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Includes Forrester Research report, ‘Seven Ways Big Data Improves Healthcare Outcomes’
Empowering the Data-driven Enterprise
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers2
EXECUTIVE SUMMARY
Healthcare data and its impact upon the patient care decision process via accurate, real-time, reliable data
from disparate sources is creating a digital health revolution. Physician groups, nursing facilities, hospitals,
pharmaceutical companies, clinical researchers, and medical equipment manufacturers are all churning out
vast amounts of data during their daily operations. This data has tremendous value and can revolutionize
patient care, diagnosis, real-time decisions and help deliver new, unimagined innovations with quality of
patient care.
Data-driven healthcare is beginning to have a huge impact addressing the challenges of every provider,
through efficient handling of huge volumes of patient care data. Patient-centered healthcare is gearing for
a 360-degree understanding of the patient. The key to improved health outcomes lies in understanding
the patient’s financial, social, and behavioral context. It requires integration of new, semi-structured and
unstructured data types such as video, medical imaging, doctors’ free-form notes, other text documents and
data from wearable medical devices, etc. This data cannot fit into the traditional data models. Big Data analysis
can quickly and easily provide evidence to fine tune the quality of care for a patient, leading to tremendous
healthcare efficiencies and a healthier world of tomorrow.
The tremendous opportunity of a data-driven strategy is apparent to providers and the patient care ecosystem,
but all these informational assets exhibiting volume, variety, and velocity need to be ingested and analyzed
for enhanced insight leading to better business decisions for quality of patient care. Data-driven technology
solution such as the Solix Common Data Platform (CDP) provides a next generation data management
platform that not only meets the analytic demands of the data-driven organization but also addresses the cost,
compliance, and governance challenges that come along. The Solix CDP combines human and computer
analysis based on huge volumes of data to produce optimal decisions at every level of the healthcare business.
Providers can take complete advantage of the data-driven healthcare revolution by adopting such a technology
foundation significantly enhancing patient care, and achieve tremendous efficiencies themselves.
Healthcare Revolution and Challenges En Route
We are witnessing a data-driven healthcare revolution with widespread digitization of electronic health
record systems. But with compelling opportunities, we also see massive data volumes, evolving patient
expectations, and expanding regulations. Data in varying formats from an increasing array of sources
must be integrated to ensure optimal outcomes, whether obtaining a diagnosis, ensuring accurate claims
processing, developing new pharmaceutical treatments, or addressing regulatory challenges.
To accelerate this healthcare revolution, the industry has to manage key challenges such as government
regulations, information security, privacy protocols, changing technology landscape (such as electronic
health records, data analytics), while also containing the cost of rolling out new drugs, plans, and products
into the healthcare market. Government healthcare programs are growing rapidly and cannot be ignored.
The healthcare organization’s need to comply with government requirements such as accountability, the
performance improvement mandate, and evidence-based outcomes, will require considering technology
options to create efficiencies. Payers, providers, the pharmaceutical industry and medical equipment
suppliers have unique challenges that are largely intertwined and require a concerted industry plan crafted
in unison.
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers3
Providers need to move towards real-time analytics that have become critical to demonstrate their quality
of care, as reimbursement by government programs can be contingent upon how providers are measured in
“Quality of Care”. For example, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, also
called the Permanent Doc Fix, changes the way Medicare doctors are reimbursed with the implementation
of a merit based incentive. The performance-based pressure is huge, which makes it imperative that every
provider consider technology solutions. Technology adoption can enhance decision-making based upon
real-time analytics, along with a complete view of the patient’s life, contributing to a high quality of care.
The constant pressure of competition and the need for cost control to stay viable also lends credence to
the value of decisions based upon data. The U.S. Government Accountability Office in partnership with the
Department of Health and Human Services (DHHS) is looking into implementing a nationwide electronic
health record. Providers need to be able to exchange patient information to support out of network care and
take smart decisions to meet patient needs.
Data-driven Healthcare Can Help Overcome Industry Challenges
The healthcare industry has recognized the emerging challenges well, is reconciled to the new versus
traditional business model, and is embracing the technology innovation that will position players for long-term
success. Every healthcare ecosystem partner will need to optimize its business models, grow its customer
base, address regulatory pressures with emerging technologies such as artificial intelligence, machine learning,
block chain, and virtual reality, along with data mining, Big Data, and analytics-based approaches.
Data powered tools can accelerate this healthcare revolution with innovations shaping and improving the
healthcare system to respond better to patient needs via accurate, collated, aggregated, and meaningful data
that provides information and actionable insights for every segment. Medical practitioners need tools that can
respond on demand to provide recommendations incorporating all the existing data and the latest medical
research, be it at the bedside or while the patient is sitting in the doctor’s office. Addressing the demand for
accurate, reliable data is key to success. Healthcare data is created at the source by providers such as physician
groups, pharmacies and medical equipment manufacturers. Ultimately, some of this financial, clinical, and
administrative information ends up with the payer, third party vendors, and government agencies.
Mounting pressure on operating margins
Complex healthcare regulations
Lack of interoperability among major healthcare
software providers
Costs associated with massive growth in healthcare
data volume
The need to integrate external medical data sources
Data security and the risk of ransomware
T
Providers
CHALLENGES
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers4
But the challenge lies in how we come to grips with the explosion of data and make it available in a usable
form to practitioners including nurses at a station, a scientists researching cures, insurance underwriters
designing new health insurance products, and private individuals trying to pick the right plan to manage their
family’s specific healthcare needs.
The current landscape of healthcare systems is
complicated and fragmented across the industry
with many data sources. The cost and complexity of
integrating, managing, and storing exabytes of data
is a constant issue for everyone within the healthcare
ecosystem. Even within a single hospital facility,
multiple disparate systems exist that have a variety
of data formats that make integrating, exchanging,
and harnessing data a challenge. In a multi-facility
network, with the imperative to exchange patient
relevant information among systems and providers,
the array of systems grows even further. Analyzing
all this critical data from all these facilities and
staging them for advanced integration and analytics
is hard but very fruitful. The alternative is to go
without knowledge of the full arc of the patient
experience. That will have consequences including
missed financial opportunities and increased data
security and compliance risk from regulatory regimes
including HIPAA, GDPR, and others. 1
The industry finds it imperative to capture and store all sorts of data that will provide the ability to run a 360-degree
analysis of the patient, with an optimal patient care recommendation. The new definition of data includes free-form
text such as doctors’ notes, radiologists’ reports, medical journal articles with the latest findings and discoveries,
emails, still images such as CAT scans, videos, recorded speech, patient historic data, social media data, genome
files, biometric, and other scientific data from clinical research and drug development. It also includes data from
stand-alone systems - EMR, PACS, RTHS, EMPI, LIS and PMS, and Internet-of-Things (IoT) data from wearables,
medical devices, respirators, blood pressure monitors, and other connected devices. All together the resulting
insights can contribute to the 360-degree view of the patient, making a huge difference in the quality of care.
There is an estimated 50 petabytes of data in the healthcare realm, predicted to grow to 25,000 petabytes by 2020.2
There are many new systems including wearables and mobile apps rolled out daily, that are adding velocity to the
data growth. But there is value only if we can analyze this data quickly and effectively. The healthcare industry has
realized quickly that extracting more meaningful insights via Big Data can make a tremendous difference.
1
http://www.zdnet.com/article/solix-launches-healthcare-data-management-platform-based-on-Hadoop/
2
http://www.scribd.com/doc/107279699/Big-Data-in-Healthcare-Hype-and-Hope
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers5
Big Data Can Revolutionize all the Healthcare segments
The healthcare world has created a volume, variety and velocity of healthcare data, a unique trifecta that,
once addressed, can make huge strides in healthcare decision-making and patient care. The volume of data in
healthcare, a lack of standardization of healthcare data from various sources such as providers, payers, disease-
management groups, social media, medical laboratories, personalized genetic testing companies, patients’
personal information, along with the need for urgency and real-time analytics that could potentially save lives,
makes Big Data ideally suited to work its magic in healthcare. Big Data can be applied to prevent deaths,
identify medical conflicts, even predict epidemics and cure diseases. It can proactively identify a child’s potential
upcoming health issues and recommend protective measures, and chart out a plan to alleviate the spend in
healthcare disbursements over the child’s lifespan. Big Data and advanced analytics can improve healthcare
decisions on patient care at all levels, from supporting Real-Time Health Systems (RTHS) to all forms of digital
medicine.
Big Data can reduce the cost of healthcare and of insurance significantly, helping to make a huge expansion
of healthcare coverage a reality. Decision algorithms can provide an additional layer of support and
interaction with the patient, in addition to the doctor. Big Data analysis can incorporate patient lab results,
the longitudinal patient record, medical imaging, etc., to make treatment recommendations, providing
better treatment while relieving the busy, overtly stretched medical professional from hours of work,
allowing her to focus on higher value activities.
Providers can optimize their existing offerings by leveraging intelligent data-driven strategies to reduce
soaring healthcare costs. Big Data analysis can optimize provider resources, distributing it among patients
based on their condition and specific need. For the payer, application areas range from fraud detection to
real-time continuous patient monitoring outside the clinical setting using personal/ IoT sensors. Other
verticals have successfully targeted customers with campaigns that have increased business. The healthcare
industry can do the same, but in this case to provide better patient care, to optimize existing resources, and
ultimately increase revenue, providing immense benefit to the patients.
BIG DATA
BENEFITS
Mine Patient data to improve care
Predict adverse outcome
Determine populations at risk
for illness
Pinpoint where education and
prevention is need
Detect medical fraud
Reduce Readmission
Identify procedures likely to succeed
Customer experience
Supply chain optimization;
timely deliveries
Reduce the cost to care for by
predictive maintenance insights
Provide additional insights to
end-user; Upsell
Ensure even utilization and wear
and tear of machines
Accelerated drug discovery
Targeted Marketing
Reduce drug fatalities via
predictive modeling
Patient compliance via IOT devices
Payer
Medical
Equipment
Pharma
Provider
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers6
Hospitals are starting to apply Big Data to sift through complex variables such as lab tests, family history,
and diagnosis, taking into account a variety of disparate data elements, in some cases to provide proactive
intervention with a patient to head off a long-term costly health challenge. Payers are leveraging Big Data
analysis to identify and prevent medical fraud early, saving billions annually. Pharmaceutical companies are
leveraging Big Data to streamline and reduce the cost of screening compounds in drugs discovery research.
Predictive analysis models working on massive virtual databases of molecular and clinical data can
accelerate the process and reduce cost, identify risk factors and can optimize yield from the drug
manufacturing process. Big Data’s impact upon order management for medical equipment manufacturers
can improve demand planning, identify customer behaviors, and provide insights to deliver goods in a
timely fashion. These are only some of the many use cases that benefit from applying Big Data.
Big Data Needs a Big Technology Shift
Traditionally, organizations depended on the Enterprise Data Warehouses (EDW) for all their analytic and
business intelligence requirements. However, with the rapidly evolving analytics landscape and the adoption
of Big Data, traditional EDWs are falling short of the capabilities needed. Not only are EDWs prohibitively
expensive, they lack the ability to store and process unstructured data, and the healthcare industry has
more unstructured than structured data. Additionally, due to its schema-on-write requirement, EDWs cannot
support the ad-hoc rapid exploration of data which is now become a key requirement of every data driven
organization.
Big Data in Action
Power clinical recommendation engines using electronic medical record data. The University of Michigan
Medical School harnesses intensive care signals and integrates them with their ICU patient charts. It mines data
and creates tools that combine bedside real-time facts with clinical rules to signal potential dangers within the
ICU. This solution flags risk and recommends diagnostic and treatment options for the critically ill patients. Like
most of these types of development initiatives, the school uses its own institution as its spearhead client. It
is developing the business programs necessary to bring these insights to market once it feels confident of the
efficacy of the solution.
Create an institutional benchmark for cancer treatment. Memorial Sloan Kettering Cancer Center built a
longitudinal repository of individuals with cancer with great fidelity. It combined publicly available Centers
for Medicare and Medicaid Services (CMS) data’s administrative facts such as diagnosis, procedure codes, and
provider IDs with clinical facts, such as what cancer stage, from the National Program of Cancer Registries. This
greatly enhances the meaning of the administrative data allowing the center to compare one institution’s results
for similar cancers to another. The melding of two public data sources to gain insight about the efficacy of
cancer treatment across the US is a significant achievement.
Ref: Forrester Research report, ‘Seven Ways Big Data Improves Healthcare Outcomes’ (included)
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers7
A Big Data technology platform such as Apache Hadoop provides in-built advantages to help realize the
data-driven healthcare vision by ingesting a wide variety of healthcare data, whether structured, semi-
structured, or unstructured, in a single repository in low cost bulk storage, eliminating costly and slow ETL
processes. The data is stored “as-is” and applies a schema on read. This allows ad-hoc analytic query and
in-memory processing in real-time as and when needed. Apache Hadoop also provides massively scalable
distributed processing, which is required for complex machine learning and analytic use cases. Finally,
Hadoop enables advanced text and voice search, structured queries and advanced analysis tools working
seamlessly against multiple data types and formats. Hadoop provides the ability to ask ad-hoc questions
to get quick responses, along with the ability to drill down to precise information based upon a natural
language search.
However, Apache Hadoop does not provide enterprise grade capabilities such as codeless data ingestion,
metadata management, Information Lifecycle Management (ILM), data governance and security.
Additionally, the constantly evolving Hadoop ecosystem makes it a daunting task for enterprises to identify
which newer Hadoop technologies are worth incorporating as part of their Hadoop cluster. What exacerbates
the problem is that Apache open source technologies are not designed to work together and have no
industry standard interfaces, making building a full technology stack a daunting task requiring scarce skills.
Organizations need an enterprise grade Big Data management system built on Apache Hadoop such as the
Solix Common Data Platform (CDP) for Healthcare.
Introducing Solix Common Data Platform (CDP) for Healthcare
The Solix Common Data Platform (CDP) is a highly scalable and robust next-generation Big Data
management platform that features uniform data collection, metadata management, data governance,
ILM, data security, data discovery, and a full set of interfaces to support plug-and-play stack creation and
modernization. It leverages the high-performance and low-cost characteristics of the open source Apache
Hadoop framework to allow economical storage and real-time processing of petabytes of structured and
unstructured healthcare data.
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers8
Solix CDP stores data “as-is” to eliminate costly ETL operations during data ingestion and provides an ability
to transform data post-ingestion to feed the unique needs of downstream NoSQL and analytic applications.
It includes modern Big Data processing engines like Apache Spark, Impala and Hive, to meet the machine
learning and advanced analytic needs of today’s real-time Data-driven organizations.
With a built-in enterprise data lake, enterprise archiving, application retirement, and eDiscovery solutions,
Solix CDP provides organizations with an unparalleled enterprise data management and analytic tools and
framework. This makes it possible for organizations to leverage data for effective medical diagnosis, clinical
trials, drug discovery, and fraud prevention, while saving on storage costs and complying with complex
healthcare regulations (including HIPPA, HITECH, CFR etc.).
Solix CDP is certified to operate with both the Cloudera and Hortonworks Hadoop distributions. Additionally,
it can be deployed on-prem or on the cloud (supports AWS, Azure, Oracle and Google cloud).
Solutions Overview:
Enterprise Data Lake for Machine Learning and Advanced Analytics
The Solix CDP-enabled healthcare data lake is a self-contained enterprise data hub that provides robust
data collection, data governance and data preparation tools with self-service visualization and business
intelligence. It provides authorized data consumers with a singular repository of structured and unstructured
healthcare data from a wide range of data sources including EHR, PACS, health trackers, diagnostic
equipment, published research, and more. This data is captured into the repository by Solix CDP in an “as
is” form along with its associated metadata. This eliminates the need for costly ETL during the ingestion
process, while making it easy to discover, understand, and consume data. It would be nearly impossible and
extremely expensive for any traditional EDW to incorporate such variety and large volume of information at
such velocity.
DATA MART
SONOGRAPHY PATHOLOGY
PHARMACOLOGY
SCANS
MEDICAL RECORDS
UNSTRUCTURED DATA
SEMI STRUCTURED DATA
FITNESS TRACKERS
IOT SENSORS
EHR/EMR DATA
IMAGER/PACS DATA RESEARCH DATA
STRUCTURED DATA
HISTORIC PATIENT DATA BIOMETRIC
CRM DATATRANSACTION/DATABASE DISCOVERY
SEARCH
STAGE
TRANSFORM
ARCHIVE
DATA LAKE
HIVEHIVE
ANALYTICS REPORTINGDATA MINING
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers9
The metadata captured during data ingestion coupled with the strong data governance and data security
features of the Solix CDP ensure the data in the healthcare data lake is made securely available to the
right people with little or no support from IT. Additionally, the in-depth data preparation features and the
inclusion of advanced open source data processing engines, like Apache Spark and Impala, make the
healthcare data lake an ideal platform for machine learning and advanced healthcare analytics.
Owing to its advanced data storage and data processing capabilities, the healthcare data lake can enable a
wide range of predictive and prescriptive analytics necessary to support delivery of quality healthcare
services leading to better patient outcomes, cost reduction, identification of abuse and fraud, better clinical
research, and more.
Enterprise Archiving and Application Retirement
In a typical enterprise, up to 80 percent
of data in core production applications
is inactive and up to 40 percent of
enterprise applications are rarely used.
This holds true even in the healthcare
industry with large volumes of unused
data in EHR, PACS, ERP systems, and the
many legacy applications occupying the
IT environment.
At a time when organizations are looking
to reduce costs, reallocate resources to
high ROI driven IT activities, enterprise
archiving and application retirement are a boon. As part of enterprise archiving and application retirement,
application data running online is first moved into Tier 2 or Hadoop infrastructure, and then purged from
its source location, according to data retention policies defined as part of the ILM strategy. Archived data
is further classified for security and compliance requirements such as legal hold, and universal access is
provided for business users through role-based structured reports and full text search.
SOLIX ENTERPRISE ARCHIVING
Information Lifecycle Management (ILM)
Data Archiving Application Retirement
• Manage data growth
• Improve application performance
• Improve availability
• Reduce infrastructure costs
• Structured, unstructured data
• Print stream archiving
• Eliminate maintenance cost
• Meet compliance & governance
objectivities
• Data center consolidation
• Print stream retirement
Semi/Unstructured Data
Universal Access
Native
Access
BI Reporting
Analytics
Solix Big Data
Suite
Archiving
Solix EDMS
Database
Archiving
Archive Database
DB
ActiveData
Structured Data
MOVE & COPY
MOVE, COPY, PRINT
Enterprise Business Record
Print Stream Capture
Search & Query Access
Retention Management and Legal Hold
SOLIXCOMMONDATAPLATFORM
Semi-ActiveData
(RDBMS)
InActiveData
(Hadoop ) Reporting/BITools
Solix
BigData
Suite
Solix APM
(Repository, Query, Search)
HISTORIC PATIENT DATA BIOMETRIC
CRM DATA
TRANSACTION/
DATABASE
FITNESS TRACKERS
IOT SENSORS
EHR/EMR DATA
IMAGER/PACS DATA
RESEARCH DATA
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers10
Enterprise archiving and application retirement frees up valuable resources in production environment
and eliminates unnecessary license and maintenance costs. This could translate into millions in potential
savings for a healthcare organization.
Enterprise Business Records (EBRs)
By modeling, ingesting, and managing all types of data into a single Hadoop repository, the Solix CDP
enables the creation of an Enterprise Business Record (EBR). An EBR is a denormalized, point-in-time
snapshot of a business transaction, which may include structured, semi-structured, or unstructured data
elements.
EBRs support both the regulatory and analytic use cases by providing a quick and well-structured access to
complete transactional data along with a history of changes. EBRs are accessible via text or voice search
and Restful APIs.
Data Governance, Security and Compliance
Proper data governance requires that compliance and security measures be in place, and nowhere is data
governance more vital than in the highly regulated healthcare industry. One key question in any patient
privacy audit is who has the access to sensitive information. Each time a hospital employee needs to access
a patient record, proper authentication must occur to ensure that only those with permission to access
records can do so.
Furthermore, all parties must handle data in compliance with the Health Insurance Portability and
Accountability Act (HIPAA) and Security Rule for electronic Protected Health Information (ePHI). Certain
healthcare organizations must adopt HL7 standards and create Healthcare Information Exchanges (HIEs) to
allow for secure submission and retrieval of patient data.
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers11
The Solix CDP provides a robust, multi-layered security model:
•	 Perimeter: Kerberos and AD/LDAP protect the Hadoop cluster with authentication and network
isolation.
•	 Access Control: Apache Sentry manages what the data users and applications can access by roles
based permissions and authorizations.
•	 Encryption/Masking: End-to-end encryption for data when in motion and at rest, tokenization and
data masking to restrict unauthorized usage
•	 Audit: Audit trail and reporting on the complete data lifecycle including security classification,
lineage, access, retention, legal hold, etc.
Additionally, the Information Lifecycle Management (ILM) capability discovers and classifies enterprise
data and then establishes rules and retention policies to manage the data throughout its lifecycle.
Comprehensive retention policies with exception handling such as legal hold and GDPR help further in
meeting complex regulatory and compliance requirements.
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers12
Data-driven Finance - Emagia Receivables Management Suite
The ready-to-deploy Emagia Receivables Management Suite (ERMS) is about finding the most cost efficient
resources to accelerate cash flow. EMRS ensures the most effective receivables, credit policy management,
and automation of credit-to-cash (CTC) and order-to-cash (OTC) processes.
EMRS is a leading data-driven solution helping customers improve their return on cash. With the
introduction of new reimbursement plans (MACRA rules, QPP, MIPS, ACO) a huge amount of data needs
to be analyzed to arrive at an appropriate reimbursement formula to maximize incentives. Emagia Cash
provides enterprise OTC and CTC solutions to transform, automate, and optimize receivables, credit, and
collections.
Furthermore, hospital networks have decentralized silos of financial information, each with separate cash
management systems. By consolidating disparate cash systems with the Solix CDP, EMRS delivers dramatic
credit risk reduction, DSO improvement and cash flow maximization.
Conclusion
Providers now have access to vast amounts of structured, semi-structured, and unstructured data from which
they can potentially identify patterns that could lead to cures for diseases, patient care improvements,
and fraud reduction. To be able to draw meaningful correlations from these patterns, organizations need to
embrace the best of Big Data technologies. Unfortunately, these technologies can be quite complex and
daunting. The good news is Solix CDP is an enterprise grade Big Data management platform that leverages
the best of open source technologies combined with enterprise class data collection, governance, and
discovery features. In a world where data analysis is the key to success and data is measured in exabytes,
the Solix CDP is vital.
Empowering the Data-driven Enterprise
Data-driven Healthcare for Providers13
Solix Technologies, Inc.
4701 Patrick Henry Dr., Bldg 20
Santa Clara, CA 95054
Toll Free:	 +1.888.GO.SOLIX (+1.888.467.6549)
Telephone:	+1.408.654.6400
Fax:		 +1.408.562.0048
URL:		 http://www.solix.com
Copyright ©2017, Solix Technologies and/or its affiliates. All rights reserved.
This document is provided for information purposes only and the contents hereof are subject to change
without notice.
This document is not warranted to be error-free, nor subject to any other warranties or conditions, whether
expressed orally or implied in law, including implied warranties and conditions of merchant- ability or
fitness for a particular purpose.
We specially disclaim any liability with respect to this document and no contractual obligations are formed
either directly or indirectly by this document. This document may not be reproduced or transmitted in any
form or by any means, electronic or mechanical, for any purpose, without our prior written permission.
Solix is a registered trademark of Solix Technologies and/or its affiliates. Other
names may be trademarks of their respectively.
Empowering the Data-driven Enterprise
Forrester Research, Inc., 60 Acorn Park Drive, Cambridge, MA 02140 USA
Tel: +1 617.613.6000 | Fax: +1 617.613.5000 | www.forrester.com
Seven Ways Big Data Improves
Healthcare Outcomes
by Skip Snow, March 25, 2015
For: CIOs
KEY TAKEAWAYS
Mining Genetic Data Reveals New Treatment Approaches
Research scientists crunch big data to discover how gene expression interacts with
the omics environment, which includes our genes and all of the interactions between
molecules, bacterium, and genes that constitute microphysiology. Insights gained from
this data allow researchers to propose new therapies that ameliorate diseases by altering
the genetic environment.
Drug Companies Harvest Social Media Streams To Find Victims Of Rare
Diseases
A great problem in fighting rare disease is diagnosing it. When a vendor can mine social
media to understand whom to rule out as potentially having a rare disease, big data
becomes a powerful clinical tool, shepherding victims of rare disease through a door of
social triage and into a consultation with the correct specialist.
Big Data Fuels A Possible Paradigm Switch For Epidemiology
Google has all but single handedly changed how we do disease surveillance. In the past
six years, it has determined where flu is based on search queries that users enter into
their phones and computers. It is now tackling new diseases, and health ministries
around the world are starting to depend on these results.
New Business Models Emerge As Big Data Fuels Solutions Offered By
Major Healthcare Providers
By harvesting internal and third-party data, tier 1 hospital systems embed insight from
data into software solutions. They seek to monetize it by licensing solutions to other
hospitals. Monetizing data drives partnerships with tech vendors, creating compelling
solutions and accelerating the globalization of care delivery.
© 2015, Forrester Research, Inc. All rights reserved. Unauthorized reproduction is strictly prohibited. Information is based on best available
resources. Opinions reflect judgment at the time and are subject to change. Forrester®
, Technographics®
, Forrester Wave, RoleView, TechRadar,
and Total Economic Impact are trademarks of Forrester Research, Inc. All other trademarks are the property of their respective companies. To
purchase reprints of this document, please email clientsupport@forrester.com. For additional information, go to www.forrester.com.
FOR CIOS
WHY READ THIS REPORT
In the healthcare industry, knowledge driven by big data is changing the shape of research, clinical, and
administrative operations; standards of care; and even fundamental business models. It is providing new
revenue opportunities previously unattainable in healthcare. Healthcare CIOs are at the center of these
groundbreaking initiatives as they struggle to build the business cases for their own programs. However,
they often ask Forrester for examples of big data in practice and the resulting ROI behind successful big data
initiatives. This report catalogs some major applications of big data Forrester has observed in its research.
Table Of Contents
Big Data Insight Feeds A New Data Economy
Individual And Population Data Combine,
Improving Clinical Outcomes
Big Data Powers Breakthroughs In Research
And Epidemiology
Healthcare Payers Add Value-Based Products
Based On Their Unique Data Access
WHAT IT MEANS
Big Data To Provide Revenue For Large
Healthcare Companies
Supplemental Material
Notes & Resources
Forrester interviewed 42 vendor and user
companies for this report.
Related Research Documents
Healthcare Meets Cognitive Computing
February 13, 2015
Healthcare Transformation Is Driving
Disruption For Payers’ Business Capabilities
December 3, 2014
Predictions 2015: The BT Agenda Underpins
Healthcare Transformation
November 17, 2014
Seven Ways Big Data Improves Healthcare
Outcomes
Compelling Business Cases For Big Data
by Skip Snow
with Patti Freeman Evans, Brian Hopkins, Abigail Komlenic, and Shaun McGovern
2
7
8
MARCH 25, 2015
FOR CIOS
Seven Ways Big Data Improves Healthcare Outcomes 2
© 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015
BIG DATA INSIGHT FEEDS A NEW DATA ECONOMY
The healthcare industry has realized data is one of its most valuable assets. Tier 1 institutions
across the healthcare ecosystem innovate by combining unlikely data streams to generate new
insights. Often this process can be turned into new products (e.g., software solutions) that other
healthcare organizations will buy. CIOs are struggling to understand the compelling business cases
that underlie a great deal of these activities. They are often heads-down responding to requests for
data analytics from their workforce without the capacity to respond to the paradigm switch as a
new economy segment within healthcare emerges. Enterprises can win a competitive advantage
by focusing their teams, developing big data initiatives to harness their organization’s unique data
assets. Below we enumerate seven important use cases to stimulate conversations about these
switches that are taking place.
The insights gained facilitate value-based care, inform payers of their reimbursement policies
efficiently, forge new fraud and waste capabilities, help in the discovery of gene interactions, and
change the shape of epidemiology (see Figure 1).
Figure 1 The Three Main Environments Of The Healthcare Ecosystem Seek Common Data Entities
Source: Forrester Research, Inc. Unauthorized reproduction or distribution prohibited.117433
• Finding patients with
rare disease
• Creating clinical test
beds
• Population management
• Health optimization
• Fraud and waste
detection
• Employee behavior
benchmark
Problems
Clinical
Administrative
Care domain
• Finding new drug
therapies
• Finding clinical
care paths
Research
• Claims data
• Clinical data
• Social data
• Epidemiological data
• Consumer behavior data
• Location data
• Criminal history data
• Credit data
• Consumer behavior data
• Omics data
• Molecule pathway data
• Corpus of knowledge
FOR CIOS
Seven Ways Big Data Improves Healthcare Outcomes 3
© 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015
Individual And Population Data Combine, Improving Clinical Outcomes
The perfect storm is brewing. Technology has learned how to find insight from within both
structured and unstructured data, and, because clinical records are now mostly digital, combining
clinical, administrative, and publicly available data often yields unanticipated insight (see Figure
2). Complex pattern-matching algorithms, the need to create a value-based environment, and fast,
inexpensive clusters of commodity computers running open source software have changed what is
possible. Forrester has found examples where big data combined with various other data sources to:
■	Power clinical recommendation engines using electronic medical record data. The University
of Michigan Medical School harnesses intensive care signals and integrates them with their
ICU patient charts. With its partners with IBM and AirStrip Technologies, it mines data and
creates tools that combine bedside real-time facts with clinical rules to signal potential dangers
within the ICU. This solution flags risk and recommends diagnostic and treatment options for
the critically ill patients. Like most of these types of development initiatives, the school uses its
own institution as its spearhead client. It is developing the business programs necessary to bring
these insights to market once it feels confident of the efficacy of the solution.
■	Create an institutional benchmark for cancer treatment.1
Memorial Sloan Kettering Cancer
Center built a longitudinal repository of individuals with cancer with great fidelity. It combined
publicly available Centers for Medicare and Medicaid Services (CMS) data’s administrative facts
such as diagnosis, procedure codes, and provider IDs with clinical facts, such as what cancer
stage, from the National Program of Cancer Registries. This greatly enhances the meaning
of the administrative data allowing the center to compare one institution’s results for similar
cancers to another. The melding of two public data sources to gain insight about the efficacy of
cancer treatment across the US is a significant achievement.
■	Diagnose rare disease by marrying big data and social media communities. Often, clinicians
cannot diagnose people with rare diseases correctly because they have never seen a case in
their practices. Corcept Therapeutics, a niche pharmaceutical company, partners with Liquid
Grid to mine social media for synonyms and semantic equivalents to the clinical descriptions
of Cushing syndrome to promote its therapy Mifepristone.2
According to Liquid Grid’s CEO
Malcolm Bohm:
“We start with our own ontology of medical terms sentiment. We mine Facebook, Twitter,
Tumblr, WordPress, and the metadata of YouTube. This takes no more than a matter of weeks,
and we are ready to use the insight we have on how a lay community describes a condition.”3
FOR CIOS
Seven Ways Big Data Improves Healthcare Outcomes 4
© 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015
Figure 2 Facebook Page Used By Concept Therapeutics To Steer Potential Patients To Doctors
Source: Forrester Research, Inc. Unauthorized reproduction or distribution prohibited.117433
Source: Corcept Therapeutics’ Cushing’s Connection Facebook page
FOR CIOS
Seven Ways Big Data Improves Healthcare Outcomes 5
© 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015
Big Data Powers Breakthroughs In Research And Epidemiology
Big data can speed time-to-market for therapies, and novel ways of doing disease surveillance
foretell a new paradigm in epidemiology:
■	Labs use big data to disrupt traditional research models and methods. Mount Sinai Hospital
has invested heavily in data scientists and equipment, creating a “dry lab” infrastructure.4
They use
computer and data science to uncover networks of interactions, revealing new targets for genetic
interventions. Clinical trials are already underway as the output of several dry lab discoveries.
Unlike traditional genetic research using computers to sequence genes and human intellect to
interpret the meaning of these sequences, computers with knowledge of what drugs do to target
gene expression suggest possible therapies to the clinicians based on gene network pathology.
Mount Sinai plans to monetize its best-of-breed ability to find patterns in the genetic data.5
■	Google’s disease surveillance invigorates epidemiology. Google parses its search stream to
detect disease instances, e.g., number of dengue fever and flu cases in many nations of the world.
Google works with major academic research institutions and public health officials to curate and
validate its epidemiology algorithms. The company also uses national epidemiology databases
to benchmark and validate its results. Over the six-year span of the project, Google’s results
have become quite accurate.6
The health departments of nations that do not have surveillance
infrastructures seem to depend on Google’s weekly updates on dengue fever.7
The potential to
change the game in epidemiology is real, and we have seen at least one startup that is trying to
capitalize on these business ideas (see Figure 3).
FOR CIOS
Seven Ways Big Data Improves Healthcare Outcomes 6
© 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015
Figure 3 Google Has Hit The Mark For US Flu Prediction As Compared With CDC Data
Source: Forrester Research, Inc. Unauthorized reproduction or distribution prohibited.117433
Note: Google and the Google logo are registered trademarks of Google, Inc., used with permission.
Google flu
Data source: Google Flu Trends (http://www.google.org/flutrends)
FOR CIOS
Seven Ways Big Data Improves Healthcare Outcomes 7
© 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015
Healthcare Payers Add Value-Based Products Based On Their Unique Data Access
As CIOs become more embedded in their organizations’ customer-facing initiatives, they will
find many opportunities to drive customer value, and thus revenue, via big data. Whether it is in
population management or fraud detection, big data initiatives provide new value and ways to
reduce costs in providing care:
■	Health insurance companies target waste and fraud with big data solutions. The insurance
industry is a leader in fraud detection. It rivals the credit card industry in detecting patterns in
data that indicates fraud. Harvard Pilgrim Health Care uses LexisNexis’ Intelligent Investigator
to ferret out fraud. It links unexpected relationships between a provider billing address and risky
individuals associated with that address to uncover more “bad guys.” The program has helped
the organization initiate many new criminal and civil investigations.
■	Pacific Blue Cross preserves privacy and provides aggregated reports to large employers.
Privacy concerns make it impossible for employers to gain access to their staff’s health records.
Pacific Blue Cross creates reports for large companies showing patterns of opportunities to
optimize staff health without exposing employees’ individual health data.8
Such advances in
data-driven, value-based products will differentiate insurance companies for the next decade as
less competent competitors strive to catch up.
W H AT I T M E A N S
BIG DATA TO PROVIDE REVENUE FOR LARGE HEALTHCARE COMPANIES
Big data will be a major driver altering the operational models of healthcare. Developing these
solutions is expensive. New forms to monetize these solutions evolve to fund the necessary
investments. New organizational models are emerging; for example, we see health companies that
traditionally only sell hospital beds to consumers hiring business-to-business (B2B) marketing
staffs. Technology vendors with global reach are looking to the major centers of excellence in care
management to create cobranded products that embed insight locked up in data. Over the next 15
years, the increased globalization of care delivery tools fueled by big data will accelerate. As trends
like retail medicine continue to mature, the data itself will allow clinical standards to evolve. These
standards will be available for economically and geographically challenged communities consuming
these solutions. The successful CIO in large healthcare companies increasingly will run business
units selling solutions. The hiring practices for BT executives is evolving; former software and
consulting executives increasingly are being recruited by traditional technology buyers now turning
into solution vendors.
FOR CIOS
Seven Ways Big Data Improves Healthcare Outcomes 8
© 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015
SUPPLEMENTAL MATERIAL
Companies Interviewed For This Report
Accenture
Aetna
Anthem Insurance
Ayasdi
Blue Shield of California
CitiusTech
Cognizant
Corcept Therapeutics
Dell
Elsevier
Epic Systems
Explorys
Google
Harvard Pilgrim Health Care
HCL Technologies
Health Integrated
IBM
Informatica
InterSystems
Kaiser Permanente
Koninklijke Philips
KPMG
McKesson
Memorial Sloan Kettering Cancer Center
Mercy Hospital
Mount Sinai Hospital
MVP Health Care
Nuance Communications
Optum
Orion Health
Pacific Blue Cross Health Benefits Society
Practice Fusion
PwC
SAS
United Healthcare
United States Department of Health and Human
Services
University of Michigan Medical School
Verisk Health
Virtual Radiologic
Webtrends
West
ZirMed
FOR CIOS
Seven Ways Big Data Improves Healthcare Outcomes 9
© 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015
ENDNOTES
1
	 Memorial Sloan Kettering Cancer Center combined data from the national cancer registry and
administrative claims data for Medicare patients from the CMS. Source: Forrester interview with John
Gunn, COO of Memorial Sloan Kettering Cancer Center, September 2014.
2
	 Check out Medscape for epidemiology on almost any disease. Source: David S. Liebeskind, MD,
“Hemorrhagic Stroke,” Medscape, January 8, 2015 (http://emedicine.medscape.com/article/1916662-
overview#a0156) and Gail K. Adler, MD, “Cushing Syndrome,” Medscape, April 4, 2014 (http://emedicine.
medscape.com/article/117365-overview#aw2aab6b2b4aa).
3
	 Source: Forrester interview with Liquid Grid, Q3 2014.
4
	 A dry lab is an increasingly important term of art in the biomedical research world. It refers to a lab that
consists of computers and computer models that pour over clinical and other data to find patterns of insight.
5
	 For more information on cognitive computing, see the February 13, 2015, “Healthcare Meets Cognitive
Computing” report.
6
	 For more information on Google’s work with the flu, see the June 20, 2014, “Google Flu Trends — A Big
Data Fail? Not Exactly” report.
7
	 Google is working with new data sources in the lab to refine its results. It is collaborating in the academic
and public health spheres to refine its results. Yet it has no current plans to monetize these innovations. In
an interview with Steve Crossan, Google’s product manager for disease surveillance, told Forrester: “We are
lucky enough not to need a business model to measure the work we are doing. We are not trying to build
a business around public health surveillance.” He went on to say that when its cycle runs slowly, it does get
feedback from the countries that need the data because it does not have public surveillance for diseases.
8
	 This information was gathered in an interview with Cindy Bratkowski, senior vice president, information
technology and client services, and Akiko Campbell, director, innovation center and security officer at
Pacific Blue Cross in September 2014.
Forrester Research (Nasdaq: FORR) is a global research and advisory firm serving professionals in 13 key roles across three distinct client
segments. Our clients face progressively complex business and technology decisions every day. To help them understand, strategize, and act
upon opportunities brought by change, Forrester provides proprietary research, consumer and business data, custom consulting, events and
online communities, and peer-to-peer executive programs. We guide leaders in business technology, marketing and strategy, and the technology
industry through independent fact-based insight, ensuring their business success today and tomorrow.	 117433
«
Forrester Focuses On
CIOs
As a leader, you are responsible for managing today’s competing
demands on IT while setting strategy with business peers and
transforming your organizations to drive business innovation.
Forrester’s subject-matter expertise and deep understanding of your
role will help you create forward-thinking strategies; weigh opportunity
against risk; justify decisions; and optimize your individual, team, and
corporate performance.
CAROL ITO, client persona representing CIOs
About Forrester
A global research and advisory firm, Forrester inspires leaders,
informs better decisions, and helps the world’s top companies turn
the complexity of change into business advantage. Our research-
based insight and objective advice enable IT professionals to
lead more successfully within IT and extend their impact beyond
the traditional IT organization. Tailored to your individual role, our
resources allow you to focus on important business issues —
margin, speed, growth — first, technology second.
FOR MORE INFORMATION
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Data driven Healthcare for Providers

  • 1. Includes Forrester Research report, ‘Seven Ways Big Data Improves Healthcare Outcomes’ Empowering the Data-driven Enterprise
  • 2. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers2 EXECUTIVE SUMMARY Healthcare data and its impact upon the patient care decision process via accurate, real-time, reliable data from disparate sources is creating a digital health revolution. Physician groups, nursing facilities, hospitals, pharmaceutical companies, clinical researchers, and medical equipment manufacturers are all churning out vast amounts of data during their daily operations. This data has tremendous value and can revolutionize patient care, diagnosis, real-time decisions and help deliver new, unimagined innovations with quality of patient care. Data-driven healthcare is beginning to have a huge impact addressing the challenges of every provider, through efficient handling of huge volumes of patient care data. Patient-centered healthcare is gearing for a 360-degree understanding of the patient. The key to improved health outcomes lies in understanding the patient’s financial, social, and behavioral context. It requires integration of new, semi-structured and unstructured data types such as video, medical imaging, doctors’ free-form notes, other text documents and data from wearable medical devices, etc. This data cannot fit into the traditional data models. Big Data analysis can quickly and easily provide evidence to fine tune the quality of care for a patient, leading to tremendous healthcare efficiencies and a healthier world of tomorrow. The tremendous opportunity of a data-driven strategy is apparent to providers and the patient care ecosystem, but all these informational assets exhibiting volume, variety, and velocity need to be ingested and analyzed for enhanced insight leading to better business decisions for quality of patient care. Data-driven technology solution such as the Solix Common Data Platform (CDP) provides a next generation data management platform that not only meets the analytic demands of the data-driven organization but also addresses the cost, compliance, and governance challenges that come along. The Solix CDP combines human and computer analysis based on huge volumes of data to produce optimal decisions at every level of the healthcare business. Providers can take complete advantage of the data-driven healthcare revolution by adopting such a technology foundation significantly enhancing patient care, and achieve tremendous efficiencies themselves. Healthcare Revolution and Challenges En Route We are witnessing a data-driven healthcare revolution with widespread digitization of electronic health record systems. But with compelling opportunities, we also see massive data volumes, evolving patient expectations, and expanding regulations. Data in varying formats from an increasing array of sources must be integrated to ensure optimal outcomes, whether obtaining a diagnosis, ensuring accurate claims processing, developing new pharmaceutical treatments, or addressing regulatory challenges. To accelerate this healthcare revolution, the industry has to manage key challenges such as government regulations, information security, privacy protocols, changing technology landscape (such as electronic health records, data analytics), while also containing the cost of rolling out new drugs, plans, and products into the healthcare market. Government healthcare programs are growing rapidly and cannot be ignored. The healthcare organization’s need to comply with government requirements such as accountability, the performance improvement mandate, and evidence-based outcomes, will require considering technology options to create efficiencies. Payers, providers, the pharmaceutical industry and medical equipment suppliers have unique challenges that are largely intertwined and require a concerted industry plan crafted in unison.
  • 3. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers3 Providers need to move towards real-time analytics that have become critical to demonstrate their quality of care, as reimbursement by government programs can be contingent upon how providers are measured in “Quality of Care”. For example, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, also called the Permanent Doc Fix, changes the way Medicare doctors are reimbursed with the implementation of a merit based incentive. The performance-based pressure is huge, which makes it imperative that every provider consider technology solutions. Technology adoption can enhance decision-making based upon real-time analytics, along with a complete view of the patient’s life, contributing to a high quality of care. The constant pressure of competition and the need for cost control to stay viable also lends credence to the value of decisions based upon data. The U.S. Government Accountability Office in partnership with the Department of Health and Human Services (DHHS) is looking into implementing a nationwide electronic health record. Providers need to be able to exchange patient information to support out of network care and take smart decisions to meet patient needs. Data-driven Healthcare Can Help Overcome Industry Challenges The healthcare industry has recognized the emerging challenges well, is reconciled to the new versus traditional business model, and is embracing the technology innovation that will position players for long-term success. Every healthcare ecosystem partner will need to optimize its business models, grow its customer base, address regulatory pressures with emerging technologies such as artificial intelligence, machine learning, block chain, and virtual reality, along with data mining, Big Data, and analytics-based approaches. Data powered tools can accelerate this healthcare revolution with innovations shaping and improving the healthcare system to respond better to patient needs via accurate, collated, aggregated, and meaningful data that provides information and actionable insights for every segment. Medical practitioners need tools that can respond on demand to provide recommendations incorporating all the existing data and the latest medical research, be it at the bedside or while the patient is sitting in the doctor’s office. Addressing the demand for accurate, reliable data is key to success. Healthcare data is created at the source by providers such as physician groups, pharmacies and medical equipment manufacturers. Ultimately, some of this financial, clinical, and administrative information ends up with the payer, third party vendors, and government agencies. Mounting pressure on operating margins Complex healthcare regulations Lack of interoperability among major healthcare software providers Costs associated with massive growth in healthcare data volume The need to integrate external medical data sources Data security and the risk of ransomware T Providers CHALLENGES
  • 4. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers4 But the challenge lies in how we come to grips with the explosion of data and make it available in a usable form to practitioners including nurses at a station, a scientists researching cures, insurance underwriters designing new health insurance products, and private individuals trying to pick the right plan to manage their family’s specific healthcare needs. The current landscape of healthcare systems is complicated and fragmented across the industry with many data sources. The cost and complexity of integrating, managing, and storing exabytes of data is a constant issue for everyone within the healthcare ecosystem. Even within a single hospital facility, multiple disparate systems exist that have a variety of data formats that make integrating, exchanging, and harnessing data a challenge. In a multi-facility network, with the imperative to exchange patient relevant information among systems and providers, the array of systems grows even further. Analyzing all this critical data from all these facilities and staging them for advanced integration and analytics is hard but very fruitful. The alternative is to go without knowledge of the full arc of the patient experience. That will have consequences including missed financial opportunities and increased data security and compliance risk from regulatory regimes including HIPAA, GDPR, and others. 1 The industry finds it imperative to capture and store all sorts of data that will provide the ability to run a 360-degree analysis of the patient, with an optimal patient care recommendation. The new definition of data includes free-form text such as doctors’ notes, radiologists’ reports, medical journal articles with the latest findings and discoveries, emails, still images such as CAT scans, videos, recorded speech, patient historic data, social media data, genome files, biometric, and other scientific data from clinical research and drug development. It also includes data from stand-alone systems - EMR, PACS, RTHS, EMPI, LIS and PMS, and Internet-of-Things (IoT) data from wearables, medical devices, respirators, blood pressure monitors, and other connected devices. All together the resulting insights can contribute to the 360-degree view of the patient, making a huge difference in the quality of care. There is an estimated 50 petabytes of data in the healthcare realm, predicted to grow to 25,000 petabytes by 2020.2 There are many new systems including wearables and mobile apps rolled out daily, that are adding velocity to the data growth. But there is value only if we can analyze this data quickly and effectively. The healthcare industry has realized quickly that extracting more meaningful insights via Big Data can make a tremendous difference. 1 http://www.zdnet.com/article/solix-launches-healthcare-data-management-platform-based-on-Hadoop/ 2 http://www.scribd.com/doc/107279699/Big-Data-in-Healthcare-Hype-and-Hope
  • 5. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers5 Big Data Can Revolutionize all the Healthcare segments The healthcare world has created a volume, variety and velocity of healthcare data, a unique trifecta that, once addressed, can make huge strides in healthcare decision-making and patient care. The volume of data in healthcare, a lack of standardization of healthcare data from various sources such as providers, payers, disease- management groups, social media, medical laboratories, personalized genetic testing companies, patients’ personal information, along with the need for urgency and real-time analytics that could potentially save lives, makes Big Data ideally suited to work its magic in healthcare. Big Data can be applied to prevent deaths, identify medical conflicts, even predict epidemics and cure diseases. It can proactively identify a child’s potential upcoming health issues and recommend protective measures, and chart out a plan to alleviate the spend in healthcare disbursements over the child’s lifespan. Big Data and advanced analytics can improve healthcare decisions on patient care at all levels, from supporting Real-Time Health Systems (RTHS) to all forms of digital medicine. Big Data can reduce the cost of healthcare and of insurance significantly, helping to make a huge expansion of healthcare coverage a reality. Decision algorithms can provide an additional layer of support and interaction with the patient, in addition to the doctor. Big Data analysis can incorporate patient lab results, the longitudinal patient record, medical imaging, etc., to make treatment recommendations, providing better treatment while relieving the busy, overtly stretched medical professional from hours of work, allowing her to focus on higher value activities. Providers can optimize their existing offerings by leveraging intelligent data-driven strategies to reduce soaring healthcare costs. Big Data analysis can optimize provider resources, distributing it among patients based on their condition and specific need. For the payer, application areas range from fraud detection to real-time continuous patient monitoring outside the clinical setting using personal/ IoT sensors. Other verticals have successfully targeted customers with campaigns that have increased business. The healthcare industry can do the same, but in this case to provide better patient care, to optimize existing resources, and ultimately increase revenue, providing immense benefit to the patients. BIG DATA BENEFITS Mine Patient data to improve care Predict adverse outcome Determine populations at risk for illness Pinpoint where education and prevention is need Detect medical fraud Reduce Readmission Identify procedures likely to succeed Customer experience Supply chain optimization; timely deliveries Reduce the cost to care for by predictive maintenance insights Provide additional insights to end-user; Upsell Ensure even utilization and wear and tear of machines Accelerated drug discovery Targeted Marketing Reduce drug fatalities via predictive modeling Patient compliance via IOT devices Payer Medical Equipment Pharma Provider
  • 6. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers6 Hospitals are starting to apply Big Data to sift through complex variables such as lab tests, family history, and diagnosis, taking into account a variety of disparate data elements, in some cases to provide proactive intervention with a patient to head off a long-term costly health challenge. Payers are leveraging Big Data analysis to identify and prevent medical fraud early, saving billions annually. Pharmaceutical companies are leveraging Big Data to streamline and reduce the cost of screening compounds in drugs discovery research. Predictive analysis models working on massive virtual databases of molecular and clinical data can accelerate the process and reduce cost, identify risk factors and can optimize yield from the drug manufacturing process. Big Data’s impact upon order management for medical equipment manufacturers can improve demand planning, identify customer behaviors, and provide insights to deliver goods in a timely fashion. These are only some of the many use cases that benefit from applying Big Data. Big Data Needs a Big Technology Shift Traditionally, organizations depended on the Enterprise Data Warehouses (EDW) for all their analytic and business intelligence requirements. However, with the rapidly evolving analytics landscape and the adoption of Big Data, traditional EDWs are falling short of the capabilities needed. Not only are EDWs prohibitively expensive, they lack the ability to store and process unstructured data, and the healthcare industry has more unstructured than structured data. Additionally, due to its schema-on-write requirement, EDWs cannot support the ad-hoc rapid exploration of data which is now become a key requirement of every data driven organization. Big Data in Action Power clinical recommendation engines using electronic medical record data. The University of Michigan Medical School harnesses intensive care signals and integrates them with their ICU patient charts. It mines data and creates tools that combine bedside real-time facts with clinical rules to signal potential dangers within the ICU. This solution flags risk and recommends diagnostic and treatment options for the critically ill patients. Like most of these types of development initiatives, the school uses its own institution as its spearhead client. It is developing the business programs necessary to bring these insights to market once it feels confident of the efficacy of the solution. Create an institutional benchmark for cancer treatment. Memorial Sloan Kettering Cancer Center built a longitudinal repository of individuals with cancer with great fidelity. It combined publicly available Centers for Medicare and Medicaid Services (CMS) data’s administrative facts such as diagnosis, procedure codes, and provider IDs with clinical facts, such as what cancer stage, from the National Program of Cancer Registries. This greatly enhances the meaning of the administrative data allowing the center to compare one institution’s results for similar cancers to another. The melding of two public data sources to gain insight about the efficacy of cancer treatment across the US is a significant achievement. Ref: Forrester Research report, ‘Seven Ways Big Data Improves Healthcare Outcomes’ (included)
  • 7. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers7 A Big Data technology platform such as Apache Hadoop provides in-built advantages to help realize the data-driven healthcare vision by ingesting a wide variety of healthcare data, whether structured, semi- structured, or unstructured, in a single repository in low cost bulk storage, eliminating costly and slow ETL processes. The data is stored “as-is” and applies a schema on read. This allows ad-hoc analytic query and in-memory processing in real-time as and when needed. Apache Hadoop also provides massively scalable distributed processing, which is required for complex machine learning and analytic use cases. Finally, Hadoop enables advanced text and voice search, structured queries and advanced analysis tools working seamlessly against multiple data types and formats. Hadoop provides the ability to ask ad-hoc questions to get quick responses, along with the ability to drill down to precise information based upon a natural language search. However, Apache Hadoop does not provide enterprise grade capabilities such as codeless data ingestion, metadata management, Information Lifecycle Management (ILM), data governance and security. Additionally, the constantly evolving Hadoop ecosystem makes it a daunting task for enterprises to identify which newer Hadoop technologies are worth incorporating as part of their Hadoop cluster. What exacerbates the problem is that Apache open source technologies are not designed to work together and have no industry standard interfaces, making building a full technology stack a daunting task requiring scarce skills. Organizations need an enterprise grade Big Data management system built on Apache Hadoop such as the Solix Common Data Platform (CDP) for Healthcare. Introducing Solix Common Data Platform (CDP) for Healthcare The Solix Common Data Platform (CDP) is a highly scalable and robust next-generation Big Data management platform that features uniform data collection, metadata management, data governance, ILM, data security, data discovery, and a full set of interfaces to support plug-and-play stack creation and modernization. It leverages the high-performance and low-cost characteristics of the open source Apache Hadoop framework to allow economical storage and real-time processing of petabytes of structured and unstructured healthcare data.
  • 8. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers8 Solix CDP stores data “as-is” to eliminate costly ETL operations during data ingestion and provides an ability to transform data post-ingestion to feed the unique needs of downstream NoSQL and analytic applications. It includes modern Big Data processing engines like Apache Spark, Impala and Hive, to meet the machine learning and advanced analytic needs of today’s real-time Data-driven organizations. With a built-in enterprise data lake, enterprise archiving, application retirement, and eDiscovery solutions, Solix CDP provides organizations with an unparalleled enterprise data management and analytic tools and framework. This makes it possible for organizations to leverage data for effective medical diagnosis, clinical trials, drug discovery, and fraud prevention, while saving on storage costs and complying with complex healthcare regulations (including HIPPA, HITECH, CFR etc.). Solix CDP is certified to operate with both the Cloudera and Hortonworks Hadoop distributions. Additionally, it can be deployed on-prem or on the cloud (supports AWS, Azure, Oracle and Google cloud). Solutions Overview: Enterprise Data Lake for Machine Learning and Advanced Analytics The Solix CDP-enabled healthcare data lake is a self-contained enterprise data hub that provides robust data collection, data governance and data preparation tools with self-service visualization and business intelligence. It provides authorized data consumers with a singular repository of structured and unstructured healthcare data from a wide range of data sources including EHR, PACS, health trackers, diagnostic equipment, published research, and more. This data is captured into the repository by Solix CDP in an “as is” form along with its associated metadata. This eliminates the need for costly ETL during the ingestion process, while making it easy to discover, understand, and consume data. It would be nearly impossible and extremely expensive for any traditional EDW to incorporate such variety and large volume of information at such velocity. DATA MART SONOGRAPHY PATHOLOGY PHARMACOLOGY SCANS MEDICAL RECORDS UNSTRUCTURED DATA SEMI STRUCTURED DATA FITNESS TRACKERS IOT SENSORS EHR/EMR DATA IMAGER/PACS DATA RESEARCH DATA STRUCTURED DATA HISTORIC PATIENT DATA BIOMETRIC CRM DATATRANSACTION/DATABASE DISCOVERY SEARCH STAGE TRANSFORM ARCHIVE DATA LAKE HIVEHIVE ANALYTICS REPORTINGDATA MINING
  • 9. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers9 The metadata captured during data ingestion coupled with the strong data governance and data security features of the Solix CDP ensure the data in the healthcare data lake is made securely available to the right people with little or no support from IT. Additionally, the in-depth data preparation features and the inclusion of advanced open source data processing engines, like Apache Spark and Impala, make the healthcare data lake an ideal platform for machine learning and advanced healthcare analytics. Owing to its advanced data storage and data processing capabilities, the healthcare data lake can enable a wide range of predictive and prescriptive analytics necessary to support delivery of quality healthcare services leading to better patient outcomes, cost reduction, identification of abuse and fraud, better clinical research, and more. Enterprise Archiving and Application Retirement In a typical enterprise, up to 80 percent of data in core production applications is inactive and up to 40 percent of enterprise applications are rarely used. This holds true even in the healthcare industry with large volumes of unused data in EHR, PACS, ERP systems, and the many legacy applications occupying the IT environment. At a time when organizations are looking to reduce costs, reallocate resources to high ROI driven IT activities, enterprise archiving and application retirement are a boon. As part of enterprise archiving and application retirement, application data running online is first moved into Tier 2 or Hadoop infrastructure, and then purged from its source location, according to data retention policies defined as part of the ILM strategy. Archived data is further classified for security and compliance requirements such as legal hold, and universal access is provided for business users through role-based structured reports and full text search. SOLIX ENTERPRISE ARCHIVING Information Lifecycle Management (ILM) Data Archiving Application Retirement • Manage data growth • Improve application performance • Improve availability • Reduce infrastructure costs • Structured, unstructured data • Print stream archiving • Eliminate maintenance cost • Meet compliance & governance objectivities • Data center consolidation • Print stream retirement Semi/Unstructured Data Universal Access Native Access BI Reporting Analytics Solix Big Data Suite Archiving Solix EDMS Database Archiving Archive Database DB ActiveData Structured Data MOVE & COPY MOVE, COPY, PRINT Enterprise Business Record Print Stream Capture Search & Query Access Retention Management and Legal Hold SOLIXCOMMONDATAPLATFORM Semi-ActiveData (RDBMS) InActiveData (Hadoop ) Reporting/BITools Solix BigData Suite Solix APM (Repository, Query, Search) HISTORIC PATIENT DATA BIOMETRIC CRM DATA TRANSACTION/ DATABASE FITNESS TRACKERS IOT SENSORS EHR/EMR DATA IMAGER/PACS DATA RESEARCH DATA
  • 10. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers10 Enterprise archiving and application retirement frees up valuable resources in production environment and eliminates unnecessary license and maintenance costs. This could translate into millions in potential savings for a healthcare organization. Enterprise Business Records (EBRs) By modeling, ingesting, and managing all types of data into a single Hadoop repository, the Solix CDP enables the creation of an Enterprise Business Record (EBR). An EBR is a denormalized, point-in-time snapshot of a business transaction, which may include structured, semi-structured, or unstructured data elements. EBRs support both the regulatory and analytic use cases by providing a quick and well-structured access to complete transactional data along with a history of changes. EBRs are accessible via text or voice search and Restful APIs. Data Governance, Security and Compliance Proper data governance requires that compliance and security measures be in place, and nowhere is data governance more vital than in the highly regulated healthcare industry. One key question in any patient privacy audit is who has the access to sensitive information. Each time a hospital employee needs to access a patient record, proper authentication must occur to ensure that only those with permission to access records can do so. Furthermore, all parties must handle data in compliance with the Health Insurance Portability and Accountability Act (HIPAA) and Security Rule for electronic Protected Health Information (ePHI). Certain healthcare organizations must adopt HL7 standards and create Healthcare Information Exchanges (HIEs) to allow for secure submission and retrieval of patient data.
  • 11. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers11 The Solix CDP provides a robust, multi-layered security model: • Perimeter: Kerberos and AD/LDAP protect the Hadoop cluster with authentication and network isolation. • Access Control: Apache Sentry manages what the data users and applications can access by roles based permissions and authorizations. • Encryption/Masking: End-to-end encryption for data when in motion and at rest, tokenization and data masking to restrict unauthorized usage • Audit: Audit trail and reporting on the complete data lifecycle including security classification, lineage, access, retention, legal hold, etc. Additionally, the Information Lifecycle Management (ILM) capability discovers and classifies enterprise data and then establishes rules and retention policies to manage the data throughout its lifecycle. Comprehensive retention policies with exception handling such as legal hold and GDPR help further in meeting complex regulatory and compliance requirements.
  • 12. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers12 Data-driven Finance - Emagia Receivables Management Suite The ready-to-deploy Emagia Receivables Management Suite (ERMS) is about finding the most cost efficient resources to accelerate cash flow. EMRS ensures the most effective receivables, credit policy management, and automation of credit-to-cash (CTC) and order-to-cash (OTC) processes. EMRS is a leading data-driven solution helping customers improve their return on cash. With the introduction of new reimbursement plans (MACRA rules, QPP, MIPS, ACO) a huge amount of data needs to be analyzed to arrive at an appropriate reimbursement formula to maximize incentives. Emagia Cash provides enterprise OTC and CTC solutions to transform, automate, and optimize receivables, credit, and collections. Furthermore, hospital networks have decentralized silos of financial information, each with separate cash management systems. By consolidating disparate cash systems with the Solix CDP, EMRS delivers dramatic credit risk reduction, DSO improvement and cash flow maximization. Conclusion Providers now have access to vast amounts of structured, semi-structured, and unstructured data from which they can potentially identify patterns that could lead to cures for diseases, patient care improvements, and fraud reduction. To be able to draw meaningful correlations from these patterns, organizations need to embrace the best of Big Data technologies. Unfortunately, these technologies can be quite complex and daunting. The good news is Solix CDP is an enterprise grade Big Data management platform that leverages the best of open source technologies combined with enterprise class data collection, governance, and discovery features. In a world where data analysis is the key to success and data is measured in exabytes, the Solix CDP is vital.
  • 13. Empowering the Data-driven Enterprise Data-driven Healthcare for Providers13 Solix Technologies, Inc. 4701 Patrick Henry Dr., Bldg 20 Santa Clara, CA 95054 Toll Free: +1.888.GO.SOLIX (+1.888.467.6549) Telephone: +1.408.654.6400 Fax: +1.408.562.0048 URL: http://www.solix.com Copyright ©2017, Solix Technologies and/or its affiliates. All rights reserved. This document is provided for information purposes only and the contents hereof are subject to change without notice. This document is not warranted to be error-free, nor subject to any other warranties or conditions, whether expressed orally or implied in law, including implied warranties and conditions of merchant- ability or fitness for a particular purpose. We specially disclaim any liability with respect to this document and no contractual obligations are formed either directly or indirectly by this document. This document may not be reproduced or transmitted in any form or by any means, electronic or mechanical, for any purpose, without our prior written permission. Solix is a registered trademark of Solix Technologies and/or its affiliates. Other names may be trademarks of their respectively. Empowering the Data-driven Enterprise
  • 14. Forrester Research, Inc., 60 Acorn Park Drive, Cambridge, MA 02140 USA Tel: +1 617.613.6000 | Fax: +1 617.613.5000 | www.forrester.com Seven Ways Big Data Improves Healthcare Outcomes by Skip Snow, March 25, 2015 For: CIOs KEY TAKEAWAYS Mining Genetic Data Reveals New Treatment Approaches Research scientists crunch big data to discover how gene expression interacts with the omics environment, which includes our genes and all of the interactions between molecules, bacterium, and genes that constitute microphysiology. Insights gained from this data allow researchers to propose new therapies that ameliorate diseases by altering the genetic environment. Drug Companies Harvest Social Media Streams To Find Victims Of Rare Diseases A great problem in fighting rare disease is diagnosing it. When a vendor can mine social media to understand whom to rule out as potentially having a rare disease, big data becomes a powerful clinical tool, shepherding victims of rare disease through a door of social triage and into a consultation with the correct specialist. Big Data Fuels A Possible Paradigm Switch For Epidemiology Google has all but single handedly changed how we do disease surveillance. In the past six years, it has determined where flu is based on search queries that users enter into their phones and computers. It is now tackling new diseases, and health ministries around the world are starting to depend on these results. New Business Models Emerge As Big Data Fuels Solutions Offered By Major Healthcare Providers By harvesting internal and third-party data, tier 1 hospital systems embed insight from data into software solutions. They seek to monetize it by licensing solutions to other hospitals. Monetizing data drives partnerships with tech vendors, creating compelling solutions and accelerating the globalization of care delivery.
  • 15. © 2015, Forrester Research, Inc. All rights reserved. Unauthorized reproduction is strictly prohibited. Information is based on best available resources. Opinions reflect judgment at the time and are subject to change. Forrester® , Technographics® , Forrester Wave, RoleView, TechRadar, and Total Economic Impact are trademarks of Forrester Research, Inc. All other trademarks are the property of their respective companies. To purchase reprints of this document, please email clientsupport@forrester.com. For additional information, go to www.forrester.com. FOR CIOS WHY READ THIS REPORT In the healthcare industry, knowledge driven by big data is changing the shape of research, clinical, and administrative operations; standards of care; and even fundamental business models. It is providing new revenue opportunities previously unattainable in healthcare. Healthcare CIOs are at the center of these groundbreaking initiatives as they struggle to build the business cases for their own programs. However, they often ask Forrester for examples of big data in practice and the resulting ROI behind successful big data initiatives. This report catalogs some major applications of big data Forrester has observed in its research. Table Of Contents Big Data Insight Feeds A New Data Economy Individual And Population Data Combine, Improving Clinical Outcomes Big Data Powers Breakthroughs In Research And Epidemiology Healthcare Payers Add Value-Based Products Based On Their Unique Data Access WHAT IT MEANS Big Data To Provide Revenue For Large Healthcare Companies Supplemental Material Notes & Resources Forrester interviewed 42 vendor and user companies for this report. Related Research Documents Healthcare Meets Cognitive Computing February 13, 2015 Healthcare Transformation Is Driving Disruption For Payers’ Business Capabilities December 3, 2014 Predictions 2015: The BT Agenda Underpins Healthcare Transformation November 17, 2014 Seven Ways Big Data Improves Healthcare Outcomes Compelling Business Cases For Big Data by Skip Snow with Patti Freeman Evans, Brian Hopkins, Abigail Komlenic, and Shaun McGovern 2 7 8 MARCH 25, 2015
  • 16. FOR CIOS Seven Ways Big Data Improves Healthcare Outcomes 2 © 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015 BIG DATA INSIGHT FEEDS A NEW DATA ECONOMY The healthcare industry has realized data is one of its most valuable assets. Tier 1 institutions across the healthcare ecosystem innovate by combining unlikely data streams to generate new insights. Often this process can be turned into new products (e.g., software solutions) that other healthcare organizations will buy. CIOs are struggling to understand the compelling business cases that underlie a great deal of these activities. They are often heads-down responding to requests for data analytics from their workforce without the capacity to respond to the paradigm switch as a new economy segment within healthcare emerges. Enterprises can win a competitive advantage by focusing their teams, developing big data initiatives to harness their organization’s unique data assets. Below we enumerate seven important use cases to stimulate conversations about these switches that are taking place. The insights gained facilitate value-based care, inform payers of their reimbursement policies efficiently, forge new fraud and waste capabilities, help in the discovery of gene interactions, and change the shape of epidemiology (see Figure 1). Figure 1 The Three Main Environments Of The Healthcare Ecosystem Seek Common Data Entities Source: Forrester Research, Inc. Unauthorized reproduction or distribution prohibited.117433 • Finding patients with rare disease • Creating clinical test beds • Population management • Health optimization • Fraud and waste detection • Employee behavior benchmark Problems Clinical Administrative Care domain • Finding new drug therapies • Finding clinical care paths Research • Claims data • Clinical data • Social data • Epidemiological data • Consumer behavior data • Location data • Criminal history data • Credit data • Consumer behavior data • Omics data • Molecule pathway data • Corpus of knowledge
  • 17. FOR CIOS Seven Ways Big Data Improves Healthcare Outcomes 3 © 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015 Individual And Population Data Combine, Improving Clinical Outcomes The perfect storm is brewing. Technology has learned how to find insight from within both structured and unstructured data, and, because clinical records are now mostly digital, combining clinical, administrative, and publicly available data often yields unanticipated insight (see Figure 2). Complex pattern-matching algorithms, the need to create a value-based environment, and fast, inexpensive clusters of commodity computers running open source software have changed what is possible. Forrester has found examples where big data combined with various other data sources to: ■ Power clinical recommendation engines using electronic medical record data. The University of Michigan Medical School harnesses intensive care signals and integrates them with their ICU patient charts. With its partners with IBM and AirStrip Technologies, it mines data and creates tools that combine bedside real-time facts with clinical rules to signal potential dangers within the ICU. This solution flags risk and recommends diagnostic and treatment options for the critically ill patients. Like most of these types of development initiatives, the school uses its own institution as its spearhead client. It is developing the business programs necessary to bring these insights to market once it feels confident of the efficacy of the solution. ■ Create an institutional benchmark for cancer treatment.1 Memorial Sloan Kettering Cancer Center built a longitudinal repository of individuals with cancer with great fidelity. It combined publicly available Centers for Medicare and Medicaid Services (CMS) data’s administrative facts such as diagnosis, procedure codes, and provider IDs with clinical facts, such as what cancer stage, from the National Program of Cancer Registries. This greatly enhances the meaning of the administrative data allowing the center to compare one institution’s results for similar cancers to another. The melding of two public data sources to gain insight about the efficacy of cancer treatment across the US is a significant achievement. ■ Diagnose rare disease by marrying big data and social media communities. Often, clinicians cannot diagnose people with rare diseases correctly because they have never seen a case in their practices. Corcept Therapeutics, a niche pharmaceutical company, partners with Liquid Grid to mine social media for synonyms and semantic equivalents to the clinical descriptions of Cushing syndrome to promote its therapy Mifepristone.2 According to Liquid Grid’s CEO Malcolm Bohm: “We start with our own ontology of medical terms sentiment. We mine Facebook, Twitter, Tumblr, WordPress, and the metadata of YouTube. This takes no more than a matter of weeks, and we are ready to use the insight we have on how a lay community describes a condition.”3
  • 18. FOR CIOS Seven Ways Big Data Improves Healthcare Outcomes 4 © 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015 Figure 2 Facebook Page Used By Concept Therapeutics To Steer Potential Patients To Doctors Source: Forrester Research, Inc. Unauthorized reproduction or distribution prohibited.117433 Source: Corcept Therapeutics’ Cushing’s Connection Facebook page
  • 19. FOR CIOS Seven Ways Big Data Improves Healthcare Outcomes 5 © 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015 Big Data Powers Breakthroughs In Research And Epidemiology Big data can speed time-to-market for therapies, and novel ways of doing disease surveillance foretell a new paradigm in epidemiology: ■ Labs use big data to disrupt traditional research models and methods. Mount Sinai Hospital has invested heavily in data scientists and equipment, creating a “dry lab” infrastructure.4 They use computer and data science to uncover networks of interactions, revealing new targets for genetic interventions. Clinical trials are already underway as the output of several dry lab discoveries. Unlike traditional genetic research using computers to sequence genes and human intellect to interpret the meaning of these sequences, computers with knowledge of what drugs do to target gene expression suggest possible therapies to the clinicians based on gene network pathology. Mount Sinai plans to monetize its best-of-breed ability to find patterns in the genetic data.5 ■ Google’s disease surveillance invigorates epidemiology. Google parses its search stream to detect disease instances, e.g., number of dengue fever and flu cases in many nations of the world. Google works with major academic research institutions and public health officials to curate and validate its epidemiology algorithms. The company also uses national epidemiology databases to benchmark and validate its results. Over the six-year span of the project, Google’s results have become quite accurate.6 The health departments of nations that do not have surveillance infrastructures seem to depend on Google’s weekly updates on dengue fever.7 The potential to change the game in epidemiology is real, and we have seen at least one startup that is trying to capitalize on these business ideas (see Figure 3).
  • 20. FOR CIOS Seven Ways Big Data Improves Healthcare Outcomes 6 © 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015 Figure 3 Google Has Hit The Mark For US Flu Prediction As Compared With CDC Data Source: Forrester Research, Inc. Unauthorized reproduction or distribution prohibited.117433 Note: Google and the Google logo are registered trademarks of Google, Inc., used with permission. Google flu Data source: Google Flu Trends (http://www.google.org/flutrends)
  • 21. FOR CIOS Seven Ways Big Data Improves Healthcare Outcomes 7 © 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015 Healthcare Payers Add Value-Based Products Based On Their Unique Data Access As CIOs become more embedded in their organizations’ customer-facing initiatives, they will find many opportunities to drive customer value, and thus revenue, via big data. Whether it is in population management or fraud detection, big data initiatives provide new value and ways to reduce costs in providing care: ■ Health insurance companies target waste and fraud with big data solutions. The insurance industry is a leader in fraud detection. It rivals the credit card industry in detecting patterns in data that indicates fraud. Harvard Pilgrim Health Care uses LexisNexis’ Intelligent Investigator to ferret out fraud. It links unexpected relationships between a provider billing address and risky individuals associated with that address to uncover more “bad guys.” The program has helped the organization initiate many new criminal and civil investigations. ■ Pacific Blue Cross preserves privacy and provides aggregated reports to large employers. Privacy concerns make it impossible for employers to gain access to their staff’s health records. Pacific Blue Cross creates reports for large companies showing patterns of opportunities to optimize staff health without exposing employees’ individual health data.8 Such advances in data-driven, value-based products will differentiate insurance companies for the next decade as less competent competitors strive to catch up. W H AT I T M E A N S BIG DATA TO PROVIDE REVENUE FOR LARGE HEALTHCARE COMPANIES Big data will be a major driver altering the operational models of healthcare. Developing these solutions is expensive. New forms to monetize these solutions evolve to fund the necessary investments. New organizational models are emerging; for example, we see health companies that traditionally only sell hospital beds to consumers hiring business-to-business (B2B) marketing staffs. Technology vendors with global reach are looking to the major centers of excellence in care management to create cobranded products that embed insight locked up in data. Over the next 15 years, the increased globalization of care delivery tools fueled by big data will accelerate. As trends like retail medicine continue to mature, the data itself will allow clinical standards to evolve. These standards will be available for economically and geographically challenged communities consuming these solutions. The successful CIO in large healthcare companies increasingly will run business units selling solutions. The hiring practices for BT executives is evolving; former software and consulting executives increasingly are being recruited by traditional technology buyers now turning into solution vendors.
  • 22. FOR CIOS Seven Ways Big Data Improves Healthcare Outcomes 8 © 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015 SUPPLEMENTAL MATERIAL Companies Interviewed For This Report Accenture Aetna Anthem Insurance Ayasdi Blue Shield of California CitiusTech Cognizant Corcept Therapeutics Dell Elsevier Epic Systems Explorys Google Harvard Pilgrim Health Care HCL Technologies Health Integrated IBM Informatica InterSystems Kaiser Permanente Koninklijke Philips KPMG McKesson Memorial Sloan Kettering Cancer Center Mercy Hospital Mount Sinai Hospital MVP Health Care Nuance Communications Optum Orion Health Pacific Blue Cross Health Benefits Society Practice Fusion PwC SAS United Healthcare United States Department of Health and Human Services University of Michigan Medical School Verisk Health Virtual Radiologic Webtrends West ZirMed
  • 23. FOR CIOS Seven Ways Big Data Improves Healthcare Outcomes 9 © 2015, Forrester Research, Inc. Reproduction Prohibited March 25, 2015 ENDNOTES 1 Memorial Sloan Kettering Cancer Center combined data from the national cancer registry and administrative claims data for Medicare patients from the CMS. Source: Forrester interview with John Gunn, COO of Memorial Sloan Kettering Cancer Center, September 2014. 2 Check out Medscape for epidemiology on almost any disease. Source: David S. Liebeskind, MD, “Hemorrhagic Stroke,” Medscape, January 8, 2015 (http://emedicine.medscape.com/article/1916662- overview#a0156) and Gail K. Adler, MD, “Cushing Syndrome,” Medscape, April 4, 2014 (http://emedicine. medscape.com/article/117365-overview#aw2aab6b2b4aa). 3 Source: Forrester interview with Liquid Grid, Q3 2014. 4 A dry lab is an increasingly important term of art in the biomedical research world. It refers to a lab that consists of computers and computer models that pour over clinical and other data to find patterns of insight. 5 For more information on cognitive computing, see the February 13, 2015, “Healthcare Meets Cognitive Computing” report. 6 For more information on Google’s work with the flu, see the June 20, 2014, “Google Flu Trends — A Big Data Fail? Not Exactly” report. 7 Google is working with new data sources in the lab to refine its results. It is collaborating in the academic and public health spheres to refine its results. Yet it has no current plans to monetize these innovations. In an interview with Steve Crossan, Google’s product manager for disease surveillance, told Forrester: “We are lucky enough not to need a business model to measure the work we are doing. We are not trying to build a business around public health surveillance.” He went on to say that when its cycle runs slowly, it does get feedback from the countries that need the data because it does not have public surveillance for diseases. 8 This information was gathered in an interview with Cindy Bratkowski, senior vice president, information technology and client services, and Akiko Campbell, director, innovation center and security officer at Pacific Blue Cross in September 2014.
  • 24. Forrester Research (Nasdaq: FORR) is a global research and advisory firm serving professionals in 13 key roles across three distinct client segments. Our clients face progressively complex business and technology decisions every day. To help them understand, strategize, and act upon opportunities brought by change, Forrester provides proprietary research, consumer and business data, custom consulting, events and online communities, and peer-to-peer executive programs. We guide leaders in business technology, marketing and strategy, and the technology industry through independent fact-based insight, ensuring their business success today and tomorrow. 117433 « Forrester Focuses On CIOs As a leader, you are responsible for managing today’s competing demands on IT while setting strategy with business peers and transforming your organizations to drive business innovation. Forrester’s subject-matter expertise and deep understanding of your role will help you create forward-thinking strategies; weigh opportunity against risk; justify decisions; and optimize your individual, team, and corporate performance. CAROL ITO, client persona representing CIOs About Forrester A global research and advisory firm, Forrester inspires leaders, informs better decisions, and helps the world’s top companies turn the complexity of change into business advantage. Our research- based insight and objective advice enable IT professionals to lead more successfully within IT and extend their impact beyond the traditional IT organization. Tailored to your individual role, our resources allow you to focus on important business issues — margin, speed, growth — first, technology second. FOR MORE INFORMATION To find out how Forrester Research can help you be successful every day, please contact the office nearest you, or visit us at www.forrester.com. For a complete list of worldwide locations, visit www.forrester.com/about. CLIENT SUPPORT For information on hard-copy or electronic reprints, please contact Client Support at +1 866.367.7378, +1 617.613.5730, or clientsupport@forrester.com. We offer quantity discounts and special pricing for academic and nonprofit institutions.