himss clinical & business intelligence community of...

HIMSS Clinical & Business Intelligence Community of Practice

May 28, 2015

Welcome

Shelley Price, MS, FHIMSS C&BI Community Organizer Director, Payer & Life Sciences, HIMSS

Nancy Devlin C&BI Community Organizer Senior Associate, Payer & Life Sciences, HIMSS

Michael Brooks, BS, MBA, CPHIMS C&BI Community Co-Chair Specialist Leader, Healthcare Information Management Deloitte Consulting LLP Michael Berger, PE

C&BI Community Co-Chair Chief Analytics Officer Affinity Health Plan

Agenda • Welcome • HIMSS C&BI Community Updates / Announcements • Presentation & Discussion: “Clinical & Business Intelligence: An Evolutionary Process”

o Charles Boicey, MS, RN-BC, CPHIMS, Stony Brook Medicine, Enterprise Analytics Architect

• Wrap-Up / Next Steps

C&BI Community Updates / Announcements

C&BI Tools and Resources

Find all our tools and resources to help you along your clinical and business intelligence journey in the HIMSS Resource Library at http://www.himss.org/library/clinical-business-intelligence

HIMSS Big Data & Healthcare Analytics Forum

The two-day forum brings together leading providers, payers, researchers, and government officials to provide • best practices, • cases studies, • peer-to-peer learning, and • expert insights into how healthcare organizations are currently using analytics

to mine data to improve clinical care and enhancing financial performance and administrative decision-making.

REGISTER TODAY: http://www.bigdatahitforum.com

C&BI Community Guest Speaker

Clinical & Business Intelligence: An Evolutionary Process

Charles Boicey, MS, RN-BC, CPHIMS Stony Brook Medicine Enterprise Analytics Architect May 28, 2015

Objectives

• The three evolutionary stages of a CI/BI initiative

• Three visualization techniques that will enhance the A strategy to incorporate “Big Data"

The doctor of the future will give no medicine, but instead will interest his patients in the care of human frame, in diet, and in the cause and prevention of disease. Thomas Edison

Evolution of Healthcare Analytics

Spreadsheets

Data Marts

Big Data Ecosystem Data Visualization

Spreadsheets

Data Visualization

Data Visualization

Data Marts Enterprise Data Warehouse Predictive Analytics Streaming Device Data Population Data Social Data

Today’s Persona

Healthcare Quality Team

Spreadsheets

Spreadsheets + Data Visualization

Data Marts + Data Visualization

Big Data Ecosystem + Data Visualization

Early Days - 2010

Naveen Ashish, PhD

NowTrending.HHS.gov

Enterprise Data Warehouse

– Suffer from a latency factor of up to 24 hours

– The EDW serves all of the following retrospectively as opposed to in real time

• Clinicians

• Operations

• Quality and research

Electronic Medical Record

– Not designed to process high volume/velocity data

– Not intended to handle complex operations

• Such as:

– Anomaly detection

– Machine learning

– Building complex algorithms

– Pattern set recognition

Current Environment

Modern Healthcare Data Platform

Sears, J., & Boicey, C. (2014, February 2). Healthcare does Hadoop. Retrieved from http://hortonworks.com/industry/healthcare/

Health Care Data Sources • Legacy Systems • All HL7 Feeds (EMR source systems) • All EMR Initiated Data • Device Data (in one minute intervals)

– Physiological Monitors – Ventilators – Smart Pumps

• Real Time Location System • Hospital Sensors • Genomic Data • Home Monitoring • Social Media

– Healthcare Organization Sentiment Analysis – Patient Engagement

New Data Sources • RFID • Streaming Device Data

– Philological Monitors – Ventilators

• Social Media • Geographic Information System (GIS) Data • Open Data

– www.data.gov • Adverse Drug Event

– www.researchae.com • Internet of Things (IoT)

Use Cases • Legacy System Retirement • Patient Condition Changes

– RRT • Early Sepsis Detection • Real Time Nursing Unit Utilization

– Staffing and Resource Allocation • Social Media Sentiment Analysis • Research

– Cohort Discovery – Data Science

• Clinician Aware Applications • Patient Monitoring External to Traditional Healthcare Setting • Event Driven Care & Real Time Quality Monitoring • Patient Scorecards

Sentiment Analysis & Tweets from the bedside

“Prom is overrated. #Name of Healthcare Organization @Name of Healthcare Organization”

Colleague Aware Applications • Preparing for the Emerging Real-time Healthcare System

– Where is my patients patients RD? – Connect me now

FHIR – The “Public API” for Healthcare? FHIR = Fast Health Interoperability Resource

– Emerging HL7 Standard (DSTU 2 soon)

– More powerful & less complex than HL7 V3

ReSTful API

– ReST = Representational State Transfer – basis for Internet Scale

– Resource-oriented rather than Remote Procedure Call (nouns > verbs)

– Easy for developers to understand and use

FHIR Resources

– Well-defined, simple snippets of data that capture core clinical entities

– Build on top of existing HL7 data types

– Resources are the “objects” in a network of URI reference links

Huff, S., McCallie, D HIMSS 2015

SMART Platform –Open Specification for Apps • “Substitutable Medical Apps”

– Kohane/Mandl – NEJM (2009)

• A SMART App is a Web App

– HTML5 + JavaScript – Remote or embedded in EHR – URL passes context & FHIR li nk

• EHR Data Access via FHIR

• OAuth2 / OIDC for security

Huff, S., McCallie, D HIMSS 2015

Some SMART Hotbeds

Huff, S., McCallie, D HIMSS 2015

Boston Childrens: SMART Growth Chart

Huff, S., McCallie, D HIMSS 2015

New Team Members

• Cognitive and Behavioral Psychology • User Experience • Human & Computer Interaction • Patients & Family

Trends: Big Data • Definition: Evolving

• Creation & Management: Distributed and augmented

• Information Governance: Shared

• Meaningful Analysis: Beyond PnL, Reporting, Connections, Correlations, Pattern Recognition, Machine Learning, Natural Language Processing

• Business Requirements: Blank Page; We don’t know what we want we will figure it out once we look at the data, the data will lead the way, AKA, Data Science

Trends: Healthcare

• Content Analytics – Suggestive Analytics* – Prescriptive Analytics

• Imaging Analytics • Moving Analytics out of the EMR Environment • Graph Data Mart

– Edge and Vertices Analysis

• Omic & Phenotype Combines • Sentiment Analysis

*Dale Sanders

Takeaways • Underpinning platforms may change but concept is

here to stay, abstract where possible.

• Machine learning will lead to the evolution of Data Science and eventual use of AI in Healthcare.

• Get used to source now, ask questions later: Healthcare evolves with data and it is not a point in time construct any longer.

• Get used to working with constant change, disruptive trends and something new that will make your “frameworks” obsolete.

Recommended Readings • Howson, C. (2014). Successful business intelligence: Unlock the

value of BI & big data (2nd ed.). New York, NY: McGraw Hill. • Feldman-Stewart, D., Kocovski, N., McConnell, B. A., Brundage, M.

D., & Mackillop, W. J. (2000). Perception of quantitative information for treatment decisions. Medical Decision Making, 20(2), 228–238.

• Redmond, E., Wilson, J. R., & Carter, J. (2012). Seven databases in seven weeks: A guide to modern databases and the NoSQL movement. Dallas, TX: Pragmatic Bookshelf.

• Sears, J. (2013, November 21). Modern healthcare architectures built with hadoop. http://hortonworks.com/blog/modern-healthcare-architectures-built-with-hadoop/

• Sears, J., & Boicey, C. (2014, February 2). Healthcare does Hadoop. Retrieved from http://hortonworks.com/industry/healthcare/

Contact Me @ Charles Boicey

charles.boicey@stonybrookmedicine.edu

(631) 444-3971

@N2InformaticsRN

• Want to get involved?

Speaker or topic ideas

Key note presenter

Blogger, twitter

Contact Nancy Devlin

• Community Website

www.himss.org/ClinBusIntelCommunity

Wrap-Up

JOIN US! • Next meeting: June 25, 2015

TBA

Next Steps

FY15 Leadership and Contact Information Chair: Michael Brooks, BS, MBA, CPHIMS Specialist Leader Deloitte Consulting LLP mibrooks@deloitte.com Mike Berger, PE Chief Analytics Officer Affinity Health Plan Mberger@affinityplan.org HIMSS Community Organizers: Shelley Price, MS, FHIMSS Nancy Devlin Director, Payer and Life Sciences Sr Assoc., Payer and Life Sciences HIMSS HIMSS sprice@himss.org ndevlin@himss.org

Thank You

…and welcome to summer!

Appendix

J.D. Whitlock, MPH, MBA, CPHIMS* -- Chair Vice-President, Clinical & Business Intelligence Mercy Health Cheryl Bowman, CPHIMS Data Manager University of Wisconsin Hospital and Clinics Michael Brooks, BS, MBA, CPHIMS, FHIMSS* Specialist Leader Deloitte Consulting LLP Robyn Chatman, CPHIMS, FAAFP, MD, MPH Physician Healthbridge Teresa Gocsik, MS, CRNA, CPHIMS* Director Aspen Advisors Michael Kurliand, MS, RN* IS Strategy Consultant Children's Hospital of Philadelphia

Sharon Lynn Morley, RN/CNS Client Manager Humedica Arthur Panov, MPH, CPHIMS* HIT Architect IBM Stuart Rabinowitz, MBA, BC Director Federal Markets - Socrata Socrata Maxine Rand, DNP (c), MPA, RN-BC, CPHIMS* Director, Clinical Education, Practice & Informatics Kaiser Permanente Chester H Robson, DO, FAAFP Regional Director of Medical Informatics, Ambulatory Systems Adventist Midwest Health Wolf Stapelfeldt, MD* Chairman, General Anesthesiology Saint Louis University Medical Center

* Indicates a returning

committee member

2014-2015 C&BI Committee Members

C&BI Community of Practice The goal of the C&BI Community is to bring together thought leadership and share knowledge that will support the future success of our members by improving their ability to understand and form partnerships to manage C&BI as a part of doing business and providing accountable and quality care to their members. The Community will support activities that promote peer-to-peer networking, problem solving, solution sharing, and education.

Topics of focus may include:

• Storage and Management of Data and Supporting Technologies

• Knowledge Management to Support Accountable and Quality Care

• Case, Risk & Cost Management

• Best Practices Clinical & Business Analytics

• Clinical Decision Support

• Research Data Warehousing/EDW

• Data Lifecycle Management

C&BI Community of Practice

• Open to all HIMSS members (current membership: approx 6,700 people)

• Will meet virtually 6 times/year

• Agenda for the meetings may include:

• Commencing with a short series of 2-Minute Drills presented various Community members

• Topical discussion with key note presenter

The ‘2-Minute Drill’ is based loosely on the sports analogy, and in this case

is a fast-paced (short in length) presentation on a hot, emerging, or timely topic, news event (e.g. research paper, game-changing market or technology news), or recent and relevant event (e.g., federal public meeting, legislative/federal/judicial news, critical conference or educational event).

2-Minute Drills foster greater peer-to-peer networking, member engagement, problem solving,

solution sharing, and education. If you are interested in presenting any drills, please contact Nancy or Shelley.

C&BI Task Forces Data and Analytics Task Force CO-CHAIR: Raj Lakhanpal, MD, FACEP | CEO | Spectramedix CO-CHAIR: Carol Muirhead, MBA | Sr. Informatics Project Specialist | PinnacleHealth This group creates resources and tools to help providers and provider organizations manage, integrate and aggregate the necessary information to support robust data and analysis, facilitate effective reporting by translating data into meaningful knowledge, resulting in improved quality, clinical and financial outcomes. Meeting times: 3rd Tuesday of the month, 1:00-2:00pm ET

Population Health-Accountable Care Task Force CO-CHAIR: William Beach, PhD | Regional Director for Regulatory Readiness, Northern Region | St. Joseph Health System CO-CHAIR: Jennifer Jackson | Senior Director, IT Population Health Data Solutions | Banner Health This group creates resources and tools to help healthcare organizations (providers, hospitals, integrated delivery networks, health plans and other stakeholders) use C&BI to execute population health management initiatives. These resources and tools to help these organizations achieve the industry transition from volume to value based population-based healthcare, particularly through delivery models such as Accountable Care Organizations. Meeting times: 3rd Wednesday of the month, 2:00-3:00pm ET