Public Health Data Standards Consortium

AT&T Government Solutions Integrated solutions from a trusted sourcesm

Public Health Data Standards Consortium

March, 2004

Maureen T. Kitchelt

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AT&T Labs – Research: Technologies for Anomaly Detection

AT&T / QuestStatisticalAnalysis

Environment

PortalB

EA

, Plumtree, O

racle, BR

IO

AT&T / QuestAlert

ManagementCenter

CO

NT

RO

LD

AT

A

CustomerData

Loading

DataWarehouse

PartnerStatisticalAnalysis

Environment

FIR

EW

AL

L

“Streaming”AnomalyDetection

“Forensic”AnomalyDetection

AnomalyWarehouse

PartnerAlert

ManagementCenter

PortalB

EA

, Plumtree, O

racle, BR

IOP

artners Portal

FIREWALL

KnowledgeManagement

Center

PortalB

EA

, Plumtree, O

racle, BR

IOPortal

BE

A, Plum

tree, Oracle, B

RIO

Alert D

istribution

ProprietaryPartners

Data

QuestDiagnostic

DataWarehouse

PartnerData

E.g. HospitalDischarge /Lab Data

AT&T / Quest DiagnosticsBioSurveillance Engine: Database, Analytics, Visualization, Case Management

Labs TechnologyBuilding Blocks:Rapid deployment,tested in critical applications

Daytona: Massively-scalable open-architecture data management system; e.g. 350M records/day, 500B records online, 92TB data warehouse.

Signature Analytics:– Signatures: Continuously-updated

historical profile, physician, geography, test combinations, for real-time anomaly detection

– Hancock: Match data streams to pattern templates at very large scale

– Community of Interest: Relationship graphs, massively updated, e.g. 500M keys, 63B comparisons daily.

Global Case Management: 1,000’s of alerts daily, managed as cases, rule-based handling by experts; YOIX, a development environment for distributed applications.

SWIFT Dynamic Visualization: US and global mapping to ZIP level and better, comprehensive boundary files, multiple variables and graph types, drill down, pixelmap (terrain) overlay.

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CDC orpublic health office

Hospital

Labs

Partners

Partners

Detection and reporting of

anomalous patterns and trends in both tests and results

Roll-up of data at county state and

national levels: Filters and transforms data,

manages security access

Alerts on conditions of concern and early warning

alerts – syndromic surveillance based on unusual

patterns of ordered tests

CDC/StatePublic Health Office

Integrate and process massive amounts of data

HealthServicesNetwork

ATT WebService Connect™: CDC/Public HealthReal time interoperable network needed for data and communicationexchange with myriad partners -- Public Health Information NetworkProvide Real-Time Access to Data for bio-surveillanceand health care data needs (treatment, policy, outcomes)

Business Objectives

• Surveillance: Detect outbreaks—bio-terrorist, foodborne, etc

• Effective interventions to prevent disease and promote health

• Investigation of causes and transmission pattern, MRSA pattern

AT&T Solution

• Provide Public Health Services directory

• Connect securely and reliably with hospitals, labs and public health offices

Client Benefits

• False Positives Reduced• Serve multiple levels of public health

data needs• Limited IT investment• Roll-up of Data at county, State and

National levels• Single source elect policy and

control access

Standards-based:SOAP, XML, WSDL,

UDDIHL7

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Alert Distribution

KnowledgeManagement

SurveillanceReporting

KnowledgeRepository

FAX

E-mail toFax Provider

Cellphonephone#@provider.comE-mail

Addressprovided by

user

Pager

pager#@provider.com

InternetDelivery

via SMTP

E-mail

MSN/Yahoo/JabberMessenger

PocketPC

Cell Phone

Pager

E-Mail GW

Instant Message GW SMS GWHTTP GWWAP GW

Voice/FAX GW Telnet GW SIP GW

AT&T Mobile Network AAA

Profiles

Location services

FirstResponders

HealthDepartment(CDC, State,

Local)

VariousInformation

Systems

(CDC, Stateand Local

HealthDept's,

Hospitals,Universities)

InformationSystem Egress

andVPN Server

InternetVia HTTP,

HTTPS,SOAP

InternetExplorer

6.0(send and

viewalerts)

Users

Universities

Physicians

Hospitals

.NETCHAINWebApp

Server

.NETAlert

ReceiverWeb

Service

InvizeonCHAINWeb

Services

VPN Server

Knowledge DrivenDelivery AgentDocuments

Database

Alerts andTrackingDatabase

Research /KnowledgeDatabase

AuthenticationServices

ActiveDirectoryDatabase

Firewall

SurveillanceDatabase

User andParticipantDatabase

Knowledge basedSurveillance Agent

KMKM EngineEngine

KMKM EngineEngine

Users

AT&T Bio-Surveillance Solution Overview

AT&T Research - LabsQuest Diagnostics ATT

WebService Connect™

kolson

Deleted Invizeon logo at top. Deleted Connect, Exchange, Empower from top.

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Partner: Quest Diagnostics

Leading provider of diagnostic testing, information and services. Clients are consumers, physicians, hospitals, insurers, employers, and government agencies.

ANNUAL TESTING PERFORMED

Personal health testing on over 100 million patient encounters

Over 375 million diagnostic laboratory tests

6.5 Million Genetic tests

WORLD’S LARGEST PRIVATE DATABASE OF CLINICAL TEST RESULTS

To provide surveillance of disease trend data

across broad populations of patients

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Partner: Health Language, Inc.

World's leading provider of terminology software, services, and language engines

• Dramatically enhances bio-surveillance pattern recognition in aggregate data with concept-indexing

• Enables use of worldwide health data code sets, standards and terminologies

• In use worldwide by major vendors and health ministries

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Partners: Quovadx

Integrate Disparate Applications and Automate Information Flow

…Rated Number 1 by KLAS for Integration Engine, 2003

Integrate incompatible applications to effectively share or distribute information

Automate the flow of associated information and processes to create operational efficiencies

Rapidly develop applications, via reusable components, to effectively manage and securely share information via the Web

Built on QDX™ Platform V, the QUOVADX™ Government Adaptive Framework gives local, state and federal agencies the ability to implement integrated, automated business processes that span agencies, geographies and partners. QDX™ Platform V delivers complete business process management and integration on an industry-leading XML Web services platform to help government

Solutions Architected for Change

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Use of Data

Standards facilitate collaboration

Collect it once, use it repeatedly

Treatment vs. Policy

Data Analytics

Future policy perspective

Real time data vs. standards-based repository

Just in time data (as needed for application)

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The AT&T Solution

Key Components AT&T Global Intelligent Network AT&T WebServices Connect AT&T Labs Technologies: DB, Signature Analytics, Visualization Quest Diagnostics’ Syndromic Surveillance; >> 8M tests daily Health Language Data Transformation tools Quovadx Hospital Information Integration Systems

Key Benefits Rule-based expert anomaly management before alerts are issued Unlimited data – No logical limit on data warehouse size Unlimited analytics – Local surveillance at a national scale Incorporates multiple levels of health data, local and national Serve multiple levels of public health surveillance needs Managed service implementation available Frees funds for solving identified problems

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Syndromic Surveillance

Standards facilitate collaboration

Analyze once, apply repeatedly

Treatment vs. Policy

Analytics & Visualization

Future policy perspective

Real time alerting vs. standards-based repository

Just in time informatics (as needed for application)


Back-Up Slides

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Scenario: Today’s Presentation FocusSyndromic Surveillance Challenges

Signal to Noise Ratio

– Excessive False Positives

– Inadequate ability to detect signal

Roll Up to National Level Takes Weeks/Months

Extremely Limited Ability to Detect an Unidentified Organism or Bio-agent, or other Unanticipated Event

Volume and Variability of Available Data

Local Efforts Do Not Detect Cross-Jurisdictional Findings

Lack of Data Standards

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The Solution:Syndromic SurveillanceWith Re-Purposing Expedite Re-Use of Data Already Being Analyzed

Deep Visibility of Out-patient/physician Office Testing Segment

Roll-up of Data at County, State, and National Levels

Single Source Electronic Reporting of National Surveillance Data for Bio-Terrorism and Emerging Infectious Disease Detection as well as for enhanced surveillance for other issues of public health concern

Properly de-identified for HIPAA Compliance

Availability of Denominator Data

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The Solution: Quest Diagnostics’Syndromic Surveillance

Complete Nation-wide Coverage

Data Distribution Representative of Population Distribution Based on Comparisons to Census Data

Routine and Esoteric Test Orders and Results

Large Normative Data Pool for Many Routine Tests

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The Solution:Integration of Other Sourcesand Compliance to Standards

Other Sources

– Hospitals

– Pharmacies

– Others

Standards – Integration with products such as Health Language products

• LOINC

• SNOMED

– HL7

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The Solution:Syndromic SurveillanceAlgorithms

Detection and Reporting of Anomalous Patterns and Trends in Both Tests and Results

Detectable Bio-terrorist Attack or Disease Outbreak on the Basis of Sudden Spikes in Orders, Even If Results All Negative

Identification of Cross-jurisdictional Outbreaks

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The Solution:Syndromic Surveillance Alerts

Targeted Alert Messages Alerts on Conditions of Concern That May

Not Currently Be Reportable Early Warning Alerts – Syndromic

Surveillance Based on Unusual Patterns of Ordered Tests

Interface to AT&T’s CHAIN-EMN™ Service– Update and acknowledgement to Public Health

Officials (State and Local, roles-based response)

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Our Value Proposition Streaming Analysis

Forensic Analysis

Results Presented Using Visualization and Other Reporting Tools

Reduce Investment and Risk

Web-Based Access and Collaboration

– Customized Portal

Applying specific funds for public health

– Surveillance

– Investigation of causes and transmission pattern

– Effective interventions to prevent disease and promote health

– Real time interoperable network for data and communication exchange with myriad partners


Thank you.

Maureen T. KitcheltDirector, Strategic SalesHealthcareAT&T Government [email protected]

Public Health Data Standards Consortium

Documents

Transcript of Public Health Data Standards Consortium