global big data bootcamp-april2016
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AccordionHealth• Foundedin2014by
– Sriram Vishwanath,PhD– YubinPark,PhD– JoyceHo,PhD
• Ateamofdata scientistsandmedicalprofessionals
• Wehelphealthcareorganizationssmoothlytransitionfromtheoldfee-for-service systemtoanewvalue-basedreimbursement system
• LocatedinAustin,TX• Website:https://accordionhealth.com
USHealthcareisExtremelyComplex• Medicare• Medicaid• IPA• Hospitals• NursingHomes• Pharmacies• Pharmaceutical
companies• DeviceManufacturers• PrivateInsurers• Employers• …
• Source:https://newrepublic.com/article/63298/your-health-care-system-map
WideSpectrumofApplications• Management/OperationSupport– AutomatedPrior-AuthorizationforPrescriptionDrugandSurgery
– Fraud,Waste,andAbuseDetection– CostandQualityOptimization*
• ClinicalDecisionSupport– MedicalImagingAnalysis– DiagnosisPrediction– ICUEarlyWarningSystem– Precision(orPersonalized)MedicineusingGenomicData
FFSà VBR“Thisantiquatedmodel(FFS)istheculpritbehindexponential
health-carecostgrowth.” - TheAtlantic
UnderFFS,- Provider:Moreservices,morereimbursements- Payer: Higherexpensesthisyear,higherpremiumsnextyear- Patient: Constantlyrisinghealthcarecosts
SoftwareCompanyAnalogyIwanttohireaniPhoneappdeveloper. Iwantto postajob
descriptionwithcompensationdetails.
Myoptionsare:- Pay by hour?- Paybythenumberlinesofthecode?- Paywhentheappiscompleted- Payabasewhentheappiscompleted,andabonuswhentheappisdownloaded10,000times- Pay abasewhentheappiscompleted,andabonuswhentheappisdownloaded10,000times,andapenaltyiftheratingisbelow2starsintheappstore
Value?DataistheKEY
- Risk-adjustedcapitatedratesforMedicareAdvantageplans- StarRatingbonusesandpenaltiesforMedicareAdvantageplans
- SharedsavingsforAccountableCareOrganizations
- Bundledpaymentsforhospitalsystems
- 30-dayreadmission rates- Otherqualitymetrics
Time
Valueismeasuredusing longitudinal patientdata(e.g.claims,ElectronicHealthRecords,prescriptiondata,etc.)
VBR:BundledPayment• Before(current)
– Hospitalsdosurgeries– SkilledNursingFacilitiestake
careofpatientsafterthesurgeries
– Patientsgothroughdifferentfacilitieswithoutpropercoordination
– Results:Highreadmissionsrates,Over-utilizationofservices,Unhappypatientsandpayers
• After(expected)– Hospitalsdosurgeries,but
theyareaccountablefortheepisodeofcare
– SkilledNursingFacilitiesworktogetherwithhospitalsforbettercare-pathsforpatients
– Patientsgothroughwell-designedcareroutes
– Results:Lowreadmissionrates,optimalresourceutilization
VBR-BP:How?
Claims,EHR
CollectData
MachineLearning
AnalyzeLongitudinal
Data
WebInterface
Care-pathDesign
WhichMachineLearningAlgorithms?
• Time-SeriesModelsareUseful– Care-pathoptimizationisnotasinglesnap-shotprocess
• Tree-basedModelsareUseful– Lotsofinteractioneffects
• Deep-learning-basedModelsareUseful– Hierarchicalfeaturerepresentation
VBR:PopulationHealthManagement
• Population-levelView– PrevalenceofChronicConditions– PatientStratification– InterventionStrategies– Toachievebetterqualityandlowercost
VBR-PHM:RiskIdentification• PredictiveIdentification– Identifyingpatientswithcertainconditions• Soundssimple?
– Identifyingpatientswho”may”havecertainconditionsinthefuture
• Intervention– Figuringoutthebestinterventionstrategyforaspecificpopulation
WhichAnalyticsTechniques?
• DataIntegrationistheKEY• Properdatapreprocessingisveryveryimportant• Identifyingwhat’sactionable/predictable• Object/Data-drivenmachinelearningmodelsaredesired– Itisalwayscase-by-case– Freshfishà Sashimi,Goodbeefà Steak,etc.
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