synthesized medical and social sciences research ©2013 Canada Infoway © 2012 CanadaHealth Health Infoway Inc.Inc. 5 “Man versus Machine” • Computers excel at: − organizing and recalling information − remembering complex information − integrating and balancing considerations • Computers have larger memories, and make far fewer mistakes than humans. ©2013 Canada Infoway © 2012 CanadaHealth Health Infoway Inc.Inc. 6 Introduction of Big Data Analytics in Health • The second white paper in the Emerging • • Technology Profile series Designed to address Big Data Analytics (BDA) from a Canadian health care perspective Intended to provide: − Insight on the potential applicability for this new technology − Context for business opportunities and challenges − Encouragement to advance activities in this space ©2013 Canada Infoway © 2012 CanadaHealth Health Infoway Inc.Inc. 7 BDA Defined • “Big data” characteristics include: high volume, high velocity and variety of types of information that demand costeffective and innovative forms of information processing. • “Analytics” is the process of examining large amounts of big data to deliver new insights that can enable decisions in real or near real time. ©2013 Canada Infoway © 2012 CanadaHealth Health Infoway Inc.Inc. 8 Origin of BDA • Key frameworks Web based & Social Media Data − Hadoop, MapReduce − Data Streaming Data Streaming • Key investments and enablers − Cloud Unstructured − R (Data Mining) & clinical data − Natural Language Processing Publication & Reference data ©2013 Canada Infoway © 2012 CanadaHealth Health Infoway Inc.Inc. Public & other data 9 “Big” vs “Small” Data Analytics Does not replace traditional analytics capabilities, as it is complementary and feeds results to traditional tools Generate Insights Predict & Model Big Data Mine Experimental, discovery, systemic & predictive Information management processes are different than traditional processes Analytics 2013 Canada Health Inc. ©2013 Canada Health Infoway Inc. © 2012 Canada HealthInfoway Infoway Inc. 10 Economics of BDA in Health Care Note: Figure used with permission of McKinsey Global Institute 2013 Canada Health Inc. ©2013 Canada Health Infoway Inc. © 2012 Canada HealthInfoway Infoway Inc. 11 Current state of BDA in Canadian healthcare • Industry research indicates progress has been slow − Activity is largely on the periphery of health care (i.e., research studies); not yet in mainstream practice − Benefits are still to be proven and documented − Privacy and security are important considerations affecting the pace of adoption 1 − Canada tends to lag behind other countries • Infoway believes − Industry focus, for the last decade, has been on digitizing points of service & the interoperable EHR − Majority of Canadian health care organizations are small; few have the financial scale to fund a BDA program 1. IDC White Paper: Survey of Big Data in Canada: Challenging Complacency for Competitive Advantage, December 2012 2013 Canada Health Inc. ©2013 Canada Health Infoway Inc. © 2012 Canada HealthInfoway Infoway Inc. 12 BDA Opportunities in Health Care Building on the EHR investments, Infoway foresees opportunities for BDA to create new insights. • Public and population health solutions − Google.org Flu counts specific search terms in queries to estimate the intensity of flu levels in a geographic area, often learning from the data itself. 2013 Canada Health Inc. ©2013 Canada Health Infoway Inc. © 2012 Canada HealthInfoway Infoway Inc. 13 BDA Opportunities in Health Care Building on the EHR investments, Infoway foresees opportunities for BDA to create new insights. • Public and population health solutions − Google.org Flu counts specific search terms in queries to estimate the intensity of flu levels in a geographic area, often learning from the data itself. • Clinical operations based solutions − Toronto Sick Kids Artemis project uses big data from monitors in real-time to provide insights which allow researchers to predict when a baby is at risk of infection, so that clinicians can intervene to prevent its occurrence. 2013 Canada Health Inc. ©2013 Canada Health Infoway Inc. © 2012 Canada HealthInfoway Infoway Inc. 14 BDA Opportunities in Health Care Building on the EHR investments, Infoway foresees opportunities for BDA to create new insights. • Clinical decision support based solutions − Memorial Sloan-Kettering Cancer Center, use of “Question and Answer” probabilistic algorithms to analyze millions of pages of unstructured text in patient records and medical literature to locate and rank the most relevant answers to diagnostic and treatment-related questions. • Personalized (genomics) care solutions − Use of Genome 1000 and biomarkers investments in cancer care research to predict individual disease risk, enable early detection of disease, and improve diagnostic classification to better inform individualized treatment. 2013 Canada Health Inc. ©2013 Canada Health Infoway Inc. © 2012 Canada HealthInfoway Infoway Inc. 15 BDA Opportunities in Health Care Building on the EHR investments, Infoway foresees opportunities for BDA to create new insights. • Policy and administrative business operations and solutions − Seton Healthcare Family mines unstructured data using natural language processing and search technologies to predict which chronic health failure patients are most at risk for readmission, by identifying known risk factors like smoking, and the lack of social supports, so health professionals can focus their efforts on keeping high risk patients at home 2013 Canada Health Inc. ©2013 Canada Health Infoway Inc. © 2012 Canada HealthInfoway Infoway Inc. 16 Predictions re: BDA Gaining Traction • The healthcare transition will start incrementally and develop slowly in sophistication − Early adopters will focus on use case development, experimentation and collaboration • Key areas of application include: − − − − Cancer treatment & genomics Clinical Decision Support Streaming data & remote patient monitoring Predictive analytics 2013 Canada Health Inc. ©2013 Canada Health Infoway Inc. © 2012 Canada HealthInfoway Infoway Inc. 17 BDA Readiness Infoway predicts: • Larger health delivery organizations particularly those with a: ─ Research base ─ Advanced level of maturity with their EHRS, DW/BI ─ Established information governance capabilities • HDOs that have demonstrated some practical success with knowledge management initiatives and are ready to take the leap to BDA 2013 Canada Health Inc. ©2013 Canada Health Infoway Inc. © 2012 Canada HealthInfoway Infoway Inc. 18 BDA Requires Enablers to Ensure Success It is more than a technology project. • • • • Business model – sustainability, business case & ROI, in-house vs. hosted service Governance – appropriate use of patient information, custodianship frameworks Leadership – vision, strategy roadmap, culture, investment Skilled resources – mathematical sciences, applied statistics, machine learning, operations research, natural language processing • Information management practices – processes, data collection, knowledge generation, context and visualization • Privacy and security policy – PHI protection, legal, policy, legislation interpretation • Ethics – use, research, legal 2013 Canada Health Inc. ©2013 Canada Health Infoway Inc. © 2012 Canada HealthInfoway Infoway Inc. 19 Call to Action Communications Opportunities to Collaborate • Identify • Don’t go it • Conduct due • Look to champions diligence to understand BDA • Share research, lessons learned alone leverage others’ work • Collaborate on use case, business cases Leadership • Address policy, legal, ethics, business model, sharing, legacy issues Cautious Execution • Limited scope pilots, solving specific clinical or business problems • Enable a supportive • Iterative, stepculture, processes, wise investments staffing for BDA that limit capital requirements • Create opportunities to bring together • Evaluate the several emerging feasibility and technologies utility of BDA 2013 Canada Health Infoway Inc. ©2013 Canada Infoway © 2012 CanadaHealth Health Infoway Inc.Inc. 20 Emerging technology resource documents: https://www.infoway-inforoute.ca/index.php/resources/presentations/emerging-technology Discussion & questions? 2013 Canada Health Infoway Inc. ©2013 Canada Infoway © 2012 CanadaHealth Health Infoway Inc.Inc. 21