Before I began my MBA program here at the University of
Utah, I worked for three and a half years at Epic, one of the leading vendors
of electronic medical records supporting their relational database/reporting
platform. There, I worked with customers
to set up and maintain extracts from the live system into RDBMS platforms for
reporting. For the last six months, I
have been working as a consultant doing reporting and database administration
for Singing River Hospital in Mississippi.
I have supported customers of all different sizes: from the relatively
small ones like St. Joseph's Hospital West Bend Clinics with databases of only
a few gigabytes, to huge ones like Cleveland Clinic, Kaiser Permanente, and
Sutter with databases of several terabytes.
Since I work in the healthcare industry, I wanted to discuss how
healthcare organizations are currently using big data and analytics and where
they are headed in the future.
Healthcare reporting
up to nowd
Analytics and big data in healthcare are in their
infancy. When I was at Epic, most
customers were doing one form of reporting or another, varying in their levels
of sophistication. Some new customers
were just starting to use the data for basic statistical reports while more
experienced customers were deeper into the data to identify, monitor, and
improve care for different patient populations.
Studies that previously would have taken months and cost hundreds of
thousands of dollars could now be done in a few minutes by one doctor who was
familiar with SQL. However, no customer
that I knew of was using the data for any kind of predictive analytics.
Epic's biggest selling point has been its integrated system [1], which
combines clinical and financial data into one medical record, which physicians
and nurses across the entire organization could access. Instead of the patient having a chart in each
office or hospital with different, each patient has one chart containing his or
her entire patient history. This in and
of itself is great, and maybe I'm biased because I work on the reporting end of
things, but I think going forward the greatest benefit EMR's will give to
healthcare organizations is the trove of data they generate and the insights
that the organizations will be able to glean from it.
Challenges
One of the reasons that healthcare organizations haven't
leverage big data are the challenges that healthcare data presents. For those who are not familiar with big data,
it is generally described using the “3 v's” model [2]: volume,
variety, and velocity. In other words,
data sets that are so large, varied, and change so quickly that they are
impossible to work with using traditional data marts. While it doesn't have to
volume or velocity of web data, healthcare data is extremely varied [3]. Last time I checked, Epic's
relational database contained over 15,000 tables and about 130,000
columns. Many healthcare organizations
have data coming from multiple systems as well, further complicating things.
Recent innovations
Organizations are beginning to find solutions to these
problems and make use of big data.
Explorys, a spinoff of Cleveland Clinic, combines clinical, operational,
and financial data in a cloud based architecture with massively-parallel data processing [4] to provide its customers high-speed data access [5]. They
currently serve 13 major
healthcare systems [6].
Recently, UPMC [7] selected Oracle [8]
as its software vendor in a $100 million analytics project [9]. Dr.
Steven D. Shapiro, UPMC's chief medical and scientific officer explained “Today’s healthcare institutions have access to
unprecedented types and volumes of data that have the potential to unlock the
secrets of human health and disease leading to new and highly personalized care
pathways.”
Some organizations have already used predictive analytics to reduce hospital re-admissions [10].
Parkland Health and Hospital system in Dallas developed a predictive
algorithm to identify in real-time heart failure patients at high risk for readmission
or death. With this, they have been able
to reduce heart failure readmissions by 20%.
Future direction
This is just the beginning.
As time goes on, more and more healthcare organizations will adopt
similar techniques and build upon the work that has previously been done,
increasing the overall knowledge base of diseases and treatment. As computing power and storage capacity increase,
genomic data will be able to be combined with medical data for analysis [11], allowing
doctors to personalize treatment to each patient based on his or her genes. I'm excited to see what the future holds.
9. http://www.forbes.com/sites/oracle/2012/10/10/upmc-picks-oracle-to-unlock-secrets-of-human-health/
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