Big Data Analytics on Acquisition Issues of Public Healthcare

Transcription

1 96 Int'l Conf. on Advances n Bg Data Analytcs ABDA'15 Bg Data Analytcs on Acquston Issues of Publc Healthcare A. Habo Wang 1, B. Chenhu Zhou 1, C. We Wang 1 and D. Yaquan Xu 2 1 Sanchez School of Busness, Texas A&M Internatonal Unversty, Laredo, Texas, USA 2 School of Scence and Technology, Georga Gwnnett College, Lawrencevlle, Georga, USA Abstract -Ths study ams to analyze the exstng federal acquston polcy n publc healthcare n the Unted States, especally n the case of chldhood mmunzaton, and present a framewor on developng a comprehensve system to analyze data on publc healthcare usng an open sourcebased meta-data acquston and aggregaton tool based on Hadoop, MapReduce and MongoDB to ntegrate databases from dfferent agences. We desgn data-drven XML schema for taggng the data entres and mplement a pacage usng open source software R to aggregate XML-transformed data nto tme and space dmensons, then propose a new multple tems multple vendors model to analyze the data, wth the objectves of lowerng costs ncludng transportaton and wastage. Ths study uses the case of chldren s mmunzaton vaccnes as an example to llustrate ts contrbuton.. The proposed system also addresses the challenge of mplementng the new government recommended mmunzaton requrements n a cost effectve manner based on the data from dfferent sources. In addton, the new acquston decson support system enhances the transparency of healthcare costs, especally n the publc health servce. Keywords: Bg Data Analytcs; Publc Healthcare; Data Envelopment Analyss; Mult Crtera Decson Analyss 1 Introducton The shortage of the nfluenza A vrus (H1N1) vaccne n 2009 and other smlar ncdents n the past ten years[1], [2], ncludng shortages n chldren s mmunzaton vaccnes, s what motvates the authors of ths study to nvestgate the exstng acquston polcy n the healthcare ndustry. The frequent wastagen vaccne[3]and other emergency medcal supples cost taxpayers bllons of dollars each year due to a poorly managed acquston polcy by the healthcare ndustry[4]. Ths wastage adds to the hgh cost of healthcare n the Unted States, whch s hgher comparng to other developed countres[5]. One major area where vaccne wastage occurs s durng chldhood mmunzatons, whch s compounded by the challenge of ncorporatng new vaccnes nto the already crowded mmunzaton schedule adopted by the U.S. government. In addton, an ncreasng numbers of health provders and parents are opposed to add mmunzaton requrements, whch prevents an effcent resource management [6]-[8]. One approach to reduce wastage and overall costs n the healthcare ndustry s to develop better acquston polcy tools than are currently avalable to decson maers. Accordng to the Centers for Dsease Control and Preventon (CDC), there are a number of manufacturers who can provde multple vaccnes and other emergency supples wth dfferent prcng schedules, even under the Federal contract purchase prce due to dfferent purchase fnancng systems[9]-[12]. These manufacturers can also offer dfferent prcng schedules on the purchase of combnatons of vaccnes to enable purchasers to tae advantage of the economes of scale[13]. However, these manufacturers are prvately owned and proft drven organzatons, and ther producton schedule depends on the nature of vaccne producton and on accurately predctng the maret needs. These needs nclude purchase contracts from the Federal government, publc sector and prvate clncs, whch result n manufacturers havng lttle motvaton to provde prcng flexblty[14], [15]. In addton, the data on vaccne producton and demand s not shared among the staeholders of publc healthcare and dfferent systems usng by dfferent agences cannot ntegrate the data smoothly. These challengng ssues are here nvestgated at frst. We present a framewor on developng a comprehensve system to analyze data on publc healthcare usng an open source-based meta-data acquston and aggregaton tool based on Hadoop, MapReduce and MongoDB to ntegrate databases from dfferent agences. In the meantme, we desgn a data-drven XML schema for taggng the data entres and mplement a pacage usng open source software R to aggregate XML-transformed data nto tme and space dmensons, then a new data-drven acquston model s proposed to lower costs and reduce wastage. 2 Pror polcy analyss and studes Accordng to a 2006 study by [16], none of the exstng decson support systems whch handle contract types and organzaton relatonshps consder qualty management because ts complexty, although the U.S. Department of Defense began employng qualty management technques after the WWII[7], [17], [18]. Other government agences such as NASA also employ a qualty assurance standard to ther contractors[19]. Qualty management concepts have also been examned n the

2 Int'l Conf. on Advances n Bg Data Analytcs ABDA'15 97 context of the publc health care feld[20], [21]. In the prvate sector, a qualty management decson support system s mplemented as a part of the Enterprse Resource Plannng System as a tool to collect data from dfferent supplers[22]. Academc researchers n the qualty management felds study the mpact of nformaton on contractng and qualty management[23] and some recommend the structure of a decson support system as a concept[24], [25] and defne a prototype but never mplemented t as operatonal tools[26] that can be easly used/ntegrated nto exstng procurement systems. Ther proposed mathematcal models focus on fndng the ey factors by usng analytc herarchy processes for multple crtera under the assumpton of ndependency of crtera[27]. There s no quanttatve analyss tool avalable to a decson-maer n the acquston process to evaluate/select vendors. Many exstng decson support systems n the acquston process are document based to provde gudelnes/nformaton, for example, the Surface Decson Support System provded to the U.S. Department of Transportaton[28]. Accordng to the General Servce Admnstraton and the U.S. Department of Health and Human Servce, the exstng acquston polces and procedures conform to the Federal Acquston Regulaton System (FARS), whch montors contractng relatonshps between the contractng offces and contractors. A qualty survellance plan should be mplemented and the contractor should be evaluated on performance based crtera. There are 11 crtera to be consdered but the evaluaton s carred out by an expert panel wth a lst of weghted factors to be consdered. There s no general decson support system avalable to the decson maer (expert panel) on evaluatng the vendors based on the qualty management crtera n addton to the crtera lsted by the FARS. These crtera are weghted accordng to the general gudelne but no specfc model or tool s avalable to ntegrate the crtera nto a software system for decson support. The FARS and ts related polces mght brng challenges n adoptng ths decson support system software across federal agences. One of the man challenges wll be the organzatonal resstance to adopt a new decson tool and the dffculty of ntegratng that tool nto the dfferent systems each agency uses. However, there s no barrer n the prvate sector for adoptng the proposed system as an analytcal tool to help busnesses mprove ther performance. Contractors can also employ the tool to desgn fnancal strateges to customze servce pacages, or to better estmate the cost of transportaton. If the decson support system becomes popular among the contractors, t wll ncrease ts credblty among federal agences and encourage the effort to ntegrate t nto ther decson support systems. By desgnng ths new tool n a spreadsheet based format, ths should reduce mplementaton barrers, as t can be easly ntegrated nto exstng procurement systems. Currently, The Center for Dsease Control and Preventon (CDC), Department of Health and Human Servce and other government agences use a commercal verson of a relatonal database such as ORACLE to store the publc healthcare nformaton. For structured and clear data prepared by professonal consultants or IT department, ORACLE s the most popular commercal database management software worldwde. Nowadays, most data s collected n real tme from n-memory data collectng systems such as scanner (RFID or bar code), moble devces, and other electronc devces. The relatonal database software such as ORACLE s not desgned to meet the challenges of data generated from nternet and moble devces n term of scale and aglty and applcaton developers have to solve the msmatch ssues between the n-memory data structure of bg data and the underlyng structure of relatonal database systems by convertng the nmemory data to tables and other relatonal structures. 3 Methodology Ths study departs from current acquston practces and brngs sgnfcant nnovaton to the data-drven acquston model. Its man advantages and nnovatons are: 1) a comprehensve system to analyze data on publc healthcare usng an open source-based meta-data acquston and aggregaton tool; 2) data-drven XML schema for taggng the data entres and aggregate XML-transformed data nto tme and space dmensons 3) a new two-step decson model wth a data envelopment analyss (DEA) approach and a non-lnear multple crtera decson analyss (MCDA) approach; 4) an ntegrated spreadsheet based software system that ncludes the cost of dstrbuton and transportaton, and s desgned to be easly mplemented wth current medcal management systems n publc and prvate sectors. The tools and methods used for the bg data analytcs n ths study nclude Hadoop, MapReduce and MongoDB, XMLschema, and R software (See Fg. 1). These open source software provde a number of benefts ncludng free dstrbuton, low cost, worldwde developer communty, and are easy to use. Hadoop s an open source software envronment for large data storage and dstrbuton that uses low cost computer clusters and MapReduce s an open source functonal programmng envronment for data manpulaton and processng. Both Hadoop and MapReduce can be deployed n the cloud or a local datacenter. MongoDB s an open source cross-platform NoSQL (not only SQL) database management software that provdes the beneft of mproved system productvty through an applcaton orented data structure and also mproves the data utlzaton effcency for storng and processng large data volumes, reducng latency and mprovng nput/output performance. XML schema s the wdely used object management standard and the foundaton of semantc systems such as search engnes and artfcal ntellgence. R software s an open source cross-platform programmng language wth a platform adaptve run-tme envronment for statstcal computng and graphcs. There are more than 3,500 applcaton/functon based pacages developed by worldwde researchers and wdely used for a

3 98 Int'l Conf. on Advances n Bg Data Analytcs ABDA'15 varety of statstcal models ncludng statstcal tests, lnear and non-lnear models, tme seres forecastng, data mnng and predctve analytcs, etc. There more functons and algorthms n R software than n the other three most popular commercal statstcal software combned. It provdes a collaboratve envronment for new applcatons or functons to be added on as a cross-platform lbrary. Fg. 2. CDC supplers and contractors data sources Fg. 1. Framewor on Data Acquston and Aggregaton on Publc Healthcare The model and methods are programmed nto a speadsheet based software system. The real world data such as the federal contracted companes and other medcal supplers from the CDC webste (see Fg. 2) and other publc domans wll be collected usng web based free screen scraper or crawler software and used to evaluate the performance of the proposed model (See Fg. 3). The outcomes of the proposed model and methodology are measured through a smulaton usng real world data wth dfferent scenaros n terms of acquston cost, qualty management of dfferent vendors, and other crtera. The frst stage of the research s to analyze the data collected and stored n a spreadsheet format by the web based automatc scraper/crawler from the CDC webstes, U.S. Census, the U.S. Department of Health and Human Servces, General Servce Admnstraton, and other publc domans. The development of the demand forecast nvolves several statstcal methods (avalable on the spreadsheet software) such as multple regresson analyss, nonlnear regresson, decomposton analyss, adaptve flterng, and trend analyss (See Fg. 4). The forecastng error s analyzed through the analyss of varance. Fg. 3. Other governmental contracted companes and medcal supplers Fg. 4. Forecastng demand usng spreadsheet The second stage s to buld a decson model for acquston, whch conssts of two steps: 1) evaluaton and selecton; and 2) cost optmzaton. The evaluaton process ofmultple supplers s based on an extenson of the data

4 Int'l Conf. on Advances n Bg Data Analytcs ABDA'15 99 envelopment analyss (DEA) model (see Fg. 5) usng qualty management crtera n addton to the crtera lsted n the Federal Acquston Regulaton for the publc sector and reports the ran of the supplers of each product to create a preferred suppler pool. In the prvate sector, the crtera lsted n the FARS wll be consdered as optonal crtera. The selecton process of multple supplers s a nonlnear mult crtera decson analyss (MCDA) model (see Fg. 6) based on the analyss of the nterdependence among products and supplers from the pool of preferred supplers and t reports the best groups of supplers. The transportaton cost optmzaton s based on the fxed-charge transportaton model. Fg. 5. DEA model use qualty management crtera Fg. 6. MCDA model for suppler selecton procedure The qualty management based DEA model provdes a rounded judgment on suppler performance tang nto consderaton multple qualty management crtera smultaneously, ncludng the crtera lsted n the FARS and then combnng them nto a sngle measure for qualty control. The mathematcal model s solved for every medcal tem and the relatve qualty score of each suppler s determned (see Fgure 8). The results of the DEA model show that the hgher a suppler s qualty score n relaton to the correspondng score of another suppler, the hgher the ran of ths suppler s n term of qualty. Ths nterdependent relatonshp plays an mportant role n terms of supply rs and long term partnershp. The DEA model s an effectve approach for vendor evaluaton but t can not be used to evaluate the supply rs and partnershp durng the selecton process. Ths mportant ssue s often overlooed n the evaluaton of

5 100 Int'l Conf. on Advances n Bg Data Analytcs ABDA'15 vendors, especally when they are contracted by the government for longer terms and t can cause shortages and waste of vaccnes. In the nonlnear MCDA approach, a decson-maer could smultaneously consder a pool of supplers from the evaluaton process and also choose a set of supplers to address supply rss and partnershp ssues. The basc notaton of ths process s defned as: 1 N { v,, v n } s the set of supplers 1 P{ p,, p m } s the set of medcal tems v,( 1,, n) s suppler j p, ( j1,, m) s medcal tem j Iv ( ) s the number of medcal tems provded by suppler n the selecton pool Q{1,, q} s the set of nterdependent crtera c s the effect of suppler on crteron S s a set of supplers that f selected together have some postve or negatve effect on crteron s the amount of effect (postve or negatve) of an nteractng set S on crteron w s the weght assocated wth crteron ( S ) ( S) s the total payoff beneft of a subset of supplers S N D s the number of supplers selected xj s equal to 1 f an suppler otherwse m v v s selected for tem j and 0 xj j1 y s equal to 1 f all of tems from suppler v are Iv ( ) selected as a bundle of tems and 0 otherwse. In general, the nterdependency relatonshp can be measured by a number of crtera: economes of scale, resource and rs sharng, and ownershp or partnershp. Wth regard to the nterdependent relatonshp, there s a weght to each crteron, and the model s represented by a nonlnear programmng functon as follows: s.t. Ths functon can be solved by a spreadsheet solver such as Frontlne Premum Solver and provde the selecton results for vendors n the next step of cost optmzaton. In the case of chldren's mmunzaton problems, the schedule of combned vaccnes wll be ncluded n the nterdependent crtera n the decson model. The transportaton cost optmzaton model s based on the fxed-charge transportaton problem, whch arses frequently n the applcaton areas of schedulng and cost control. In a medcal supply system, a varety of sources ncludng nternatonal supplers, local manufacturers, and wholesalers are all capable of sendng medcal supples to a prmary dstrbutor. The prmary dstrbutor has to develop a transportaton strategy for cost control. The next step n the process of solvng ths ssue s to model t as a fxed-charge transportaton problem. The fxed charge problem determnes the amount of shpments made from a gven set of supplers to a sngle destnaton, such that the total demand s satsfed at a mnmum cost. A fxed charge and cost proportonal to the quantty shpped occurs when a suppler s employed. The fxed charge problem can be mathematcally formulated n terms of an nteger programmng problem as follows: s.t. Where D s the demand magntude, M s the number of supplers, F s the fxed management cost ncurred when usng suppler, b s the capacty of suppler, f s the electve unt varable cost of suppler, and z s an nteger varable tang the value of 1 when suppler s used, and 0 otherwse. The soluton to the problem s a vector d=(d 1..d 2..d M ) of nonnegatve ntegers (also called the transportaton profle) for whch d s the amount allocated to suppler. Ths lnear nteger programmng model can be solved usng a standard spreadsheet solver and reported to the decson maer n a numerc or graphc fashon. 4 Concluson Whle the analytcal methods n ths study are ready to be mplemented, the collecton of data from dfferent sources may be lmted. Dfferent governmental agences have ther own lsts of vendors and specfc evaluaton crtera/procedures under the Federal Acquston Regulaton System. In the case of chldhood mmunzaton, the lst of vendors of vaccnes and ther cost profles mght not be frequently updated. Ths study departs entrely from current acquston practces and brngs sgnfcant nnovaton to the current acquston model. The proposed framewor also addresses the challenge of mplementng the new government

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7 102 Int'l Conf. on Advances n Bg Data Analytcs ABDA'15 [26] R. Bose, "Knowledge management-enabled health care management systems: capabltes, nfrastructure, and decson-support," Expert Systems wth Applcatons, vol. 24, pp , 1// [27] C. Holsapple and A. Whnston, Decson Support Systems: A Knowledge-Based Approach. Sant Paul, Mnnesota: West Publshng Company, [28] Federal Busness Opportunty. Avalable: