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What’s the Big Picture
for Big Health Data? 25-May-2013
Tracy Allison Altman, PhD
PepperSlice
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
prostate cancer
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
prostate cancer
testosterone levels in womb
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Why study big health data?
• Correlation
• Association
• Inference
• Cause & effect
• Explanation
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
A little philosophy.
What does “cause” mean?
What’s a “satisfactory” explanation?
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
• Diagnosis
• Treatment
• Quality of care
• Cost of care
• Patient outcomes
It’s about outcomes.
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Health data is the same.
• Rigorous scientific research
• Predictive analytics
• Social influences: Adherence, behavioral, marketing
• Business pressure: Accountability
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
• Human lives at stake
• Institutional barriers, incentives
• Public policy issues
• Findings are closely scrutinized
Health data is different.
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
• Diagnosis precision
• Treatment precision
• Quality, satisfaction
• Cost, operational efficiency
• Patient QOL, function, lifespan
It’s not easy measuring outcomes.
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
• Bird flu outbreaks
• Drug-resistant bacteria
• Communicable diseases
Public Health vs. Medicine.
• Population health
• Personalized medicine
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Big data is changing Medicine.
Payment models are shifting:
• Away from fee-for-service
• Toward accountable care: How to define & measure success?
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Population: Health by numbers.
Accountable Care Organizations (ACOs) manage population health.
• Predictive analytics to prioritize care
• Analysis showing what affects outcomes
• EHR and claims are crucial
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
We need a Single Patient Identifier.
Big data analytics are handcuffed.
• Need to follow a patient’s progress
• US has no single patient identifier
• Difficult to identify success
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
It’s all about me: Personalized medicine.
• Big $ investments now
• Individual profiles (genetic, behavioral, social, spatial, etc.)
• Pinpoint diseases, conditions, responses,
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Traditional vs. Modern.
• Research question
• Deterministic
• Proprietary
• RCTs
• Structured
• Clinical
• Discovery
• Probabilistic
• Open
• Algorithms
• Unstructured
• Real-world
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Sources of health data: Big & small.
• Genetic info
• Insurance claims, EHR, clinical notes
• Real-time monitoring (ICU)
• Patient-reported outcomes
• Peer-reviewed research, gray literature
• Order sets, knowledge assets
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Analytical methods for health data.
• De-identifying records & claims
• Aggregating massive data sets
• Developing statistics, algorithms
• Applying machine learning, semantics
• Ingesting ontologies
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Not all research is created equal.
• Prospective better than retrospective?
• Interventional vs. observational?
• Comparative effectiveness reliable?
• Are core outcome sets the future?
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Example: Watson.
Answering questions:
• Precision of diagnosis and treatment
• Insurance pre-authorizations
• Ontologies, structured data, and unstructured evidence
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Example: IBM is setting the pace.
AI, analytics, integration.
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Example: Apixio.
Big data healthcare platform.
• Risk management & revenue cycle
• Analyzing text, scanned, coded data
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Example: Treato.
Mining social networks for pharma info.
“See what millions of
patients are saying.”
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
• Taking trial-and-error out of RX
• The ‘Wanamaker’ problem: What works, and for whom?
Example: GNS Healthcare.
‘Big Data Is BS in Healthcare.
When Will It Become Real?’
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
• Develop breakthrough algorithm
• Use patient data to predict and prevent unnecessary hospitalizations (how measuring outcomes?)
Example: $3M Heritage Prize.
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Example: 23andMe.
Precisely targeted, patient-centered.
• Estimate likelihood of disease
• Take preventive steps
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Example: Ayasdi.
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Ayasdi: Topological data analysis.
• Characterize patients based on gene expression levels, biological properties, clinical data
• Discover without asking research questions or running queries
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
• Aggregates patient-reported data, shares with R&D companies
• New Open Research Exchange for validating ways to measure health outcomes
Example: Patients Like Me.
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Example: Text messaging.
• Rock Health: SF startup incubator
• Several focus on adherence & education
• Predicting who won’t seek care, who will be a no-show, who needs follow-up
It appears you are at 7-11. Don’t buy things that are bad for you!
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Example: CMS $1B.
• US Centers for Medicare, Medicaid Services
• Up to $1B for innovations that could reduce costs and improve outcomes
• Non-hospital care
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
• Diagnosis
• Treatment
• Quality of care
• Cost of care
• Patient outcomes
It’s (still) all about outcomes.
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Some practical advice.
• Don’t get lost in data
• Aggregate data that supports prioritized improvement efforts
• Measure specific outcomes
• Prepare for close scrutiny
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
Avoid random association syndrome.
• Big data means lots of correlation
• Random associations with health outcomes are a distraction
Big Data Science Meetup 25-May-2013
Tracy Allison Altman, PhD
PepperSlice
Health analytics startup.
Visualize, analyze, and optimize information assets (medical evidence, outcomes research, clinical/EHR analytics, operational data).
Tracy Allison Altman, PhD
email: [email protected] twitter: @EvidenceSoup