Big Data in Healthcare

1. Big Data in Healthcare John Stearman, Baptist Health

2. Outline • Introduction • What the heck is BIG DATA? • Examples of Big Data • What are the tools? • Big Data’s role in healthcare? • How it affects (or doesn’t) HIM • Questions? RVHIMA 2014 Spring Meeting

3. Introduction • John Stearman, MS, RHIA • Background • 25+ years Hospital I.S. • Baptist Healthcare System • Siemens Medical Solutions – consultant • Jewish Hospital & St Mary’s Healthcare • LOTS of experience with reporting and analytics • 5+ years lab & pharmacy experience • RHIA in 2008 geek nerd RVHIMA 2014 Spring Meeting

4. Show of hands . . . .(aka unscientific, small data research) • Does anyone know anything about BIG DATA? • Is anyone using BIG DATA? • John is not claiming to be an expert btw RVHIMA 2014 Spring Meeting

5. A Couple of Background Principles Wisdom Knowledge Information Data Credit to Dr John Dillon, PhD, Brown University, University of Louisville RVHIMA 2014 Spring Meeting

6. What are the characteristics of Regular, pre-BIG Data? • Largely structured • Last Name ____________ • First Name ____________ • Initial ________ • SQL query from a database Select L_Name, F_Name, Initl From Demographics where admit_date >= 01/01/2014 • Text fields (unstructured data) available but query-guys hatethem  “The patient was cooperative – glucose was well controlled – strong, productive coughing – 25 year smoker, probably COPD” RVHIMA 2014 Spring Meeting

7. Tools for Regular, Pre-BIG Data • Structured Query Language (SQL) • Oracle • Microsoft SQL server • others • Crystal Reports / Business Objects • SAS, SPSS • Microsoft Access and Excel • Our old friends: paper and scanned images of paper RVHIMA 2014 Spring Meeting

8. What is Big Data? • It’s more than the same data we’ve always had except larger quantities of it – largely unstructured • “A full 90 percent of all the data in the world has been generated over the last two years. Internet-based companies are awash with data that can be grouped and utilized.” http://www.sciencedaily.com/releases/2013/05/130522085217.htm RVHIMA 2014 Spring Meeting

9. What is Big Data? (cont.) • From the beginning of recorded time until 2003, humans had created 5 exabytes (5 billion gigabytes) of data. In 2011, the same amount was created every two days • “There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don't know. But there are also unknown unknowns. There are things we don't know we don't know.” • Donald Rumsfeld, US Secretary of Defense RVHIMA 2014 Spring Meeting

10. Where does Big Data come from? • The types of big data includes: • Social media • Machine measurement of whatever • Medical devices • Astronomy • Face recognition • Machine measurements of themselves • Amazon.com, LinkedIn, etc RVHIMA 2014 Spring Meeting

11. BIG Data Sources • Tebow’s 80-yard overtime touchdown pass during AFC Wildcard game reached 9,420 tweets per second • Everyday, we create 2.5 quintillion bytes of data – so much that 90% of the data in the world today has been created in the last two years alone • In 2000, Sloan Digital Sky Survey (astronomy) collected more data in its first few weeks than the entire data collection in the history of astronomy • Wal-Mart handles more than 1M customer transactions every hour • Decoding the human genome originally took 10 years to process, can now be achieved in one week Source: https://www-950.ibm.com/events/wwe/grp/grp004.nsf/vLookupPDFs/Jon%20Whitman%20-%20IBM%20Big%20Data%20Intro/$file/Jon%20Whitman%20-%20IBM%20Big%20Data%20Intro.pdf RVHIMA 2014 Spring Meeting

12. Big Data Characteristics • Structured, unstructured and semi-structured data • Let’s dissect a Tweet • Date / time stamp – structured data • Subject - #topic – structured data • Body of the text, unstructured RVHIMA 2014 Spring Meeting

13. 5 Top Tools for Big Data • Apache Hadoop • Hortonworks (a cloud version of Hadoop) • Ingres Corp. Actian • Amazon (yes, THAT Amazon) • Cloudera • HP Vertica http://www.informationweek.com/big-data/big-data-analytics/16-top-big-data-analytics-platforms - Jan 2014 RVHIMA 2014 Spring Meeting

14. What are NOTBIG Data Tools? • Remember these???? • Pieces of paper or scanned images – aka manual abstraction • Run of the mill Structured Query Language (SQL) • Business Objects • Microsoft Access • Microsoft Excel Who AREN’T you going to call? RVHIMA 2014 Spring Meeting

15. How Do BIG Data Tools Work? • Creation of a data warehouse where all the data is found • With Hadoop, can be a standard servers • Structuring un-structured data • Rows of data 100’s or 1000’s of columns wide The answers are in there! “The X-Files” – a TV show from the 1990’s RVHIMA 2014 Spring Meeting

16. What the heck does that mean? “The patient was cooperative – glucose was well controlled – strong, productive coughing – 25 year smoker, probably COPD”

17. So what does all this mean to Healthcare? • The unknown unknowns • The drive is towards better outcomes – • Additional data available by more patient engagement (weight, bp, glucose, data collection in running shoes) • And of course, a brandnew concept to healthcare – reducing costs • Marrying clinical data with payment data – true pay for performance RVHIMA 2014 Spring Meeting

18. Steps For Healthcare To Get There(John opinions only) • Paradigm shift from paper/scanned images to true use of electronic information • This will have to come from the top-down • Higher data IQ • It can no longer be an option • HIM should have a place at this table – will we? RVHIMA 2014 Spring Meeting

19. What about HIM?aka let’s be self centered a moment • Paper-based systems have been archaic for a long time – BIG data is the future and we, as HIM pros, need to get on-board • What do we code? What if the machine could structure the unstructured physician notes? • What if we had the ability to Health Information Manage a living database the care providers could query with Google-like tools instead of producing paper or paper-like images? RVHIMA 2014 Spring Meeting

20. Questions / Discussion? RVHIMA 2014 Spring Meeting

21. Thank you for your attention! BIG Data HUGE Data ENOURMOUS Data RVHIMA 2014 Spring Meeting