Predictive Analytics in Healthcare
Predictive Analytics in Healthcare
Healthcare
Predictive Analytics
Predictive Analytics
In Healthcare
A data-driven approach to transforming care delivery
Three global trends in healthcare have the potential to 3. Government reform and policies drive change
impact this transformation.
Government policy can influence healthcare providers’ data
1. Digital transformation means more data strategy in various ways. In the US, for example, policies
The digitization of healthcare is resulting in the creation such as the CMS EHR Incentive Program8 and the HiTech Act9
of massive new data sets. One of the most significant have increased investment in healthcare since 2011. This has
examples of this is the Electronic Medical Record (EMR). accelerated the adoption of digital solutions, which in turn
Over 85 percent4 of healthcare organizations in the US has led to a boom in the volumes of data a typical healthcare
have now adopted an EMR system5. Health claims data, organization holds. Six years on, many are reaching the
radiology images and lab results are other common data point at which they have a large enough pool of current and
sets. In the future ‘omics (i.e. genomics) data is expected to historic data to make really meaningful analytics possible.
grow significantly as precision medicine gets increasingly Similar trends can be seen or expected in Europe, where
integrated into standard clinical workflows. government initiatives in the UK, France and Sweden10 are
also spurring investment in this area.
Meanwhile, around the world, governments are placing
"Digitization has allowed us to have a more pressure on providers to demonstrate and track
more meaningful conversation compliance with data protection and other regulations,
often across lengthy processes involving multiple people
around how to use predictive analytics and departments. Rising pressure to curb spending and the
need for improved outcomes has pushed responsibility for
to improve patient outcomes3." managing the risk of poor outcomes and high costs from the
payer to the provider.
Outside of the clinical setting patients generate a significant Advanced analytics is closer than you think
amount of quasi-health data through the use of wearable
health and fitness trackers and health applications. The The ability to meet many of these challenges now forms
proliferation of health-related Internet of Things (IoT) the basis of key performance indicators (KPIs) for many
devices, as well as apps and other health-monitoring healthcare providers. Failure to respond can result in
technologies also generate a huge amount of data every day. competitive disadvantage, a negative impact on bottom line,
reputational damage, unhappy patients, or loss of staff.
Healthcare providers have an unprecedented opportunity to
incorporate these disparate data sources and structures into
new solutions. For example, to understand population health
trends, it is important to use external resources such as social Real-world results: Penn Medicine
media or publicly available government data, in addition to
Penn Medicine operates a network of healthcare
a hospital’s own records. However, 94 percent of hospitals6
facilities in Pennsylvania and southern New Jersey.
are not currently capturing enough information to carry out
Working with Intel, it has created a collaborative data
effective population health analytics.
science platform, based on the open source Trusted
2. External pressures to meet the Quadruple Aims Analytics Platform* to help clinicians make faster,
smarter decisions based on large-scale clinical data
Regulators, staff, patients and peers within the industry and big data.
all have expectations of the healthcare providers that they
come into contact with. The Quadruple Aims7 that each In its first trials of the platform, called Penn Signals*,
organization must commit to addressing are: the organization developed algorithms to help predict
and prevent two of the most common and costly issues
• Improving access to resources and services for patients for hospitals: sepsis and heart failure. It was able to
and clinicians, enabling them to find what they need, correctly identify about 85 percent of sepsis cases (up
when they need it, securely and quickly from 50 percent), and to make these identifications
• Reducing operating costs and ensuring that limited as much as 30 hours before the onset of septic shock
financial resources can be channeled towards the most (as opposed to just two hours prior, using traditional
value-adding priorities while optimizing the bottom line identification methods). This meant clinicians could
deliver treatment sooner, speeding time to recovery for
• Improving treatment outcomes by helping physicians the patient and saving resources for the hospital.
to make diagnoses faster, deliver the most personalized
treatment possible for the patient, and reducing average Meanwhile, Penn Medicine estimates that using
length of stay traditional methods of diagnosis, between 20 and 30
percent of heart failure patients had not been properly
• Optimizing provider satisfaction by ensuring that busy identified. With the predictive model it was able to
staff, working in a stressful environment, are able to identify these patients and give them the education to
focus on delivering patient care and achieving positive self-manage their condition successfully. As a result,
outcomes rather than grappling with complex tools and readmission rates dropped.11
workflows
3 White Paper | Healthcare Predictive Analytics
Figure 3: Levels of executive engagement are much higher in the top 10 percent of analytics in healthcare initiatives
different use cases and workflows. Now, most have larger Commitment to invest must come from the top, and a study
EMR systems that pull much of this into one place. While the conducted by the International Institute for Analytics18 shows
vendors of these systems tend to take responsibility for data that the top 10 percent of performers in healthcare analytics
governance and management within their own parameters, have a significantly higher level of executive support and
the evolution of analytics capabilities means healthcare engagement than other organizations (see figure 3). However,
providers now also want to bring in external data types which expectation of a positive ROI is not enough. Early selection
may not be so stringently managed. Properly collating and of analytics projects is critical to building a solid foundation
managing these disparate systems can be a challenge in of support. Analytics teams without proper guidance run the
itself. Add to that the fact that sentiment-based data such as risk of selection projects that are academically stimulating,
social media posts – while extremely valuable – is much more but not well positioned to drive business value. One of the
ambiguous and open to interpretation than an EMR database, best ways to ensure that a project is on the right track is
and the challenge becomes more complex. It’s important that framing it within a defined business need. This need should
you work with your IT department to set rules around how have a clear definition for success, ideally quantified by some
certain data should (and should not) be interpreted by an financial measure, and a clear path to implementation.
analytics system.
Data collection and delivery must also be carefully
controlled, with defined rules and processes to ensure that
"It’s necessary to have a multidisciplinary
as your data grows, it uses standardized characteristics to team, with clinical, analytics, data
maintain consistency and quality. If analyzing your data
management capabilities for the first time, it is recommended science, information technology, and
to use a recognized framework like the Data Management
Maturity (DMM) Model from the CMMI Institute16. Control your
behavior change skill sets available
data fidelity and quality by putting in the time up front to from start to finish17."
define decision models and data sets upon which the system
can learn and build.
Projects scope and strategy must also be considered. As
Finally, ensure your methodologies for conducting analytics
Prashant Natarajan states in his book, Demystifying Big Data
and applying insights are clear and accessible to your user
and Machine Learning For Healthcare, “many use cases,
base. By providing standard approaches, you can empower
while meeting the requirement of ROI and strategic impact,
users, minimize risk and maximize the value you glean from
have such large scope and complexity that success may be
your analytics investments.
put at risk through over-reach”. Meeting these requirements
2. Organizational alignment requires a significant amount of up front work. However the
Building a lasting advanced analytics capability requires tight long-term payoff, being able to show measurable benefit to
alignment to clinical and business stakeholders. Depending the organization, is well worth it.
on the scope of the advanced analytics program, significant Finally, ensure proper cross-functional representation within
investment may also need to be made in infrastructure to the analytics program. It is critical to engage subject matter
collect, store and process large data sets. Ensuring that experts (SMEs) to provide context to the business problem
this investment is available will require demonstrable ROI. being addressed. SMEs can help address changes in data like
6 White Paper | Healthcare Predictive Analytics
when a data collection process evolves, or external factors optimization is key to extracting those game-changing
that may impact the way that model results are used. insights that will get your patients feeling better sooner or
let your busy nurses finish their shifts on time. However, it
Some questions to consider here are:
does mean that your data management and clinical teams
• Who are the executives and key leaders that need to may need to change the way they work and collaborate,
champion the predictive analytics program? What incorporating more time for feedback and iteration to ensure
business results will speak to them? long-term success.
• What are our organization’s stated business goals and • Which aspects of organizational culture will be affected
strategy over the short and medium term? How do and how will you ensure your innovations work with,
proposed uses cases align to those goals? rather than against, it? James Merlino, MD’s book Service
Fanatics describes the significant effort that Cleveland
• Who are the cross-functional stakeholders that will be Clinic undertook to change its internal culture to be more
impacted by the project? Who are the SMEs that should patient-centric. While a different goal, it shows how much
be engaged to provide context and understanding? work can go into influencing a hospital culture.
• When and how are successes shared? What are the key • Who will lead change management efforts, an internal
internal meetings that you can embed team members in to team or external consultant? How might this change over
ensure alignment with the business? time?
• What will the data science group be known for? What are • Who are the formal and informal leaders that can bring
standard deliverables that will define the team throughout support for change initiatives?
the organization?
• How will insights be shared with hospital managers,
3. Change management clinical staff and consultants? What would be the most
Change management is one of the greatest challenges useful format, channel and cadence for them?
that many organizations face as they begin to implement
advanced analytics. Moving from retrospective analysis to • How will you demonstrate the value of any changes to
predictive analysis, requires workflows to be adaptable, those they impact?
sometimes in real-time, based on new data. Clearly this Technology
presents technical considerations, but just as, if not more
important, are the considerations for cultural adoption of this When building an analytics environment, picture it as
new approach. forming four complementary layers (see figure 4), each
including a variety of technologies, depending on your own
Organizations must have a strategy for how to implement organizational needs, legacy systems and preferences, and
change across the business. As your data yields more the type of analytics you need.
insights, how will you adapt existing clinical workflows
to make the most of them? Predictive analytics projects The infrastructure layer: This is the foundation that will
are constantly evolving. Many follow the CRISP-DM enable you to acquire, store and protect your data, and
lifecycle process which lays out six phases from Business to run commercial and open source analytics. A typical
Understanding to Deployment19. This continuous infrastructure layer will support a number of different
7 White Paper | Healthcare Predictive Analytics
1 Professor Vasant Dhar, Stern School of Business, New York University, Predictive Analytics: The power to predict who will click, buy, lie, or die, Eric Siegel
2 All statistics in this paragraph are from: Healthcare Disrupted: Next Generation Business Models and Strategies, Jeff Felton and Anne O’Riordan
3 Vindell Washington, MD, National Coordinator for HIT in the US Department of Health and Human Services , Healthcare Executive Magazine, volume 31, Number 5, September/October 2016
4 https://www.cdc.gov/nchs/fastats/electronic-medical-records.htm
5 https://dashboard.healthit.gov/quickstats/quickstats.php
6 Healthcare Executive Magazine, volume 31, Number 5, September/October 2016
7 From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider, Thomas Bodenheimer, MD and Christine Sinsky, MD, http://www.annfammed.org/content/12/6/573.full
8 https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/ehrincentiveprograms
9 https://www.healthit.gov/policy-researchers-implementers/health-it-legislation
10 France: http://blog.ihs.com/frances-2016-social-security-financing-act-a-figure-is-worth-a-thousand-words
UK: https://www.eiuperspectives.economist.com/sites/default/files/ValuebasedhealthcareUK.pdf
Sweden: http://ki.se/en/lime/value-based-health-care
11 https://www.intel.co.uk/content/www/uk/en/big-data/penn-medicine-trusted-analytics-platform.html
12 Driving Clinical and Operational Performance Through Analytics, International Institute of Analytics, August 2017
13 Data Science For Business: What you need to know about Data Mining and Data-Analytic Thinking, Foster Provost & Tom Fawcett
14 Building Data Science Teams, O’Reilly Media: http://www.oreilly.com/data/free/building-data-science-teams.csp
15 https://www.intel.co.uk/content/www/uk/en/healthcare-it/solutions/documents/montefiore-advance-patient-care-solution-brief.html
16 http://cmmiinstitute.com/data-management-maturity
17 Getting Buy-In for Predictive Analytics in Health Care, Meetali Kakad, MD; Ronen Rozenblum; David Westfall Bates, MD, https://hbr.org/2017/06/getting-buy-in-for-predictive-analytics-in-
health-care
18 Driving Clinical and Operational Performance Through Analytics, International Institute for Analytics, August 2017
19 Machine Learning for Predictive Data Analytics, John Kelleher, Brian Mac Namee, Aoife D’ Arcy
20 https://www.intel.com/content/www/us/en/healthcare-it/solutions/documents/using-machine-learning-and-emr-data-to-predict-patient-decline-case-study.html
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