Advanced analytics: All systems go
This is Part III of our three-part June 2015 print cover story on healthcare analytics. Part I focuses on the first steps of launching an analytics program. Part II focuses on intermediate strategies, and Part III takes a look at the advanced stages of analytics use.
When it comes to providing the right care to the right patient in record time, the nation's policymakers, researchers, doctors and nurses seem on the verge of critical mass, or what author Malcolm Gladwell would call "the tipping point."
Today, healthcare organizations – big, medium and small – have the spotlight shining on the promise of data analytics, and recent government initiatives are providing synergy with ambitious and promising new efforts on the big data and personalized medicine front.
President Obama launched his push for precision medicine on Jan. 30. It's a project led by National Institutes of Health Director Francis Collins, MD. It's the same Francis Collins who directed the Human Genome Project, which was completed ahead of time and under budget, making precision medicine possible.
[Part I: A beginners guide to data analytics]
In the U.S. House of Representatives, the 21st Century Cures initiative, led by Rep. Fred Upton, a Republican from Michigan, and Rep. Diana DeGette, a Democrat from Colorado, is gaining traction.
"All of us at NIH believe passionately in this mission, and are dedicated to the pursuit of knowledge and, ultimately, cures," Kathy Hudson, MD, deputy director for science, outreach and policy at the NIH, said April 30 when she appeared before the House Energy and Commerce Subcommittee that Upton chairs.
"With your support," Hudson added, "we can anticipate a bright future of accelerating discovery across NIH's broad research landscape, from fundamental scientific inquiry to translational and clinical research."
Here are a few samplings of advanced data work occurring across the country.
Many healthcare systems across the country have already started to plumb the data available to them today for insights into how best to treat their patients. Academic medical research centers may lead on this score. However, there are plenty of hospitals and health systems that are showing the smart use of data analytics is not limited to the academic realm.
Take Inova, for example. The five-hospital, community-based health system is located in northern Virginia, just a couple of miles from the nation's capital. Five years ago, Inova put up $150 million to launch the Inova Translational Medicine Institute. Today, the Institute, led by John Niederhuber, MD, former director of the National Cancer Institute, has a team of 65 people – all dedicated to working with genomic and other data to discover interventions and cures for diseases of all kinds.
Among various data projects underway at the Institute today, is one that applies genetic sequencing to babies admitted to Inova's neonatal intensive care unit with symptoms that could be a congenital anomaly.
"We can sequence the patients," Aaron Black, informatics director at the Institute told Healthcare IT News. "We have doctors who come in who specialize in this. The mother, the father, the baby or any other person we think is pertinent to that analysis, we sequence them, run the results in special algorithms and provide those results back to the family."
"The mother, the father, the baby or any other person we think is pertinent to that analysis, we sequence them, run the results in special algorithms and provide those results back to the family." – Aaron Black
Inova physicians have been able to diagnose 60 percent of cases this way, Black said. At large academic hospitals, the diagnosis rate is about 30 percent. "So, we've been able to double that success rate," Black said.
Black credits better sequencing and mature algorithms for the success, in part. Mostly he credits the doctors.
"It's one thing to have computers that are really fast, but you need somebody that can interpret that and filter through things fairly quickly," Black said. "Inova Translational Medicine Institute is really the showcase for what we hope is the future."
Headquartered in Minneapolis, Allina Health is a 13-hospital health system with more than 90 clinics across Minnesota and Wisconsin. This past Jan. 2, its CEO, Penny Wheeler, MD, entered into an unprecedented shared-risk partnership with a vendor she had done business with since 2008. Allina invested $100 million in data warehousing and analytics company Health Catalyst. The deal combines the two organizations' analytics technology, clinical content and personnel to "turbocharge" financial, operational and clinical outcomes improvement via a "living laboratory" for healthcare transformation, Health Catalyst CEO Dan Burton said in announcing the pact.
Over the past seven to eight years, Allina had been working on its analytics platform and doing a good job, Ross Gustafson, told Healthcare IT News. Through the new partnership, Gustafson has the dual role of vice president at Allina and Health Catalyst. Working with the Health Catalyst analytics platform and sharing intellectual property, tools and apps, will enable Allina to improve more clinical outcomes and do so more quickly.
Health Catalyst now thinks of itself as an outcomes company, Gustafson said.
"It just so happens that their core competency is around data management, or data warehousing and analytics," he said. "But, you know, a number is just a number until you can interpret it and actually do something with it to keep someone out of the hospital, keep someone's diabetes in control, keep someone's weight management under control or whatever it may be."
[See also: Allina goes all in for outcomes with Health Catalyst.]
Intermountain, known for its early work in data analytics, even before the advent of Excel spread sheets offered a tool for analysis, is three years into a five-year partnership with consulting firm Deloitte to tap the data Intermountain has accumulated – going back to the1970s. The data, amassed from Intermountain’s 22 hospitals and 200 clinics, is particularly effective for medical studies and analyzing optimal treatments for many health conditions, according to Intermountain. The products are available on a subscription basis.
"The use of our technologies will allow clinicians and researchers to more quickly discover practices that improve quality and keep costs lower," Intermountain CIO Marc Probst told us in a 2013 interview. "Research studies that previously might have taken years to complete could be conducted in just a few weeks instead.”
More recently, as Probst worked with the Cerner team on Intermountain's rollout of its new EHR system, dubbed iCentra, the team built in the 350 care process models that patient safety and analytics guru Brent James, MD, developed over many years.
James, chief quality officer and executive director of the Institute for Health Care Delivery Research at Intermountain, is known around the world as a longtime champion for standardizing care by employing data collection and analysis. Now the data he knows works best for patient care is part of the digital system accessible to all Intermountain clinicians.
[See also: Intermountain live with Cerner EHR.]
So many more
There are countless more examples of big data already at work making a big difference in healthcare organizations across the country.
Earlier this year, L.A. Children's Hospital announced it would expand its Center for Personalized Medicine. The investment in the center will focus on three areas: cancer, inherited diseases and infectious diseases. "This is just one example of bench-to-bedside translational research involving pediatric cancer genomics already under way at CHLA," said Alexander R. Judkins, MD, executive director of the Center for Personalized Medicine at CHLA and head of the hospital's department of pathology and laboratory medicine, when CHLA announced its expansion plans in February.
[See also: L.A. children's hospital gets personal.]
Cleveland Clinic, Mayo Clinic and others are making their algorithm analytics on Apervita, a startup that bills itself as an analytics marketplace.
Then, there's the broad and expanding reach of IBM's supercomputer, Watson. IBM announced at HIMSS15, it would build a business unit called Watson Health. On May 5, the computing giant announced it would work with EHR company Epic to develop patient treatment protocols, personalize patient management for chronic conditions, and intelligently assist doctors and nurses by providing relevant evidence from the worldwide body of medical knowledge, putting new insight into the hands of clinical staff. IBM's Watson Health is also collaborating with 14 leading cancer institutes to accelerate the ability of clinicians to identify and personalize treatment options for their patients. Collaborations with more cancer centers are in the offing, IBM announced.