big data: the use of analytics to bend the cost curve and

© 2014 IBM Corporation

Big Data: The Use of Analytics to Bend the Cost Curve and Deliver

Effective Health Services for Patients

Perspectives towards a “proactive health system”

14th Annual Health Summit – Setting Priorities for Healthcare

Panel Session – 1035am – June 26th, 2014

Paul Sulkers

Health Industry Executive

IBM National Health Team


2

The benefit of proactively managing Population Health via Health Analytics is

huge – bigger than ‘big data’ – but requires a set of capabilities.

• We know that once patients cross the threshold into acute care, readmissions occur – an average of $33k per patient for the top 1%.

• Critical to manage a patient in lower cost settings, before they cross thresholds in care.

• Prevent a patient becoming a “1 percenter” in the first place.

Ambulatory care

Ambulatory care

threshold

Primary care

Primary care

threshold

Self-care

Self-care

threshold

Hospital care

Effective self-care controls disease

progression and avoids repetitive

crossing of thresholds

Acute admission/

readmission occurs

Illness Severity

Progression of Illness over time


3

Population Health requires increased focus on aggregation of data to segment

populations and derive “accountability” metrics – independent of source system …

Custom

Reporting

Advanced

Analytics

Research

Clinical Excellence

Operational

Dashboards

Program

Services

IBM Data Model

Clinical Data

Risk Stratification

& Care Mgmt data

Medical Abstracts

Population

Risk Rating

HR Data


4

… translating data into insights to change behaviour at point of care - in support

of new accountability and quality measures and preventive programs.


5

Population Health requires both social and clinical determinants – leverage clinical

notes via Watson’s NLP engine – convert non-structured (text) to structured factors.

A 42-year old male presents for a physical. He lives alone and recently cut back from 2 packs to 1 pack per day. He recently had a right hemicolectomy invasive grade 2 (of 4) adenocarcinoma in the ilocecal valve was found and excised. At the same time he had an appendectomy. The appendix showed no diagnostic abnormality.

Patient Age: 42

Gender: Male

Smoker: Yes

Living Arrangements: Alone

Hx

Procedure

hemicolectomy

diagnosis: invasive adenocarcinoma

anatomical site: ileocecal valve

grade: 2 (of 4)

Hx

Procedure

appendectomy

diagnosis: normal

anatomical site: appendix


6

Retrospective is necessary but not sufficient! … using both structured and

non-structured features to predict the onset of CHF six months earlier.

• Prediction significantly

improves as

complementary data

driven risk features are

added, beyond a base of

existing knowledge

based risk features.

• A significant

improvement occurs

when we add first 50

data driven features.

+200+150

+100+50

allknowledgefeatures+diabetes

+Hypertension

CAD

0.5

0.55

0.6

0.65

0.7

0.75

0.8

0 100 200 300 400 500 600

AUC

Numberoffeatures


7

Based on predictive models, Catalonia segmented their populations (risk

profiling) – to focus resources based on Clinical Risk Groups (CRGs).


8

Population Analytics is all about Smart Process – Population Management means

ability to monitor in real-time - allowing us to take actions in time – via BPM.


9

99% 60% 10%

Understands

natural

language and

human speech

Adapts and

Learns from

user selections

and responses

Generates and

evaluates

hypothesis for

better outcomes

3

2 1

…based on a set of massively parallel

probabilistic evidence-based algorithms.

Lastly, Knowledge Management converges with Population Health – personalize care

by combining patient attributes with knowledge – via Watson for Healthcare.

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10

Thank you

big data: the use of analytics to bend the cost curve and

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