This document discusses applications of big data and data analytics in healthcare. It provides two case studies: 1) a rural clinically integrated network in Kansas that uses data analytics to identify at-risk patients and reduce costs, and 2) an analysis of billing data for a Department of Justice investigation. The document also outlines other healthcare data analytics projects and discusses growing demand for data analytics expertise and the potential for analytics to improve healthcare outcomes and reduce costs.

1. Page 0February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Big Data Applications
in Healthcare
Martin D. Brown
President
PYA
Brian A. Worley
President and Chief Executive Officer
PYA Analytics

2. Page 1February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Outline of Presentation
• Case Studies
• Big Data and the Fourth Dimension
• Data Analytics in Science
• Data and US Healthcare
• PYA Analytics Applications

3. Page 2February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
University of Kansas Hospital
Hays Medical Center

4. Page 3February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Healthcare Case Study 1:
Rural Clinically Integrated Network
Kansas Heart and Stroke Collaborative
• 3-year, $12.5 million award from the Center for Medicare and Medicaid
Innovation led by the University of Kansas Hospital and a rural clinically
integrated network including a rural regional referral center, 10 Critical Access
Hospitals, primary care providers, and specialists
• Develop a care delivery and payment model to improve rural Kansans’ heart
health and heart attack and stroke outcomes to reduce total cost of care for
that population.
Goals
• Reduce total cost of care for target population by $13.8 million (1.9 % savings)
• Reduce deaths from heart and cerebrovascular disease by 20 %

5. Page 4February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Healthcare Case Study 1:
Analytics’ Key Role
•Develop Shared Analytic Infrastructure (SAI)
developed for CMS by computational scientists
while at Oak Ridge National Laboratory
•Maintain an architecture for management and
analysis of large volumes of disparate data
Summary:
Management of heterogeneous data sets; cloud-
based infrastructure for dynamic and on-demand
data; resource provisioning; innovative, and
informal (ad-hoc) visualizations; Web-Oriented-
Architecture application programing interface for
remote access to data and analytic functions
critical in a “virtual” model; and real-time claims
and clinical data from diverse sources
Specifications:

6. Page 5February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Healthcare Case Study 1:
Analytics’ Key Role
•Identify at-risk patients
•Facilitate interoperable use of population health IT
solutions with KHSC staff and vendors
•Track total cost of care for the KHSC patient
population
Functions:
•Conduct real-time analysis and predictive
modeling to develop a transformational payment
model that incentivizes and supports treating the
target population
•Assist in conducting performance evaluations
reported to CMS
Outcomes:

7. Page 6February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Healthcare Case Study 2:
DOJ Investigation
…analyzed 9,426,517 lines of data. Each of
the 9,426,517 lines of data represented
7 years of data with one or more units of a
single service rendered and billed by
two disparate billing systems…

8. Page 7February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Example of
Healthcare Data Analytics Projects
Use CMS-established algorithms to calculate the
Hierarchical Condition Categories for qualifying
patients within the health provider network.
Building algorithms from published requirements
and performing analysis using the algorithms and
clinical data.

9. Page 8February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Example of
Healthcare Data Analytics Projects
Perform text analysis against contract documents to
identify the financial contract terms and compare with
actual invoicing costs.
Apply natural language processing to extract
contract terms from pdf documents and automate
the comparison of the terms against actual billing
from the financial system.

10. Page 9February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Business Problem
• Text-based data largely underutilized or ignored
• Lack of understanding as to the capabilities and possibilities
in text analysis
• Digital universe will total 35
zettabytes in 2020 (in 2011 it
was 1.8 zettabytes)[IDC 2011 Digital
Universe Study]
• 80% of digital data is
unstructured or text-based
data [2013 Forbes]

11. Page 10February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Text Analysis and Natural Language
Processing
• Taking unstructured text-based data and deriving high-quality
structured information from it
• Types of information include:
– Linguistic metrics: e.g., total words, parts of speech, spelling errors
– Named entities: e.g., people, locations, organizations, dates
– Semantic
representations: concepts
contained in the data
– Similarity measures and
clustering

12. Page 11February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Use Cases and Current Projects
• Healthcare
– Tennessee Department of Children’s Services (DCS)
– Centers for Medicare & Medicaid Services (CMS)
– Emergency room and doctors’ offices
• Legal space
– Legal invoicing
– Pre-discovery and discovery phase data processing
– Defense sector
– Condition-based maintenance
– Law enforcement support
• Business
– Email tracking

13. Page 12February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
DCS Project Overview
• Project drivers
– Evaluate the quality of case notes (writing, information provided)
across the entire state; use findings to improve the training.
• Key idea
– Use essay auto-grading-like techniques, enhanced with PYA
Analytics proprietary algorithms for quantitative and qualitative
content analysis.
• Implementation
– Quantitative and qualitative analysis implemented as Python and
Java programs and deployable to DCS IT as an appliance.

14. Page 13February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Data Provided by DCS
• Narratives and metadata (description of the data
and cases)
– 5 gigabytes (GB) with over 11 million unique entries
• Good and bad tagged case notes
– Over 100 pre-classified examples with additional
comments concerning the reasoning behind the given
classification
• Keyword lists

15. Page 14February 6, 2015
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CMS Measures Management System
• Develop automated system to conduct environmental
scan of available literature to support the new and
current CMS measures
• Provide unsupervised knowledge extraction and search
capabilities
– Support of other contractors’ work on semantic representations of
existing measures
• Develop conceptual representations for measure areas
that are lacking in evidentiary research

16. Page 15February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Legal Invoicing
• Develop software system that will facilitate and
automate the detection of rule violations in legal
invoices
• Implement optical character recognition (OCR) that will
convert paper documents to digital form
• Create logic-based set of rules and analyze text within
invoices to detect violations and anomalies
– E.g., Tasks designed for paralegal being billed at lawyer rates

17. Page 16February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Source: http://www.modernhealthcare.com, November 19, 2014
CMS names
First Chief
Data Officer…
“tasked with
overseeing
improvements in
data collection and
dissemination…”

18. Page 17February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
The Business of Big Data
• $300 billion annual value of big data for the US healthcare
system, two-thirds of which would come in reduced
expenditures (McKinsey).
• $165 billion worth of value for big clinical data (McKinsey).
• 966 petabytes data stored by discrete manufacturing
companies in the US during 2009; 848 petabytes of data
stored by government in the same year (McKinsey).
• By 2020, IT departments will have 10 times more servers
and 50 times more data to look after than they do now.

19. Page 18February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Data Analytics Expertise
is in High Demand
• The US will face shortages of:
– between 140,000 and 190,000 individuals with “deep”
analytical skills capable of working with very large data
sets
– between 300,000 and 400,000 skilled technicians and
support staff
– about 1.5 million “data-savvy“ managers and analysts
(McKinsey)

20. Page 19February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Healthcare Analytics Will Reduce
Costs by Addressing Key Issues
• Unwarranted medical procedures
• Fraud, waste, and abuse
• Administrative costs
• Provider inefficiencies
• Coordinated care
• Preventable conditions

21. Page 20February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Healthcare Analytics for
Improving Care
• Ability to mine wide population data to
improve patients’ diagnosis and outcomes
• Reduction of medical errors
• More successful drug development
• Data-driven preventive care
• Consumers of healthcare, not just patients

22. Page 21February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Your Physician Can
Make Use of Data
Story Visualization Translate

23. Page 22February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Computerized Analytics May Perform Much of
the Initial Diagnosis and/or Inform the Physician
• Who has perfect memory and can read everything needed?
Analytics platforms such as IBM Watson
• Computers have the potential to assist/perform:
– Collecting patient symptoms
– Collecting patient history
– Comparing the two to a large data base
– Identify successful and poor outcomes of various treatments
– Provide informed recommendation of potential treatments with
probabilities of success

24. Page 23February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Coming Soon –
Genomic Data will be Added to your Health Records

25. Page 24February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Increasing Role of Social Media

26. Page 25February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Real-time Diagnostics from Sensors

27. Page 26February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Improved Emergency Care
Emergency room will know your
issues and history before you
arrive
Specialized field care can be
applied based on your history

28. Page 27February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Reduced Exposure
Data can be collected from
social media to track disease
spread
Tracking medical radiation
exposure more accurately in
real time
No child sick waiting rooms

29. Page 28February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Focus on Health
Use data to demonstrate
how you as individual can
maintain and improve health
Increased use of health
physicians versus care
physicians

30. Page 29February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
PYA Analytics, LLC
• Headquartered in Knoxville, Tennessee
• Advanced Analytics Company
– Text Analysis and Natural Language Processing
– Statistics, Data Mining, and Predictive Analytics
– Geospatial/Temporal Analytics
– Information Visualization for Decision Support
– Big Data Architectures

31. Page 30February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
PYA Analytics Applications
• Healthcare
• Food Industry
• University Academics and Operations
• State Social Services
• Legal – Compliance and Litigation
• Internet Radio
• Sports
• National Security

32. Page 31February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Food Industry
• What are the profit drivers across
the brand, franchises, and
individual stores?
• What are the influences of
demographics, weather, and
distance to critical infrastructure?
• What price bundling is predicted
to increase profit?
• Where is fraud taking place?

33. Page 32February 6, 2015
Prepared for Georgia Society of Certified Public Accountants – Healthcare Conference
Contact Information
Martin D. Brown mbrown@pyapc.com
President http://www.linkedin.com/in/martybrowncpa
PYA http://twitter.com/healthcarecpa
(800) 270-9629 www.pyapc.com
Brian A. Worley bworley@pyaanalytics.com
President and CEO
PYA Analytics
(865) 862-4196 www.pyaanalytics.com
Amber McKenzie amckenzie@pyaanalytics.com
Data Scientist https://www.linkedin.com/in/ambermckenzie
PYA Analytics
(865) 862-4196 www.pyaanalytics.com