An Enterprise Data Strategy for Powering Healthcare ... Hosp Rev webinar...An Enterprise Data...

© COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.

An Enterprise Data Strategy for Powering Healthcare Modernization & Innovation MarkLogic Corporation & Intel Corporation

BILL GAYNOR

U.S. Healthcare Executive,

MarkLogic

MARCEE CHMAIT

Strategic Development &

Innovation, SCAN Health

Plan

DAVID E. DANHAUER,

MD, FAAP

System VP / CMIO,

Owensboro Health

DAVID DILORETO, MD,

FACS, MBA

HCEG Board Member

SVP, GE Healthcare

Camden Group

SLIDE: 2 © COPYRIGHT 2017 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED.

“It ain’t what you don’t know that gets you into trouble.

It’s what you know for sure that just ain’t so.”

— The Big Short (2015)


Healthcare Organization Data Challenges HEALTHCARE IN 2017

50 LOWER

Compared to other service and

insurance industries … leveraging

unstructured data Satmetrix

High Price, High Volume FFS

Procedures Most Impacted,

Shift to Value-Based Models CMS

$355 per record, $158

average in other industries Ponemon Study

20 REDUCED

PAYMENTS

% MILLION PER

BREACH

$ 4 %

SATISFACTION


The Massive Cost of Legacy Technology DATA CHALLENGES

60 % OF TIME

By data scientists just

wrangling data NYT

WASTED

In 2016 on data integration

software Gartner

Of data warehouse projects

is on ETL TDWI for Informatica

3.5 BILLION IN

SPENDING

$ % OF THE

COST 80


Healthcare’s Experts at Integrating Data From Silos

1,000+ global customers

Decade of customer success

250+ partners

525+ employees worldwide

Capitalized for success (lead

funding from Sequoia Capital

and Wellington)

CREDIBILITY MATURITY EXPERTISE

Consulting Services

Data integration experts

for payers, providers and HIT vendors

24x7 Expert Support

From true engineers

Online Community

Free dev software, collaborate with

tens of thousands of people

Free Training

Web-based and instructor-led

HEALTHCARE:

ICA

Healthcare.gov Aetna

AHA, American

Hospital

association,

Health Forum

AMA, American

Medical

Association

Wellcare

M Modal


Solving Enterprise Data Integration Challenges DATA CHALLENGES

Enterprise Data Hubs

Consumer360, Medicaid, Operational

Data, Metadata, Structured &

Unstructured Data, Real-time Delivery

at Scale … and Centers of Excellence

Data Services Hub & App Dev

Platform for Real-Time Enrollment

“The largest personal data integration

government project in the history of the

Republic.”

- STEPHEN PARENTE, PHD, MPH, MS

Dynamic Content Delivery at Scale

Integrated Data, Multi-Device Delivery Global Trade Store

Integrated Data, Integrated Post-Trade

Processing

3 Top 10 Payers


Popular Healthcare ―Next Gen‖ Data Projects DATA CHALLENGES

FLEXIBLE DATA MODEL

UNSTRUCTURED & STRUCTURED DATA

FAST INGEST, INDEX, SEARCH & ALERTING

ENTERPRISE RELIABILITY

Enterprise

Data Hub

IT Initiatives Business Initiatives

Master Data Management

Data Governance & Compliance /

Security

Cybersecurity

Metadata / Search

Hadoop ―Complement‖

Hadoop Alternative

Data Enrichment / Semantics

IoT – Health Device Data

Building Apps

Mergers & Acquisitions

Engagement & Service

360⁰ View & Search of ―Anything‖

Communications & Social Media

Payment Reform

ACO, MACRA, FWA

Quality & Outcomes

STARS, HEDIS

Real-time Alerts

Product / Plan Management

Clinically Integrated Networks (CIN)


Not Just a NoSQL Database … An Enterprise Platform Native advanced features add greater value and deliver a simplified enterprise architecture

SLIDE: 9

© COPYRIGHT 2016 MARKLOGIC CORPORATION. ALL RIGHTS RESERVED. CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties

NoSQL DB Includes Native Search & App Server

KEY-

VALUE

COLUMN

DOCUMENT

GRAPH

A.I.

COGNITIVE

COMPUTING

PROPERTY

GRAPHS

TRIPLE

STORES

PREDICTIVE

ANALYTICS

NATURAL

LANGUAGE

PROCESSING

Data Platform vs. Standalone Tools

DATA

MINING

MACHINE

LEARNING ENTITY

EXTRACTION

KNOWLEDGE

GRAPHS

MarkLogic Native Capabilities

DR. DAVID DANHAUER OWENSBORO HEALTH


Owensboro Health

Owensboro Health is a nonprofit serving communities in Kentucky and Indiana with two hospitals, a

medical group comprising over 180 providers in 25 locations, a certified medical fitness facility and a

cancer center. Owensboro Health has been recognized for outstanding care, safety and clinical

excellence by The Joint Commission, U.S. News & World Report and Becker’s Hospital Review. As the

largest employer west of Louisville, Owensboro Health has 4,088 employees, and in FY 2015 saw

18,380 inpatient admissions and 823,072 outpatient encounters.


Physician Documentation Issues

Challenges in EMR versus paper

Patient story lost

Time-consuming and cumbersome

Limited Integration with transcription/voice recognition technology

―Note bloat‖

Copy/paste

Templating

Lost communication with Care Team

Coding issues


The Quest for Innovation

Replace outdated legacy technology

Innovative technology

- Functional

- Easy to use

- Maintain workflows

- Integrated

- Improved quality of notes

- Transform unstructured data to discrete data

Metrics Driven - ROI


The Process for Catalyzing Innovation

Search committee of key stakeholders

Delineation of problem and needs

Vendor search

Head-to-head business and technical evaluation

Formal ranking against needs

Selection of vendor

Project Development

- Scope, timeline, budget, etc.

- Metrics


Outcomes: Focusing on Physician Satisfaction

Physician Satisfaction

Ease of use

- 5 ways to document to help meet differing providers workflows

- Survey – 70% favorable, 41% above average or exceeds expectations

- No lost voice files due to cloud-based solution

- Mobile

Quality of notes – Provider reviewing provider notes

- Survey – 83% favorable, 37% above average or exceeds expectations

Turn-Arounds

All turn-around times well beyond HIM requirements


Outcomes: Leveraging Unstructured Data

Transform Unstructured Data to Discrete Data

CAPD

- 53% response to suggested documentation improvements

- Most alerts related to ICD-10 documentation

CDI

- Coding is current without backlog

Patient Safety/Quality

- Abdominal aortic aneurysms

- Lung nodules

MARCEE CHMAIT SCAN HEALTH PLAN


Keeping Seniors Healthy and Independent

SCAN HEALTH PLAN

SCAN Health Plan is one of the nation’s largest

not-for-profit Medicare Advantage plans with nearly

180,000 members in California. Part of the SCAN

family, SCAN Health Plan is committed to keeping

seniors healthy and independent. In addition to

Medicare Advantage, SCAN Health Plan also offers

Special Needs Plans, including coverage for those

who are dually eligible for Medicare and Medi-Cal.

Our story…40 years of seniors serving seniors


Consumer Access to Healthcare Seems Impossible CARE CHALLENGES

Health Plan

Enterprise Systems

Medical Records

Cle

arin

gho

use

/Po

rtal

s

Serv

ice

Cen

ter/

Po

rtal

EOB, Claims, Bills


Innovation Requires a Leap Frog Approach CARE INNOVATION

Service & Data Model

Business Model

MA Plan

Senior Experience Company


Connecting the Consumer to Their Ecosystem GRAPH TECHNOLOGY

BBC: Storyline Graph

Facebook: Social Graph

Google’s Knowledge Graph CrunchBase: Business Graph

LinkedIn: Economic Graph Walmart: Loyalty Graph

CO

NS

UM

ER

-CE

NT

RIC

D

OM

AIN

-CE

NT

RIC


Our Independent Living Knowledge PERSONALIZED CARE

PREPARE to live

Independently

PLANNING

WHAT TO EXPECT

Senior-Specific

Planning:

For independent

living:

• Financial plan

• Legal plan

• Social support

BALANCE their caregiving

with life living

TRANSITIONING

PERSONAL NEEDS

Senior-Supporting

Services:

• Personal care

• Family connection

• Friendly visitors

• Geriatric case

management

SIMPLIFY your daily living

at home

SLOWING

LIVING NEEDS

Senior-Tailored

Services:

• Getting to

doctor appts.

• Transportation

• Eating well

• Housekeeping

• Yard work

• In-Home Tech

• Pet Care

ENGAGE in your local

community

RETIRING

SOCIAL NEEDS

Senior-Friendly

Places:

• Working

• Volunteering

• Interest Groups

• Local Events

• Learning Venues

ADAPT as your capabilities

change

DECLINING

ADAPTING NEEDS

Senior-Designed

Products/Services:

• Seeing

• Hearing

• Walking

• Talking

• Remembering

TR

IGG

ER

C

ON

TE

NT

E

XP

ER

IEN

CE

S

ST

AG

E

RISE TO INDEPENDENT LIVING Personal

Pathways

in a Graph


The Independent Living Situation Using Graphs PERSONALIZED CARE

Proactive Education

Consumer Intent

Brand Innovations

Connected Life

Experience Content inspires a better way

Personalized

Content Streams

Family & Friend Circle plans for independence

Progressive

Profiles

Personal Assistant elevates results

Proactive

Conversations

Prescriptive

Algorithms

Senior-Tailored Services improves adoption


The Independent Living Platform PERSONALIZED CARE

CONNECTED ECOSYSTEM

Client Team

Planning

& Partnership

Community

Education

& Onboarding

DIGITAL

ENGAGEMENT

GUIDED EXPERIENCE

Community

Insight

Consumer

Surveys and

Assessments

Business

Metrics

Employee

App

Rise

Advisors

Local

Service

Networks

Senior

Circle

Planning Needs

Social Needs

Home Needs

Capability Needs

Care Needs

Engage Simplify

Adapt Balance

Rise

Path Prepare

PERSONAL PATHS

• Assessed goals

• Guiding content

• Progressive solutions

• Assisted daily routine

COMMUNITY

EDUCATION

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiOoNuss_TPAhVDNrwKHd7kAaEQjRwIBw&url=http://downloadicons.net/assessment-icons&psig=AFQjCNGQRnZs3MDhL4vlZzaQ3VgdNh480w&ust=1477431359220926

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwiZkf7Ps_TPAhWMVrwKHZiMAVQQjRwIBw&url=https://avopix.com/premium-photo/256631272-shutterstock&bvm=bv.136593572,d.dGc&psig=AFQjCNGhXYryBMUJzrzYl4iKNDusjkIZdw&ust=1477431556206106

https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwi_yI-Dgf7PAhXCTbwKHYL3B7oQjRwIBw&url=https://www.iconfinder.com/icons/100255/google_maps_icon&psig=AFQjCNHhZUPWmjdYZuyxbp1Az7Agb_qt-Q&ust=1477761580961032

DR. DAVID DILORETO HCEG BOARD MEMBER

GE HEALTHCARE CAMDEN GROUP


The Healthcare Executive Group

The HealthCare Executive Group (HCEG) is a national network of executives representing the supply

side of healthcare: health plans, health systems, provider organizations and other health industry

participants coming together to continually learn, grow, share and reshape the industry.

HCEG’s members are executive leaders from some of the most dynamic health plans, health systems,

and provider organizations in the United States. The HealthCare Executive Group is supported by a

select network of sponsor partners, industry advisers and alumni. A single membership fee covers all

HCEG events and content including HCEG’s Annual Forum, Executive Leadership Forums, a wide

range of live and recorded education content and programming delivered via multiple channels, and

other benefits.

QUESTIONS [email protected]

Next Gen Data Tech in Healthcare Video:

Harness the Power of Modern, Innovative Healthcare With

MarkLogic and Intel (3:24) - http://bit.ly/2j6FW00

http://bit.ly/2j6FW00

SLIDE: 29


APPENDIX A: Additional Solution Information


The MarkLogic Alternative

An Operational and Transactional Enterprise NoSQL Database

Data ingested as is (no ETL)

Structured and unstructured data

Data and metadata together

Adapts to changing data

and changing data structures

EASY TO GET DATA IN Flexible Data Model

Index once and query endlessly

Real-time and lightning fast

Query across JSON, XML, text,

geospatial, and semantic triples

in one database

EASY TO GET DATA OUT Ask Anything Universal Index

Flexible cloud deployment

Enterprise-grade data security

Reliable data and transactions

(100% ACID compliant)

Out-of-the-box failover,

replication, and backup

TRUSTED TO RUN YOUR BUSINESS Enterprise Ready

SLIDE: 31


Flexible Deployment Run It Wherever You Want

Linux or Windows

On-premises (virtual or physical)

Private cloud, hybrid cloud, public cloud

AWS or Azure

Any storage architecture, including Hadoop

PHYSICAL

CLOUD

VIRTUAL

SLIDE: 32


How MarkLogic Data Hub Works ... Improved Agility & Time to Market


MarkLogic 9 (early release phase)

DATA INTEGRATION

- SEMANTICS, QUERY, MOVEMENT

PRODUCT ROADMAP & INVESTMENT THEMES

CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties

SECURITY

ADVANCED ENCRYPTION, REDACTION, CERTIFICATION

MANAGEABILITY

OPS DIRECTORY, ROLLING UPGRADES, TELEMETRY

SLIDE: 34


How Does it Work?

Schema-agnostic design

Real-time indexing for search and query

Reverse queries for event processing and alerting

Scale-out shared-nothing cluster topology

Analytics and Visualization

Transactions

Bitemporal


Platform for building apps, analytics and running your business

Operational Data Hub Solution – Next Gen Enterprise Integration Pattern

Convergent: Operational & Analytical. Provides 2-

way interaction between users and data

Contextual: Data harmonized with semantic

metadata

Data-centric: Integrates at the data level, not just

functionally

Cost-effective: Minimizes ETL, data copying,

business silos, technical silos and people-centric

integration

Secure: Provides a platform for rich data

governance

Complementary: Leverages existing assets and

patterns

OPERATIONAL

APPLICATIONS MULTI-CHANNEL

DISTRIBUTION

BIDIRECTIONAL

ANALYSIS

OF ALL DATA

SSD, DAS, SAN, NAS,

S3, Hadoop/HDFS

JSON

XML

Data-Centric

Architectural

Pattern

CONFIDENTIAL – Proprietary Information – Do not disclose or distribute to third parties


MarkLogic Data Hub

HA

RM

ON

IZE

ING

ES

T

Enveloped

Documents

(Entity 1)

SE

RV

E

Enveloped

Documents

(Entity 2)

RDBMS

Source 1

Documents

Message Bus

Content Feed

Staging Final Source

Systems

Consuming

Applications

Source 2

Documents

Source N

Documents

… …

Enveloped

Documents

(Entity N)

Operational Apps

Analysis/BI

Data Feeds

Indexes, Query, Scripts Indexes, Query, Scripts

Data Flow

SLIDE: 37


MARKLOGIC APPROACH TO

DATA INTEGRATION

2

3

1

4

1 Ingest Data As-Is

2 Access the Data

3 Harmonize & Enrich the Data

4 Operationalize

Better Data Ingest, Index, Search, Harmonization & Enrichment


Load Data As-Is

Load structured and unstructured data

Keep data and metadata together

Harmonize data in the database

Ability to skip:

– Upfront modeling

– ETL tools

HOW MARKLOGIC DELIVERS JSON

XML

SEMANTIC

DATA

GEOSPATIAL

DATA

MLCP

BINARY

OTHER METHODS

REST APIs, Java Client API, Node.js Client API, Java / .NET XCC


Developer and User Access

Variety of Interfaces – Modern

programming languages familiar to

developers

Application Services – Simplifies

architecture and speeds up development

Developer Productivity – Tools and

frameworks to speed delivery

HOW MARKLOGIC DELIVERS

SEARCH APPS

JAVASCRIPT

XQUERY

SPARQL

REST API

JAVA API

SQL VIEWS

TRANSACTIONAL

APPS

ANALYTICAL

APPS

SLIDE: 40


Real-Time Analytics

Range indexes can be used for

Faceted search

Aggregation and visualization

Analytics…

…including custom user-defined functions

Co-occurrence

SQL, ODBC, and BI integration

ODBC

SQL

Range Indexes


If You Have an EDW

MarkLogic Data Hub Enterprise Data Warehouse

Real-time interactive

Two-way analysis & operations

All of your data

Load data as-is, model

alongside discovery

Proactive, alert-capable at

massive scale

Batch-oriented

Analysis only

Structured data

ETL and model dependent

Reactive, query-based


If You Have a Data Lake

MarkLogic Data Hub Data Lake

Advanced data governance and

provenance features

Real-time

Two-way analysis & operations

Save and index everything for

sub-second processing

Mature and fine-grained security

model with redaction features

Advanced Semantics capability

for rich context

Multi-model capability eliminates

technical silos

Issues with data governance

and provenance

Batch-oriented

Analysis only

Save everything and process

with brute force

Simplified security model

Limited or no context

Multi-layered ecosystem

encourages technical silos

An Enterprise Data Strategy for Powering Healthcare ... Hosp Rev webinar...An Enterprise Data...

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