The Imperative of Big Data in Public Health Transformation

Transcription

1 The Imperative of Big Data in Public Health Transformation Charles Safran, MD Chief, Division of Clinical Informatics, BIDMC Associate Professor of Medicine, Harvard Medical School 1

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3 Volume Velocity Variety Value Visualiza2on Vitality Veritas Outline 3

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5 It is a very sad thing that nowadays there is so little useless information. Oscar Wilde

6 How BIG is BIG? Bytes Byte One One character of text Kilobyte Thousand One page of text Megabyte Million One small photo Gigabyte Billion 8.6 min of HD video Terabyte Trillion Largest hard drive Petabyte % of data at our medical center Exabyte % of all the data on all the hard drives in the world ZePabyte % of global data in

7 Not only how much but how FAST 3000 tweets per second 1 million transac2ons per hour at Walmart 40 billion Facebook photos Google processes 1 petabyte per hour CERN generates 40 terabytes every second Compound annual rate of increase 60% 7

8 Global Mobile Data Exabytes per Month Cisco VNI Mobile,

9 Only 5% of data is structured 9

10 Where is health data coming from? Hospitals Physician s office Payors Commercial Labs Pharmacies Public Health/ Gov Mobile devices Apps Social media Sensors Computer games Personal Health Records In the future, health data will overwhelming come from outside the health system. 10

11 Workflow enabled information and tools NOTES PROBLEMS MEDICATIONS Alerts Electronic Health Records RESULTS FLOW SHEETS REFERRALS 11

12 Chem7 Panel (BUN, Creat, Lytes, Gluc) New orders/day Stopped orders/day Neilson, EG, et al Ann Intern Med. 2004; 141:

13 Personal Health Records What is a personal health record? An on- line soaware communica2on tool between clinicians and pa2ents What does a personal health record do? Facilitates clinician- pa2ent collabora2on U2lizes the pa2ent as a resource for pa2ent self management How does it do this? Access to medical informa2on - online medical record e.g. clinical notes, inves2ga2ons, lab results, diagnosis list - electronic medical educa2on and knowledge support - pa2ent self- monitoring Administra2on online appointment making Electronic messaging between clinicians and pa2ents 13

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16 Some2mes visualiza2on reveals 16

17 Some2mes data are hard to interpret 17

18 Some2mes visualiza2on reveals nothing 18

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20 Electric Health HR BP Health Ac2vity Level Diabetes Heart Ac2vity Calories Breath Meds Temp 20

21 Discovery and Predic2on 21

22 If you really want to transform health care, you basically build a sort of heath-care economy around the data that is related to people a central asset in trying to improve every aspect of health care. Craig Mundie, Chief Strategy Officer, Microsoft

23 Consuming Digital Crumbs 23

24 Connec2ng the Dots 24

25 Spread of Methicillin- Resistant Staphylococcus aureus in a Large Ter2ary NICU: Network Analysis From Geva et al, Pediatrics

26 Person of Interest 26

27 Unexpected Connections 27

28 Open is the new new thing 28

29 Crowd Sourcing Before earthquake 12 days a2er earthquake 29

30 CureTogether 30

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32 Ci2Sense - Open Transparency Adapted from Bill Griswold contribute Ci2Sense EPA distribute 32

33 Veracity 50% of CIO s don t trust their data 95% of data is unstructured Standards usually address syntax not meaning Local knowledge is lost in aggrega2on Clinical data is a mess Person generated data will be overwhelming 33

34 Maybe we can store the data Maybe integrate or fuse the data Maybe we have adequate electricity supply Maybe we have tools to visualize the data Maybe we can make some sense of the data BUT Do we have the PEOPLE trained for these tasks 34

35 Where is the wisdom we have lost in knowledge? Where is the knowledge we have lost in information? T.S. Eliot Where is the information we have lost in data? C Safran 35