What's the Big Deal About Big Data?

My career has allowed me to learn quite a few things.  I have worked with software, testing it to ensure it met the requirement needs of clients. I have worked at a small cell phone company, trying to create a small and primitive data warehouse.  Now I work assisting in gaining adherence to ITIL methods for the entire government of a country.  These have all been great positions, but I have to say my first job out of college was by far my favourite.

At AIG, I was able to work with some very brilliant minds on the executive team, engage on some fraud reporting and saw my reports used throughout the United States.  I had a great manager, and awesome co-workers   However, by far the best part was working with data, reporting and writing SQL.  I loved it.  If you go back into my past a little further, you would see me asking my professor, after my class was finished for the semester, could I retain access to the database so that I could practice SQL more (can you say NERD!).

Nowadays my use of SQL is very limited and I miss it.  I miss reporting, seeing trends in data, and creating tools that guide decision making that can change the outcomes of the business and how everything interacts to create success.  So you should not be surprised that this term I have been hearing brings about a level of excitement for me.  It is Big Data.

OK, so I am sure you have heard of big data.  Maybe you know exactly what it is.  I am hoping to shed some light on this for people that have heard what it is, but have not had the time to look into it further.  Also I would like to convey why it will be important to healthcare.

What is Big Data?

When I was at AIG we had a data warehouse that had, most likely, millions and millions of records.  It was massive.  Big data is even bigger than that.  According to Wikipedia, big data is data sets so large that using standard database tools or data processing becomes very difficult.  The reason data is growing so much is because it is “increasingly being gathered by ubiquitous information-sensing mobile devices, aerial sensory technologies (remote sensing), software logs, cameras, microphones, radio-frequency identification readers, and wireless sensor networks."  Wikipedia goes on to say that, "The world's technological per-capita capacity to store information has roughly doubled every 40 months since the 1980s; as of 2012, every day 2.5 quintillion (2.5×1018) bytes of data is created."

Wow, that is big!

This data is being used for data analytics, business intelligence and effective decision making.  Cliff Saran of ComputerWeekly.com alludes to a fact.  The bigger your data, the larger the gap grows in competitiveness that lies between you and your competitors.

With these advantages, come some challenges.  The biggest, ironically, is the size of the data.  Saran says that "big data will cause traditional practices to fail, no matter how aggressively information managers address dimensions beyond volume."  Another challenge is trying to understand how to use unstructured formats, such as text and video (McDonnell, 2011).  According to McDonnell, some other challenges include storage of this data and getting the most important data to the right people at the right time.  And of course there are going to be immense challenges when it comes to security and privacy.

Big Data in Healthcare

Is big data important to healthcare?  Irfan Khan (2012) says that if we estimate that each of our cells contains 1.5 GB of data, each one of us is walking around with approximately 150 zettabytes of data.  Thanks 150 billion terabytes.  So, it seems, big data is already in health care.  We just need to capture this data. By capturing this data there is a great potential for improved healthcare "including personalization of care, defining patient populations with a greater level of granularity, analysing unstructured data, mining claims data for insights that can improve wellness and patient compliance, advancing medical research, and helping governmental agencies detect fraud, identify best care delivery practices, and improve bio-surveillance (Terry, 2012)."

Big data has big possibilities, including better healthcare outcomes.  It also has big challenges, such as storage, privacy and how to work with new and unstructured data, to name a few.  The benefits outweigh the challenges, however.  mHealth, EHR and all of the technologies related to health informatics will continue to grow big data.  The big question is, are you ready?

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Khan, I.  (2012 November 15).  Where's the big data in healthcare IT? Look in the mirror.  Retrieved from http://www.itworld.com/big-data/315298/where-s-big-data-healthcare-it-look-mirror

McDonnell, S.  (2011 June 21).  Big Data Challenges and Opportunities.  Retrieved from http://spotfire.tibco.com/blog/?p=6793

Saran, C. (n.d.).  What is big data and how can it be used to gain competitive advantage?  Retrieved from http://www.computerweekly.com/feature/What-is-big-data-and-how-can-it-be-used-to-gain-competitive-advantage

Terry, K.  (2012 October 15). Health IT Execs Urged To Promote Big Data.  Retrieved from  http://www.informationweek.com/healthcare/clinical-systems/health-it-execs-urged-to-promote-big-dat/240009034

Wikipedia.  (2012 December 23).  Big Data.  Retrieved from http://en.wikipedia.org/wiki/Big_data

Is cloud computing safe for healthcare?

So I am learning today one of the pitfalls of this new [old] technology called Cloud computing.  AWS, the cloud service from Amazon, has gone down.  How did I notice?  It took Netfilx down with it, meaning I am missing out on my Star Trek marathon I had planned for Christmas Eve.  So this has me thinking.  How can we trust cloud computing?  Can we trust it with healthcare, where there are so many life or death decisions made everyday?  What ways can be implemented to ensure uptime if using cloud computing in healthcare?  Any thoughts?

Link: Netflix Down!!

mHealth's Emergence

Not too long ago I thought I had the best technology in the world.  Someone could call my number and this little gadget on my hip would beep.  I could then call them back.  As I look back at those days in nostalgia, I also think that this was also the latest in "mobile health" technology.  In an emergency a doctor could be reached at any time and respond to the needs of his or her patients.  Now days if we need to contact our doctor the latest emerging trend is mobile health or mHealth.  Messages, images, prescriptions, notes and all sorts of medical information are now traded on mobile phones and tablets.  mHealth is posed to change the way we interact with our providers, view our medical history and try to "self-diagnose" ourselves.  But this is not all that mHealth is bringing us.  We can also track our weight, create workout programs and monitor how we eat.  Diabetics can have their blood sugar automatically sent to their doctors, who in turn can create health plans to keep these people on track.

This all sounds like it is going to make life easier for all of us, right.  Well for certain groups of people these advancements are far from easy.  These people are the politicians and regulatory groups that must enforce safe and secure transfer of data.  People selling applications must also sell the products in a harsh economical environment, and find a way to convince consumers that it is worth paying for some of these pieces of software.  There are also researchers who must conduct studies to see how these technologies will fit in an ever-changing social environment.  And last but not least, the people that must build the infrastructure to support this massive flow of information.  Lets take a look at some of these complexities and see how mHealth will move forward.

Politics, Regulations and Your Mobile Freedom

Ponemon Institute, a research organization that conducts studies on privacy, data protection and information security policies, found that 94% of healthcare organizations have had at least one data breach in the past two years (SIW Editorial Staff, 2012).  This number is scary.  The most common types of breaches include lost equipment, employee errors, third-party error, criminal attack and technology glitches (SIW Editorial Staff, 2012).  Now with the rise of mHealth, there is a new avenue for private data to be leaked to people who should not have access.  Yes we are entering a world of more mobile access, but this access comes with a price.  This price is the potential for data to be stolen, lost or mishandled.  Eric Wicklund (2012), editor at mHIMSS, learned from Peter Tippett of Verizon Enterprise Solutions that "healthcare is 'dead last' among industries in using cloud computing and IT" and that "part of the reason for that is regulatory overhang."  Technology is advancing and healthcare is just entering the game.  There are many regulations and laws to be created to make sure data is safe as it flies over the airways.  Also with Bring Your Own Device (BYOD) it is becoming difficult for CIOs to find a happy medium between company policy and the law (Comstock, 2012). 

mHealth Faces the Economy

The economy may be a barrier to mHealth adoption, especially in developing nations.  Dan Jellinek (2012), states that one barrier is lack of investment funds because of the worldwide economic crisis.  Another is the misalignment of funding incentives (Jellinek, 2012).  He advises that governments around the world take these into account when planning infrastructure and policy (Jellinek, 2012). 

How mHealth will affect the Socio-Economic Climate

There is no doubt that this emerging technology will make an impact on how healthcare is delivered.  Studies are already being done on how far the impact will be.  The Boston Consulting Group (BCG) was commissioned to study these impacts.  These impacts will be especially felt in emerging economies.  BCG found that mHealth will provide the solutions needed in these economies and do it quickly (BCG, 2012).  They also found that mHealth will free up health resources by reducing paperwork, reducing human error, avoid duplication and reduce administrative burdens by 20 - 30 percent (BCG, 2012).  This will go a long way in countries that face short budgets and start to save and improve lives all over the globe.  Another example of the socio-economic effect is how mHealth will improve mother and child health.  Voice of America (2012) (VOA) gives the scenario of a pregnant woman whose mobile device sends messages timed to her pregnancy that tells her what to do and when to do certain things.  It will even alert her when to get special treatment, or prevention care (VOA, 2012). 

Building a Foundation

When using the technology to facilitate mHealth, there are a few challenges that need to be considered when building the infrastructure on which all platforms will live.  One consideration is the quality of connection and performance of the end device, according to Jenny Laurello (2011).  There must be a high quality of connections (Laurello, 2011).  Unfortunately in most cases connects on mobile devices are not as consistent as a desktop device (Laurello, 2011).  One way around this is to create a wireless network at the organization that can accommodate the increased load of all the mobile devices (Laurello, 2011). 

As you can see mHealth will make a great impact on healthcare of the future.  There are few barriers such as lack of oversight and regulation that can lead to data breaches, and key parts of the infrastructure must be upgraded, especially wireless technology like Wi-Fi.  There is also the lack of investment in a world recovering from a global economic catastrophe.  If these barriers can be over come the socio-economic affect will be saved and improved lives across the world and because of this the future of mHealth looks bright.

References:

Boston Consulting Group.  (2012 April).  The Socio-Economic Impact of Mobile Health.  Retrieved from http://telenor.com/wp-content/uploads/2012/05/BCG-Telenor-Mobile-Health-Report-May-20121.pdf

Comstock, J.  (2012 December 06).  BYOD, HIPAA are rock and hard place for CIOs.  mobihealthnews.  Retrieved from http://mobihealthnews.com/19385/byod-hipaa-are-rock-and-hard-place-for-cios/

Jellinek, D.  (2012).  A changing world.  Vodafone mHealth Solutions.  Downloaded from http://mhealth.vodafone.com/health_debate/insights_guides/politics_economics/index.jsp

Laurello, J.  (2011 June 28).  Network and infrastructure considerations for mHealth and mobile devices.  Retrieved from http://www.circadence.com/news/current/Network-and-infrastructure-considerations-for-mHealth-and-mobile-devices

SIW Editorial Staff.  (2012 December 10).  Study: Healthcare Data Breaches A Growing Concern.  SECURITYINFOWATCH.COM.  Retrieved from http://www.securityinfowatch.com/news/10840149/study-healthcare-data-breaches-a-growing-concern

Voice of America.  (2012 December 05).  Using a Mobile Phone to Improve Mother and Child Health.  Retrieved from http://learningenglish.voanews.com/content/wireless-phone-pregnancy-mama-baby-medical-mobile/1559325.html

Wicklung, E.  (2012 December 04).  Verizon's Tippett says mHealth data transfer and security must be invisible and seamless.  mHIMSS.  Retrieved from http://www.mhimss.org/news/verizons-tippett-says-mhealth-data-transfer-and-security-must-be-invisible-and-seamless

Click here for article: mHealth Q&A

Picture courtesy of http://healthinformatics.wikispaces.com/mHealth

Business Intelligence and Generating Revenue in Healthcare

Business intelligence and analytics have created an atmosphere of greater decision making for businesses for many years.  Using data from the many transactions that businesses perform has been one of the most valuable tools for businesses.  Business has created teams of people to crunch numbers and this is now aided with reporting tools like MS SQL Server Reporting Service and even simple spreadsheets and graphs generated in MS Excel.  Now that health care is moving towards capturing information electronically, how can these organizations leverage these types of tools to contribute to revenue generation?

FIrst, here is a quick definition of business intelligence (BI).  BI is, according to Margaret Rouse (2006), "a broad category of applications and technologies for gathering, storing, analyzing, and providing access to data to help enterprise users make better business decisions."  This means that BI encompasses the tools that gather the data, making sure that the data is clean and abides by a set of standards.  It is the databases and data warehouses that store the data and the use of SQL to retrieve the data.  BI practices are used to analyze the data by use of spreadsheets, pivot tables, graphs and charts.  The findings are they presented on presentations, accessed through portals that house dashboards, sent through emails and a host of other ways to present the data for decision making.

According to Paul Bradley and Jeff Kaplan (2010), when it comes to the financial information system's data, health care organizations can support the revenue cycle by targeting high value claims or accounts, identifying root causes of missed charges or bad debt, enhance staff productivity, and speed up resolution of bad debt.  These are all done by predictive analytics, which identify trends and use these to make predictions to head off issues before they can begin (Bradley & Kaplan, 2010).  

On the clinical side, by leveraging BI, hospitals can "provide an efficient means for clinical results reporting" according to Healthcare Financial Management Association (2008).  This efficiency can present data that shows and measures the efficiency and effectiveness of clinical processes (HFMA, 2008).  Also by opening up the systems to physicians to input various data, this can support the physician's own billing, which turn can improve coding (HFMA, 2008).

Ferranti, Langman, Tanaka, McCall & Ahmad (2010) point out that use of BI can help support revenue generation through clinical improvement in these ways:

1. Prevention of medical errors through use of enterprise data.

2. Using data to improve the business cycle.

3. Using health analytics for emerging health issues.

As you can see BI can help to increase revenue by use of data from both the clinical information systems and from the financial information systems.  By using predictive analytics, the organization can head off billing and bad debt before it becomes a problem.  Clinical data can improve outcomes, patient safety and look towards the future so that these organizations can make better decisions which will increase revenue in the long run.

References:

Bradley, P. & Kaplan, J.  (2010 February).  Turning hospital data into dollars.  Healthcare Financial Management, 64(2), pp. 64-68.  ISSN: 0735-0732

Ferranti, M., Langman, M. K., Tanaka, D., McCall, J. & Ahmad, A.  (2010).  Bridging the gap: leveraging business intelligence tools in support of patient safety and financial effectiveness.  Journal of the American Medical Informatics Association, 17(2), pg. 136.  DOI: 10.1136/jamia.2009.002220

Healthcare Financial Management Association.  (2008 August).  Leveraging Business Intelligence for revenue improvement.  Healthcare Financial Management, 62(8), pg. 1.  ISSN: 0735-0732

Rouse, M. (2006 November).  Business Intelligence (BI).  SearchDataManagement.  Retrieved from http://searchdatamanagement.techtarget.com/definition/business-intelligence