Big Data: Opportunities for the Dental Benefits Industry

Transcription

1 Big Data: Opportunities for the Dental Benefits Industry Joel Reichert - VP, Data Strategy Herschel Reich - VP, Payer Consulting September 16, 2014 Big Data: Opportunities for the Dental Benefits Industry Joel Reichert - VP, Data Strategy Herschel Reich - VP, Payer Consulting 1

2 Agenda Big Data 101 Use Cases For Big Data Analytics in Insurance & Healthcare Opportunities for the Dental Benefits Market Challenges for Implementing Big Data Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 3 From Big Data to Big Dental The Old Paradigm: Big Dreams Big Deficits Big Disappointments The New Paradigm Big Data Big Drilling Big Dental Big Disclaimer Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 4 2

3 How I Learned about Big Data! I watched Captain America: The Winter Solider 3 times on an eleven hour flight In Captain America's latest big screen adventure, his arch-enemy isn't a diabolical super villain or space alien. It's big data. "The 21st century is a digital book," the captain is told. "Your bank records, medical histories, voting patterns, s, phone calls, your damn SAT scores! [Our] algorithm evaluates people's past to predict their future. While most of the people in this room won t go as far as Hydra in eliminating the competition, we can appreciate it s business context. I never did see Moneyball but the concept of using analytics to win in sports is only getting more extreme! Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 5 What influenced the development of Big Data solutions? Data Growing data volumes and sources Structured (claims, eligibility, etc.) & Un-Structured (social media, images, etc.) Platform A new scalable solution to manage the data and processing (Hadoop & GFS) Storage New ways to store data in various formats (Text, NoSQL, Columnar, etc.) Processing New ways of processing the data (Batch, Stream, In-Memory, etc.) Analytics New Insights Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 6 3

4 Big Data Quiz Which of the following is not one of the 4 V s of Big Data? 1. Volume 2. Veracity 3. Variety 4. Victory 5. Velocity Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 7 What is Big Data?. Big data is high-volume, -velocity and -variety information assets that demand cost-effective, innovative forms of information processing for enhanced insight and decision making. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 8 4

5 History of Big Data The world just wanted a better open-source search engine. Doug Cutting and Mike Cafarella set out to build it. They called their project Nutch. Sanjay Ghemawat, Howard Gobioff, Shun-Tak Leung release paper on GFS (Google File System) 2004 Sanjay Ghemawat and Jeffery Dean Google release paper on MapReduce 2005 Cutting and Cafarella built up the underlying file systems and processing framework that would become Hadoop (in Java, notably, whereas Google s MapReduce used C++) and ported Nutch on top of it 2006 Cutting goes to Yahoo, to build open source technologies based on GFS and MapReduce. Launches Hadoop as an open-source Apache Software Foundation project Christophe Bisciglia, a Google engineer, begins teaching a computer science course at the University of Washington focusing on web-scale data. Google s MapReduce code was proprietary, so adopts Hadoop as a proxy Slow march of horizontal scalability, growing Hadoop s capabilities from the single digits of nodes into the thousands, every factor of 2 or 1.5 required re-engineering. With Google s blessing, Bisciglia incorporated a company called Cloudera in March 2008 and closed its first funding round in April Yahoo spins off Hortonworks as a separate company in June of Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 9 What is Big Data? The characteristics of Big Data (aka Hadoop) Scalable Fault-tolerant Open Source Distributed system for Data Storage Processing Commodity Hardware The components of Hadoop Distributed File System (HDFS) the storage manager MapReduce the programming model YARN the resource manager Common libraries and utilities Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 10 5

6 The Old Data Management We are leaving the old age of data storage and processing with finite and absolute use cases. Storage limited to files and relational data stores Processing options were limited to scripting, ETL tools and in database processing Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 11 Age of New Data Management Data storage and processing are no longer finite and absolute. The new goal is matching storage and processing, which continue to expand. Spectrum of storage options: ASCII File ProtocolBuffers, Thrift and Avro serialization Sequence File RecordColumnar File ORC (Optimized RC) File Key-Value Column Family Document Property Graph RDF/Triple Stores Row Oriented Column Oriented Spectrum of processing options: Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 12 6

7 Proliferation of New Data Management Tools Courtesy of Knowledgent ( Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 13 The New Data Management The aspiration is to match storage, processing and analytics to create new value. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 14 7

8 Non-Techie Spin on the New World Data, Storage, Processing and Analytics are all increasing rapidly and not necessarily sync Storage has evolved to handle non-structured data in non-relational databases In many cases, Big Data Analytics are being used today even on non- Big Data assets Actuaries need to evolve or will be replaced by AI beings with better personalities! Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 15 Big Data Industry Use Cases Courtesy of Knowledgent ( Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 16 8

9 Use Cases in Healthcare Clinical Risk Helping providers understand the risk profile of their members using medical records. Member Health Profiles Helping insurance payers understand the risk profile of their members administrative data (claims, labs, etc.) Provider Payer Value Based Reimbursement Helping insurance payers understand and measure provider quality and efficiency. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 17 Examples of Big Data Applications for the Dental Space Provider Profiling & Fraud Detection in Real Time Customer Service Integrated Cross-Platform / Cross-Product Views Optimized work assignment for underwriters and claim adjudicators Risk Evaluations based upon Claims, HRA and EHR Data Predictive and Prioritized Network Recruiting Guided Customized Product Enrollments Outcomes Based Reimbursement Claim Review performed by AI Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 18 9

10 Big Data Adoption Gartner Survey Reveals That 64 Percent of Organizations Have Invested or Plan to Invest in Big Data in 2013 Big data investments in 2013 continue to rise, with 64 percent of organizations investing or planning to invest in big data technology. However, less than eight percent of survey respondents have actually deployed. Of the 64 percent of organizations investing or planning to invest in big data technology in 2013, 30 percent have already invested in big data technology, 19 percent plan to invest within the next year, and an additional 15 percent plan to invest within two years. Industries leading big data investments in 2013 are media and communications, banking, and services. Thirty-nine percent of media and communications organizations said that they have already invested in big data, followed by 34 percent of banking organizations and 32 percent of services firms. Planned investments during the next two years are highest for transportation (50 percent), healthcare (41 percent) and insurance (40 percent). However, every vertical industry again shows big data investment and planned investment. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 19 Big Data & The Hype Big Data is approaching the peak of inflated expectations. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum

11 The Pending Trough? In a study of more than 100 data scientists.. 71 percent of data scientists believe their jobs have grown more difficult as a result of a multiplying variety of data sources, not just data volume. 1 Only 48 percent of respondents said they had used Hadoop or Spark for their work and 76 percent felt Hadoop is too slow, takes too much effort to program or has other limitations 1 Hadoop has been unrealistically hyped as a universal, disruptive big data solution, noting that it is not a viable solution for some use cases that require complex analytics. 1 Twenty-two percent of the data scientists surveyed said Hadoop and Spark were not well-suited to their analytics. [It was] also found that 35 percent of data scientists who tried Hadoop or Spark have stopped using it Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 21 Big Data Challenges Confidential property of Optum. Do not distribute or reproduce without express permission from Optum

12 Non-Techie Translation on the Big Data Challenges If you haven t put this to good use yet, you re in good company The tools are still evolving If you want to succeed, you need a good consultant! Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 23 Thank you. 12

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