User Needs and Requirements Analysis for Big Data Healthcare Applications

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User Needs and Requirements Analysis for Big Data Healthcare Applications Sonja Zillner, Siemens AG In collaboration with: Nelia Lasierra, Werner Faix, and Sabrina Neururer MIE 2014 in Istanbul: 01-09-2014 / Zillner 1 BIG 318062

Overview Setting the Stage The context of our Work: The BIG Project Definition of Big Data in Healthcare Our Approach Methodological Approach Results User Needs Drivers and Constraints Requirements Conclusion Key Findings and Summary MIE 2014 in Istanbul: 01-09-2014 / Zillner 2 BIG 318062

The EU Project BIG Big Data Public Private Forum Trigger Europe needs a clear strategy for leveraging Big Data Economy in Europe Objectives Work at technical, business and policy levels, shaping the future through the positioning of Big Data in Horizon 2020. Bringing the necessary stakeholders into a sustainable industry-led initiative, which will greatly contribute to enhance the EU competitiveness taking full advantage of Big Data technologies. Facts Type of project: Coordination & Support Action Project start date: September 2012 Duration: 26 months Call: FP7-ICT-2011-8 Budget: 3,038 M Consortium: 11 partners MIE 2014 in Istanbul: 01-09-2014 / Zillner 3 BIG 318062

Project Structure (Sectorial forums and Technical working groups) Industry driven working groups Health Public Sector Finance & insurance Telco, Media & Entertainment Manufacturing, Retail, Energy, Transport Needs Supply Value Chain Data acquisition Data analysis Data curation Data storage Data usage Structured data Unstructured Data Event processing Sensors networks Streams Data preprocessing Semantic analysis Sentiment analysis Other features analysis Data correlation Trust Provenance Data augmentation Data validation RDBMS limitations NOSQL Cloud storage Decision support Decision making Automatic steps Domain-specific usage Technical areas MIE 2014 in Istanbul: 01-09-2014 / Zillner 4 BIG 318062

Big Data in Healthcare What are we taking about? Definition of Big Data in Healthcare Industry Big Health Data technologies help to take existing healthcare business intelligence, health data analytics and health data management application to the next level by providing means for the efficient handling and analysis of complex and large healthcare data by relying on data integration, real-time analysis as well as predictive analysis often discussed under the label Advanced Health Data Analytics Characteristics of Health data Health data is not big in terms of large size Exceptions are medical images and NGS, however the analysis of analytics approaches for medical images and NGS is immature and in development Health data is complex Heterogeneous data (images, structured, unstructured data, etc.) Various data domains (administrative, financial, patient, population, etc.) MIE 2014 in Istanbul: 01-09-2014 / Zillner 5 BIG 318062

Methodology 1 2 3 Stakeholder Groups: patients, clinicians, hospital operators, pharmaceutical industry, research and development, payors, medical product providers Interview Questionnaire with 12 questions: Open and close questions, in average 75 minutes Scope: Direct inquiry of user needs, indirect evaluation of user needs via potential use cases reviewing constraints that need to be addressed Aggregating high level application scenarios To analyze implicit user needs and requirements that need to be addressed MIE 2014 in Istanbul: 01-09-2014 / Zillner 6 BIG 318062

Big Data applications in the health domain Some examples 1 2 3 4 5 6 Comparative Effectiveness Research: compare the clinical and financial effectiveness of interventions in order to increase efficiency and quality of clinical care services. Next generation of Clinical Decision Support Systems: use of comprehensive heterogeneous health data sets as well as advanced analytics Clinical Operation Intelligence: identify waste in clinical processes in order to optimize them accordingly, e.g. analyzing medical procedures to find performance opportunities, such as improved clinical processes, fine-tuning and adaptation of clinical guidelines Secondary usage of health data is the aggregation, analysis and concise presentation of clinical, financial, administrative as well as other related health data in order to discover new valuable knowledge, for instance to identify trends, predict outcomes or influence patient care, drug development, or therapy choices, e.g. Identification of patients with rare diseases Patient recruiting and profiling Forecast of clinical process performance Healthcare Knowledge Broker Public Health Analysis aims to analyze comprehensive data sets of patient populations in order to learn about the overall /population-wide effectiveness of treatments, the quality and cost structure of care settings, etc. By using nation-wide disease registries, i.e. databases covering secondary data related to patients with a specific diagnosis, condition or procedure. Patient Engagement aims to establish communication portals that foster the active engagement of patients in their healthcare process. MIE 2014 in Istanbul: 01-09-2014 / Zillner 7 BIG 318062

User Needs Potential Benefits and Advantages Improved Efficiency of Care 1 Combine clinical, financial, and administrative data to monitor outcomes relative to resource utilization Measure physician performance against peers and other institutions Mine population level data for clinical research Helps organizations manage regulatory compliance through detailed information reporting Improved Quality of Care 1 Empowers users with key knowledge needed for effective decision making Identify high-risk patients and patient populations Develop predictive models leading to proactive patient care Enables uniform and multi-dimensional view of patient and population data Real Impact of Big Data Analytics is expected on integrated data sets 1= Frost & Sullivan U.S. Hospital Health Data Analytics Market (2012) MIE 2014 in Istanbul: 01-09-2014 / Zillner 8 BIG 318062

Multiple Data Pools in Healthcare Main impact by integrating various and heterogeneous data sources Patient Behaviour & Sentiment Data Pharmaceutical & R&D Data Health data on the web Owned by consumers or monitoring device producer Encompass any information related to the patient behaviours and preferences Clinical Data Owned by providers (such as hospitals, care centers, physicians, etc.) Encompass any information stored within the classical hospital information systems or EHR, such as medical records, medical images, lab results, genetic data, etc. Owned by the pharmaceutical companies, research labs/academia, government Encompass clinical trials, clinical studies, population and disease data, etc. Highest Impact on integrated data sets Mainly open source Examples are websites such as PatientLikeMe, Linked Open Data, etc. Claims, Cost & Administrative Data Owned by providers and payors Encompass any data sets relevant for reimbursement issues, such as utilization of care, cost estimates, claims, etc. MIE 2014 in Istanbul: 01-09-2014 / Zillner 9 BIG 318062

Value-Based Healthcare Delivery A new paradigm for effective collaboration Value-based healthcare is becoming focus of many healthcare reforms The goal is to implement more effective healthcare delivery that allows to limit healthcare expenditure and at the same time help to increase the quality of care settings Value = Patient health outcomes per euro spent Example: US healthcare reform or provider starting to publishing high quality outcome data Principles 1 Quality Improvements Prevention of illness, early detection, right diagnosis, right treatment to right patient, rapid cycle time of treatments, fewer complications, fewer mistakes, slower disease progression, etc. Goal: Better health and less treatments Example Big Data Technology......will play an important role to establish means to track and analyze treatment performance of patients and patient populations 1= Porter and Olmsted Teisberg. Redefining German Health Care, 2006 MIE 2014 in Istanbul: 01-09-2014 / Zillner 10 BIG 318062

Drivers and Constraints Drivers Increase in volume of electronic health care data Need for improve operational efficiency US Healthcare Reforms HITECH & PPACA Trend towards value-based healthcare delivery Trend towards new system incentives Trend towards increased patient engagement Constraints Only a limited portion of clinical data is yet digitized lack of standardized health data (e.g. EHR, common models / ontologies) affects analytics usage Data and Organizational silos Data security and privacy issues hinder data exchange High investments are needed Existing incentives hinder cooperation Missing business cases and unclear business models MIE 2014 in Istanbul: 01-09-2014 / Zillner 12 BIG 318062

Requirements Challenges that need to be addressed High Investment 1 1 Data Digitalization Long-term investments require conjoint engagement of several partners 1 Data Security only small percentage of data is documented (lack of time) with low quality Legal processes for data sharing & communication are needed 2 Value-based system incentives Current incentives enforce high number instead of high quality of care services 2 Data Quality Reliable insights for health-related decisions require high data quality 2 Semantic Annotation transform unstructured data into structured format 3 Business Cases 3 Data Sharing Undiscovered und unclaimed potential business values Overcome data silos and inflexible interfaces Not-Technology-related Regulation & Technology Technology-related MIE 2014 in Istanbul: 01-09-2014 / Zillner 13 BIG 318062

Key Findings Impact of Big Data Applications in Health Domain Technology-wise = Evolution Big Data Technology (e.g. scalable data analytics, semantic technologies, machine learning, scalable data storage, etc.) is ready to be used Now these techniques are combined and extended to address big data paradigm Domain-specific requirements needs to be addressed (e.g. health data anonymization, understand analytic needs) Business-wise = Revolution The lack of business cases is hindering block Integrating of heterogeneous data sources beyond organization boundaries relies on effective cooperation of multiple stakeholder with diverging interests => existing industrial business processes will change fundamentally, new players & business models will emerge MIE 2014 in Istanbul: 01-09-2014 / Zillner 15 BIG 318062

Summary Big data revolution in healthcare is in a early stage 1 2 3 4 5 6 Several developments in the healthcare domain, such as escalating healthcare cost, increased need for healthcare coverage and shifts in provider reimbursement trends trigger the demand for big data technology. The availability and access of health data is continuously improving but more efforts are needed The required big data technology, such as advanced data integration and analytics technologies, are theoretically in place First-mover best-practice application demonstrate the potential of big data technology in healthcare Current roadblocks are the established system incentives of the healthcare system which hinder collaboration and, thus, data sharing and exchange The trend towards value-based healthcare delivery will foster the collaboration to enhance the treatment patient of the patient, and thus will significantly foster the need for big data applications MIE 2014 in Istanbul: 01-09-2014 / Zillner 16 BIG 318062

Thank you for your attention! Any Questions? http://www.big-project.eu/ Contact: Prof. Dr. Sonja Zillner sonja.zillner@siemens.com MIE 2014 in Istanbul: 01-09-2014 / Zillner 17 BIG 318062