coi all script app challenge canary

Allscripts

Open App

Challenge

Cardinal Team

Cardinal Optimization turning theory into reality

Canary: An Analytical Tool for

Reducing 30-day

Readmission Rates

Contact: Holly Jin, President [email protected]

Cardinal Optimization Proprietary and Confidential (Not

permitted to distribute to third party without prior consent) 2/15

Healthcare Problem Addressed

• Healthcare/Business problem addressed: – 71 million+ individuals in the US admitted to hospital each year

– Over $30 billion spent on unnecessary hospital admissions (2006)

– Lack of effective tools for healthcare professionals to accurately

predict high risk patients for hospital visits in order for them to

take preventative measures to get the early treatments patients

need to avoid or shorten hospital stays

• Canary app addresses both the following categories: – Applications that improve management of high cost chronic

diseases, such as diabetes, stroke, renal, cancers, and others

– Innovative approaches to effectively reduce 30-day readmission

rates



High Level Solution Description

• Use of patients’ historical claims records in building

analytic models to effectively predict future hospital

visits of high risk patients in particular in the high

cost categories of chronic diseases

• Imbed the Canary inside an Allscripts app fully

taking advantage of Allscripts’ huge provider

/patients database

• High risks patients for next 30-day hospital

admission are identified with index 1 through 10 to

indicate risk factors

• Healthcare providers equipped with Canary apps

utilize the predictive results in order to take actions

to prevent unnecessary hospitalizations



Novel Approach

• Support Vector Machines (SVM)

– A large-scale, parallelizable framework for rapidly

classifying sets of data

• Bayesian analysis

– A set of statistical algorithms that allow a user to compute

probabilities of future events of interest

• Statistical regression

– Applications of high-dimensional calculus and linear

algebra for establishing relationships between variables and

predicting likely future events



Usability and Design

• PCPs equipped with the Canary apps receive

realtime (daily) warnings of relevant high risk

patients for hospital visits for the next 30 days

• PCPs take preventive actions on these high risk

patients leading reduced number of patients for

hospital visits or the length of stays

• In particular, the Canary app also provides high risks

factor index to the PCPs to assist them with

diagnosis and preventive actions



Development Stage

• A working prototype has been developed

– Prototype built utilizing 3 years of patients claims data from

the Heritage Provider Network

– Code development already in place for building effective

predictive algorithms used in Canary app

• Clustering analysis and prediction of hospital stay

risk index for Renal patients as pilot applications

developed

• Further analysis and expansions to other high cost

chronic diseases that resulting in frequent hospital

visits including heart disease, diabetes, cancer and

others



Integration Description

• Allscripts integration

– Canary app integrated with Allscripts EHR in order to obtain

relevant historical claims data

– Canary app push relevant data back to Allscripts EHR

• Additional data in refining Canary engine (Phase 2)

– Laboratory, clinical and drug data from Allscripts

– Integration with IMPACTMeds medication adherence and

community pharmacy data



Allscripts Integration: APIs/Web Services

Canary App AWS/Unity

WCF/Webservices

Canary App <-> Unity SDK data flow

1.Start session authenticating via Unity GetSecurityToken()

2.Data retrieval/update using Unity Magic commands

e.g. GetChangedPatients(), GetPatientActivity(), GetPatientIDs(),

GetProcedures(), GetPatientList() etc.

3.Close session using Unity RetireSecurityToken()

Canary DB Allscripts DB



Business Partners and Customers

• Support from IMPACTMeds Nephrology platform

• Dallas Nephrology Associates

– The second largest group of practicing nephrologist in the

country and will participate in multiple ACO’s.

– IMPACTMEDS received endorsement from Dallas

Nephrology Medical Director and Fresenius Medical Director

• Dialysis Clinics: interested as Beta customers



Market Strategy

• Pilot to Dallas Nephrology Associates

– An Allscripts customer

– 72 Nephrologists in 30+ locations

– 30,000 patients

– Offers pilot participations in using Canary app to predict

next 30-day hospital stays for patients under the care of a

nephrologist

• License Canary app to DaVita and Fresenius as beta

customers (Planed in Phase 2)

– Awareness of the doctors and staffs to high risk patients

benefit them in keeping patients out of hospital as business

goal



Market Strategy +

• Hospitals and specialties of internal med using

Allscripts will be targeted as customers and users

• Seeking Government healthcare agencies in

providing incentives to vendors for utilizing Canary

resulting bigger savings to the government

• Seeking healthcare insurance companies in

providing incentives to vendors for utilizing Canary

app resulting huge reductions to the healthcare

insurance cost



Business Model

License the application to organizations as a per

member per month fee.



Video Demonstration

• Link: http://www.youtube.com/watch?v=iafvbkDgAqc

• Description of what the demo shows: A preview that

shows how Canary can be used to forecast future

patient hospital stays, analyze historical patient

information, and identify the “risk factors” that affect

patients’ needs to use the hospital.



Why this solution be selected !

• Great market need and significant social impacts:

– Improving patients’ quality of life and saving lives

– Effective management tool to healthcare professionals

– Resulting in huge savings in the billions of dollars to

Medicare/Medicaid cost

• Ease of use:

– User friendly interface

– Intuitive statistically sound results

– Easy integration to Allscripts customers

• Committed pilot customers on Allscripts, Beta

customers lined up

• Simple and affordable pricing model



Why this solution be selected +!

• Novel solutions for a complex and difficult problem:

– Innovative technology: uses of cutting-edge research

developed from Cardinal team members who specialize in

computational mathematics, data analytics, and statistical

analysis

– Accuracy: expected improvements over existing methods

by up to 15x (see submitted video)

– Scalability: algorithms are parallelizable and can be applied

to huge datasets (thousands of dimensions/millions of

entries)

• Award-winning innovative team members:

– team members are highly innovative area experts

– PhDs credentialed from Stanford, Harvard, and Cambridge