CDM Data Analytics Using a RIM approach Diane

CDM Data Analytics Using a RIM approach Diane Gutiw Ph. D SAIC Canada Health Solutions Business Unit

CDM Data Analytics Discussion … n n n The Business Problem Overview of CDM Workflow Overview of the need for Data Analytics Support in V 3 messaging and RIM How to implement Bio. Sense as potential solution for CDM

The CDM Business Problem n Multiple disease conditions q n n n Diabetes, CHF, COPD, HBP, Asthma, Renal, Depression, Arthritis, Alzheimer's, Epilepsy, Hepatitis, CF, Eating Disorders, Obesity, Cancer, Anemia, AIDS/HIV etc. May be overlap in conditions Treatment focus is disease management not cure CDM Clinician collaboratives Data sharing based on treatments and outcomes rather than POS data Challenges of data collection Challenges of data standardization/normalization

Potential Data Sources Drug Repository EMR EMR SHR RIM Lab Repository Pharmacy ADT Provider Location Repository Client Registry DI Repository Immunization Repository

CDM Workflow Collaborate Protocols Outcomes Treatment Assessment Diagnose Condition

Support in Messaging n Supporting Messages: q q q n Lab Diagnostic Imaging Immunization Prescription ADT … Gaps identified in existing reporting for CDM

Gaps in HL 7 v 3 Messaging n n n Use existing Registries/Repositories as “source of truth” CDM elements available in RIM Clinical data specific to CDM not in any existing RMIM Data required for CDM Analytics outside of existing repositories: q Clinical background (smoking cessation, diet, weight loss) all available in SNOMED q Concept of Collaborative Teams q Includes combined assessment, referrals, treatment, hospitalizations and adjusted treatment pattern for CDM q Treatment refusals, testing negation indicators and lifestyle adjustments/refusals critical to data analytics And then how to consolidate data and extract for “meaningful use”?

Benefits of a RIM-based solution n n Supports data modeling requirements Supports standardization Supports normalization Extends to multiple conditions, treatments, outcomes Supports reporting needs

Bio. Sense Solution: To provide a technology platform which simplifies the enablement of public health reporting in a healthcare-centric environment, satisfying the requirements of HITECH and “meaningful use” objectives relative to Public Health.

Bio. Sense Architecture Ø Ø Ø A toolset that can be run standalone, or can be integrated into an existing system or system interface. An interface that allows loose coupling. This allows it to be integrated into proprietary platforms such as Microsoft . NET. A design to support Public Health reporting, and flexible enough to support future health reporting requirements. Interoperable Hardware and software vendor independent. Able to collect appropriate and targeted hospital/jurisdictional data.

Bio. Sense System Integrator Rhapsody POS Hospitals & Clinics The Integrator “listens” to the source’s HL 7 traffic and places needed data on-line Secure Messaging Data Broker Rhapsody Receives source data, un-batches and transforms HL 7 files to XML & send XML to queue Provides a guaranteed message delivery service across the internet Extract, Transform, Load (ETL) Informatica Apply business rules to data and load Data Warehouse Secure Data Network POS Labs Provides Certificate based authentication services Retail Pharmacy Rx Application Public Health Users And CDM Users Bio-Intelligence Users Data Marts SAS Web. Logic ESRI Life. Ray Portal Application specific, de -normalized & decentralized data SAS Analytics 12 Data Warehouse Centralized Data Repository

Example: Stand-alone Solution for Surveillance PHORS leverages SAIC’s healthcare and HL 7 messaging knowledge. The PHORS architecture is designed to allow Infection Control Practitioners (ICPs) to define detection rules which are then stored in a rules based engine and used by web services to identify patient data to assist ICPs in managing and reporting of Hospital Acquired Infections (HAI) Public Health Open Reporting System (PHORS) NATIONAL HEALTH SAFETY NETWORK BIOSENSE ELR BIOSENSE 13

Bio. Sense Features Ø Configurable by the end user Ø Additional reporting available Ø Ø You select the characteristics of the records Ø Controllable by the end user Can add other characteristics or reports for local needs Ø Supports a multitude of data feeds Ø Can require user approval prior to reporting 14

Next Steps…. Ø Bio. Sense currently in production in US for Public Health §Bio. Sense currently receives > 4 million clinical records daily §Batch (Not Real Time) § 913 Veterans Affairs (VA) facilities § 375 Department of Defense (DOD) facilities §Real Time § 117 facilities from 24 Hospital Systems § 536 facilities from 9 Syndromic Systems § 2 National Reference Labs (Lab. Corp and Quest) §>35, 000 retail pharmacies (Per. Se, Mc. Kesson Relay. Health) Ø Ø Bio. Sense to be presented to Canadian Public Health and CDM business users Bio. Sense to be adapted to meet CDM requirements as POC

Questions or follow up … Ø Diane Gutiw gutiwd@saic. com