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IBM Content and Predictive Analytics for Healthcare The first Watson Ready solution © 2011 IBM Corporation Working together IBM Content and Predictive Analytics for Healthcare and IBM Watson for Healthcare Evidence Based Learned Knowledge IBM Content and Predictive Analytics for Healthcare Books, clinical guidelines, web resources, journals and other healthcare authoritative resources Leverage learned knowledge with QA-style interactions for clinical applications such as diagnosis Past, present and future analysis compliments Watson – with focus on customer data for clinical and operational outcomes Ready for Watson Clinical Outcomes 2 Operational Outcomes IBM Watson for Healthcare WellPoint and IBM Announce Agreement to Put Watson to Work in Health Care September 12, 2011 “… clinical best practices to help a physician advance a diagnosis and guide a course of treatment" © 2011 IBM Corporation IBM Content and Predictive Analytics … Ready for Watson Complements IBM Watson to analyze and visualize past, present and future scenarios in context Question What is Known Complement ICPA with Watson for Healthcare to get real time, confidence based answers with evidence based learning 3 Analyze and Visualize the Past See the Present Predict the Future Understand trends, patterns, deviations, anomalies, context and more in large corpuses of historical clinical and operational information to reveal new insights Analyze and extract text from in-process documents or other information to find structured data errors … feed the results to other cases and systems Use predictive models and scoring to make more informed decisions through predictive and future scenario modeling © 2011 IBM Corporation IBM at 100: Innovation That Matters in Healthcare 100-year track record of innovation and progress TAKMI Bringing Order to Unstructured Data • In 1997, IBM researchers at the company’s Tokyo Research Laboratory pioneered a prototype for a powerful new tool capable of analyzing text. The system, known as TAKMI (for Text Analysis and Knowledge Mining) was a watershed development: for the first time, researchers could efficiently capture and utilize the wealth of buried knowledge residing in enormous databases of text • In 2009, TAKMI was commercialized as IBM Content Analytics 4 © 2011 IBM Corporation What is UIMA and NLP? Natural Language Processing (NLP) is the cornerstone to translate interactions between computers and human (natural) languages – Watson uses IBM Content Analytics to perform critical NLP functions Unstructured Information Management Architecture (UIMA) is an open framework for processing text and building analytic solutions – Many IBM products leverage UIMA text analytics processing including Watson and IBM Content and Predictive Analytics for Healthcare – Now an OASIS open source standard – Apache UIMA is sponsored project by the Apache Software Foundation 5 © 2011 IBM Corporation Medical Transcription Discharge Summary Sample # 2: Cardiology Consultation Transcribed Medical Transcription Sample Reports REFERRING PHYSICIAN: John Doe, MD CONSULTING PHYSICIAN: Jane Doe, MD HISTORY OF PRESENT ILLNESS: This (XX)-year-old lady is seen in consultation for Dr. John Doe. She has been under consideration for ventral hernia repair and has a background of aortic DATE OF DISCHARGE: MM/DD/YYYY valve replacement and known coronary artery disease. The patient was admitted with complaints of abdominal pain, anorexia, and vomiting. She underwent a CT scan of the abdomen and pelvis ADMITTING DIAGNOSIS: Syncope. and this showed the ventral hernia involving the transverse colon, but without strangulation. There was an atrophic right kidney. She had bilateral renal cysts. The hepatic flexure wall was thickened. There was sigmoid diverticulosis without diverticulitis. It has been recommended to her that she CHIEF COMPLAINT: Vertigo or dizziness. undergo repair of the ventral hernia. For this reason, cardiology consult is obtained to assess whether she can be cared from the cardiac standpoint. HISTORY OF PRESENT ILLNESS: This is an (XX)-year-old male with a past medical history of coronary artery disease, CABG done a few PAST CARDIAC HISTORY: Bypass surgery. She underwent echocardiography and cardiac years ago, atrial fibrillation, peripheral arterial disease, peripheral neuropathy, recently retired one year ago secondary to leg pain. The catheterization prior to the operation. Echocardiography showed an ejection fraction of 50%. There patient came to the ER for an episode of vertigo while reaching for some books. The patient was able to reach the books, to support was marked left ventricular hypertrophy with septal wall 1.60 cm and posterior wall 1.55 cm. self, but did not have any syncope. No nausea or vomiting. No chest pain. No shortness of breath. Came to ER and had a CT head, Coronary arteriography showed 90% stenosis in the anterior descending artery, situated distally just before the apex of the left ventricle. Only mild to moderate narrowing was seen elsewhere in which was within normal limits. The impression was atrophy with old ischemic changes but no acute intracranial findings. No focal the coronary circulation. weakness, headache, vision changes or speech changes. The patient has had similar episodes since one year. Peripheral neuropathy CORONARY RISK FACTORS: Her father had an irregular heartbeat and her brother had a fatal since one year and not relieved with multiple medications. The patient also complains of weight loss of 25 pounds in the last 6 heart attack. She herself has had high blood pressure for 20 years. She has elevated cholesterol Echocardiogram Sample Report: months. No colonoscopy done. Recent history of hematochezia but believes it was secondary to proctitis and secondary to decreased and takes Lipitor. She has had diabetes for 20 years. She is not a cigarette smoker. She does little appetite. No nausea, vomiting, no abdominal pain. physical exercise. DATE OF STUDY: MM/DD/YYYY REVIEW OF SYMPTOMS: CARDIOVASCULAR AND RESPIRATORY: She has no chest pain. She sometimes becomes short of breath if she walks too far. No cough. She has occasional swelling of her feet. Occasionally, she gets mildly lightheaded. Has not lost consciousness. She tends to be PROCEDURES PERFORMED: The patient had x-ray, which showed cardiomegaly with atherosclerotic heart disease, pleural DATE OF INTERPRETATION OFa chest STUDY: aware of her heartbeat when she is tired. She has no history of heart murmur or rheumatic fever. thickening and small pleural effusion, a left costophrenic angle which has not changed when compared to prior examination, COPD GASTROINTESTINAL: Recent GI symptoms as noted above, but she does not usually have such pattern. TheEchocardiogram patient also had awas headobtained CT which for showed atrophy with old ventricular ischemic changes. No acute intracranial findings. problems. She has had no hematemesis. She has no history of ulcer or jaundice. She sometimes assessment of left has loose stools. No constipation and no blood in the stool. GENITOURINARY: She tends to have function. The patient has been admitted with diagnosis of urinary frequency. She gets up once at night to pass urine. No dysuria, incontinence. She has had Cardiology Consultation Transcribed Medical Transcription Sample Reports syncope. Overall, the study was suboptimal due to poor sonic window. previous urinary infections. No stones noted. NEUROLOGIC: She has occasional headaches. No CONSULTS OBTAINED: A rehab consult was done. DATE OF CONSULTATION: MM/DD/YYYY seizures. No trouble with vision, hearing, or speech. No limb weakness. MUSCULOSKELETAL: She REFERRING PHYSICIAN: John Doe, MD tends to have joint and muscle pains and has a history of gout. HEMATOLOGIC: No anemia, CONSULTING PHYSICIAN: Jane Doe, MD FINDINGS: abnormal bleeding, or previous blood transfusion. GYNECOLOGIC: No gynecologic or breast REASON FOR CONSULTATION: Surgical evaluation for coronary artery disease. PAST MEDICAL/SURGICAL HISTORY: Positive for atrial fibrillation. The patient had AVR 6 years ago. Peripheral arterial disease with HISTORY OF PRESENT ILLNESS: The patient is a (XX)-year-old female who has a known history of coronary artery problems. disease. She underwent previous PTCA and stenting procedures in December and most recently in August. Since that time, hypertension, peripheral neuropathy, atherosclerosis, hemorrhoids, proctitis, CABG, and cholecystectomy. PAST MEDICAL HISTORY: She has had shoulder and hand injuries and has had carpal tunnel 1. Aortic root appears normal. she has been relatively stable with medical management. However, in the past several weeks, she started to notice some surgery. has been diabetic and has been on insulin. She has chronic renal insufficiency with exertional dyspnea with chestispain. For the most part, the pain subsides with rest. For this reason, she She was re-evaluated 2. Left atrium is mildly dilated. No gross intraluminal pathology creatinine around 2.2. She has had hypothyroidism. She has had morbid obesity. She has chronic with a cardiac catheterization. This demonstrated 3-vessel coronary artery disease with a 70% lesion to the right coronary recognized, although subtle abnormalitiesartery; could not excluded. Right this wasbe a proximal left main had a 70% stenosis. The circumflex also hadobstructive a 99% stenosis. Overall leftand uses BiPAP. She has had hysterectomy and oophorectomy in the past. sleep apnea FAMILY HISTORY: Positive for atherosclerosis, hypertension, autoimmune diseaseslesion. in the The family. ventricular function was mildly reduced with an ejection fraction of about 45%. The left ventriculogram didas note someabove. apical Otherwise noted atrium is of normal dimension. hypokinesis. In view of these findings, surgical consultation was requested and the patient was seen and evaluatedPrior by Dr.to hospital, she was taking glipizide XL 2.5 mg daily, metoprolol 50 mg MEDICATIONS: 3. There is echo dropout of the interatrialDoe. septum. Atrial septal defects b.i.d., Cipro 250 mg b.i.d., atorvastatin 40 mg daily, Synthroid 75 mcg daily, aspirin 81 mg daily, PAST MEDICAL HISTORY: could Never not besmoked. excluded. SOCIAL HISTORY: Alcohol socially. No drugs. 1. Coronary artery disease as described above with previous PTCA and stenting procedures. and Lantus 36 units daily. Currently, she is taking Lipitor 40 mg daily, Lantus 10 units at bedtime, 2. Dyslipidemia. Synthroid 75 mcg daily, metoprolol 50 mg b.i.d., and Zosyn 2.25 grams q.6h. 4. Right and left ventricles are normal in internal dimension. Overall left 3. Hypertension. ventricular systolic function appears to be4.normal. Eyeball ejection for cancer with followup radiation therapy to the chest. SOCIAL HISTORY: She does not drink alcohol. Status post breast lumpectomy PHYSICAL EXAMINATION: ALLERGIES: fraction NO KNOWN DRUG ALLERGIES. ALLERGIES: None. wall motion is around 55%. Again, due to poor sonic window, GENERAL APPEARANCE: She is not currently dyspneic, in no distress. She is alert, oriented, and MEDICATIONS: Aspirin 81 mg daily, Plavix 75 mg daily, Altace 2.5 mg daily, metoprolol 50 mg b.i.d. and Lipitor 10 mg pleasant. abnormalities in the distribution of lateralq.h.s. and apical wall could not be HEENT: are normal and react normally. No icterus. Mucous membranes well colored. SOCIAL HISTORY: She quit smoking approximately 8 months ago. Prior to that time, she had about aPupils 35- to 40-pack-year excluded. REVIEW OF SYMPTOMS: Weight loss of 25 pounds within the last She 6 months, shortness of breath, constipation, bleeding from history. does not abuse alcohol. NECK: Supple. No lymphadenopathy. Jugular venous pressure not elevated. Carotids equal. FAMILY MEDICAL HISTORY: Mother died prematurely of breast cancer. Her father died prematurely of gastric 5. Aortic valve is sclerotic with normal excursion. Color flow imaging and hemorrhoids, increased frequency of urination, muscle aches, dizziness and faintness, focal weakness and numbness in both legs, knees HEART: The heart rate is 82 per minute and regular and the blood pressure 132/78. The cardiac carcinoma. impulseNohas a normal and feet. Doppler study demonstrates trace aortic regurgitation. REVIEW OF SYMPTOMS: There is no history of any CVAs, TIAs or seizures. No chronic headaches. asthma, TB, quality. There is a grade 3/6 ejection systolic murmur heard medial to the and athas thenoaortic area, with well heard radiation to the neck vessels. hemoptysis or productive cough. There is no congenital heart abnormality or rheumatic fever apex history. She 6. Mitral valve leaflets are also sclerotic with normal excursion. Color flow clear to percussion and auscultation. Normal respiratory effort. palpitations. She notes no nausea, vomiting, constipation, diarrhea, but immediately prior to CHEST: admission,Chest she didisdevelop imaging and Doppler study demonstratessome tracediffuse to mild degree of mitral abdominal discomfort. She says that since then, this has resolved. No diabetes ABDOMEN: or thyroid problem. Therenontender. is Soft and The presence of a large ventral hernia is noted. PHYSICAL EXAMINATION: VITAL SIGNS: Blood pressure 188/74, pulse 62, respirations 18 and saturation of 98% on room air. General no depression or psychiatric problems. There is no musculoskeletal disorders or history of gout. There are no hematologic EXTREMITIES: There is no edema. Posterior tibial pulses were felt bilaterally, but I did not feel the regurgitation. problemsConjunctivae or blood dyscrasias. No bleeding tendencies. sheNo had a history of breast cancer and underwent Appearance: The patient is a pleasant man, comfortable. HEENT: are normal. PERRLA. EOMI.Again, NECK: pedis. lumpectomyPulmonic procedures valve for this is with followup radiation therapy. She has been followed in thedorsalis past 10 years and 7. Tricuspid valve is delicate and opens normally. not masses. Trachea is central. No thyromegaly. LUNGS: Clear to auscultation andnopercussion Irregular SKIN: No rash or significant lesions are noted. mammography shows evidence of bilaterally. any recurrentHEART: problems. There is no recent fevers, malaise, changes in appetite or clearly seen. No evidence pericardial effusion. LABORATORY AND DIAGNOSTIC DATA: Electrolytes are normal. BUN and creatinine 18/2.2. changes in weight. rhythm. ABDOMEN: Soft, nontender, andof nondistended. Bowel sounds are positive. GENITOURINARY: Prostate is hypertrophic with PHYSICAL EXAMINATION: Her blood pressure is 120/70, pulse is 80. She is in a sinus rhythm on the EKG150. White count is 7.6, hemoglobin 11.7 with hematocrit 34.9, platelets 187,000. Blood sugar smooth margin. EXTREMITIES: Upper and lower limbs bilaterally normal. SKIN: Normal. NEUROLOGIC: Cranial nerves are grossly monitor. Respirations are 18 and unlabored. Temperature is 98.2 degrees Fahrenheit. She weighs pounds, she Hemoglobin is 5 feet LFTs 160 were normal. A1c 7.7. TSH 1.82. Troponin I was normal on three occasions. CONCLUSIONS: within normal limits. No nystagmus. DTRs are normal. Good sensation. The patient awake, and pleasant orientedfemale x3. Mild 4 inches. In general, this was is analert, elderly-appearing, who confusion. currently is not in acute distress. Skin color and Chest x-ray showed turgor are good. Pupils were equal and reactive to light. Conjunctivae clear. Throat is benign. Mucosa was moist and an enlarged heart with postoperative changes, but no evidence of acute pathology. EKG shows probable left atrial enlargement. Low voltage QRS, probable inferior wall noncyanotic. Neck veins not distended at 90 degrees. Carotids had 2+ upstrokes bilaterally without bruits. No lymphadenopathy was appreciated. Chest had a normal AP diameter. The lungs were clear inmyocardial the apices and bases, no and anterior wall infarction, age undetermined. infarction 1. Poor quality study. wheezing or egophony heart had a normal S1, MCV S2. No murmurs, clicks or gallops. The abdomen was soft, LABORATORY AND RADIOLOGICAL hemoglobin 13.4,appreciated. hematocritThe 39.8, platelets 207,000, 91.6, ASSESSMENT: 2. DATA Eyeball ejection fractionRESULTS: is 55%. WBC 8.6, nontender, nondistended. Good bowel sounds present. No hepatosplenomegaly was appreciated. No pulsatile were 1. Aortic valvemasses replacement with bioprosthetic valve. Residual systolic murmur. neutrophil percentage of 72.6%. Sodium 133, potassium 4.7, chloride 104. Blood urea nitrogen of 18 and creatinine of 1.1. PT 17.4, INR felt. No abdominal bruits were heard. Her pulses are 2+ and equal bilaterally in the upper and lower extremities. No 3. Trace to mild degree of mitral regurgitation. 2. Arteriosclerotic heart disease with severe stenosis in anterior descending artery, but this is 1.6, PTT 33. clubbing is appreciated. She is oriented x3. Demonstrated a good amount of strength in the upper and lower situated distally and subtends only a small mass of myocardium. 4. Trace aortic regurgitation. extremities. Face was symmetrical. She had a normal gait. 3. Well systolic function. The EKG appearance of previous myocardial IMPRESSION: This is a (XX)-year-old female with significant multivessel coronary artery disease. Thepreserved patient alsoleft has ventricular a left main lesion. She has undergone several PTCA and stenting procedures within the last year to year and half. At this infarction is aprobably serious, indicating multiple other medical problems as listed above DATE OF ADMISSION: MM/DD/YYYY Unstructured data is messy but filled with key medical facts Medications, diseases, symptoms, non-symptoms, lab measurements, social history, family history and much more in order to reduceheart the risk of any pleural possible thickening ischemia in the The patient had a chest x-ray, which showed cardiomegaly point, with atherosclerotic disease, andfuture, small surgical pleural myocardial revascularization is and also documented in the chart. recommended. effusion, a left costophrenic angle which has not changed when compared to prior examination, COPD pattern. The patient also had a IBM Corporation PLAN: We will plan to proceed with surgical myocardial revascularization. The risks and benefits of this procedure were RECOMMENDATIONS: It appears that she does not wish© to2011 proceed with the head CT, which showed atrophy with old ischemic changes.explained No acute findings. to intracranial the patient. All questions pertaining to this procedure were answered. surgery at this time, and if such surgery is not IBM is helping to transform healthcare Revealing clinical and operational insights in the high impact overlap between clinical and operational – enabling low cost accountable care IBM Content and Predictive Analytics for Healthcare Readmission prevention Diagnostic assistance Claims management Clinical treatment effectiveness Critical care intervention Research for improved disease management Fraud detection and prevention Clinical Outcomes Operational Outcomes Voice of the patient Patient discharge and follow-up care Improved patient satisfaction at lower costs Enhanced patient care with optimized outcomes 7 © 2011 IBM Corporation California Pacific Medical Center Using advanced cardiac risk models to reduce risks and recovery times for patients "IBM SPSS offers many time-saving features that enable us to obtain and publish results faster… With data analysis, we have been able to reduce heart attack patient mortality by 8%" Dr. Richard Shaw, Director of Cardiac Research, Division of Cardiology, California Pacific Medical Business Challenge Cardiac research program needed to manage, track and analyze vast amounts of disparate patient data collected from departments throughout the hospital. What’s Smart? Implemented models that improved patients’ long-term outcomes and shorten patients’ length of stay and reduced costs of treatment. Smarter Business Outcomes Cal Pacific Medical Center has been able to shorten patients’ length of stay and reduce costs of treatment. IBM SPSS provides the power, flexibility and ease of use the research team needed to support multidisciplinary, data-intensive projects. 8 © 2011 IBM Corporation BJC Healthcare and Washington University Partnership Improving care and increasing revenue while lowering research costs "We anticipate this solution to be a game changer in biomedical research and patient care … accelerate the pace of clinical and translational research …" Dr. Rakesh Nagarajan, MD, PhD, Associate Professor, Department of Pathology and Immunology, Washington University Business Challenge Existing Biomedical Informatics (BMI) resources were disjointed, siloed, redundant and only available to a few researchers - key insights not accessible, trapped in unstructured clinical notes, diagnostic reports, etc. What’s Smart? Leverage unstructured information along with structured data by using IBM Content Analytics with IBM InfoSphere Warehouse Smarter Business Outcomes Researchers now able to see new trends, patterns and find answers in days instead of weeks or months eliminating manual methods also enables new grant revenue 9 © 2011 IBM Corporation What IBM is Announcing IBM Content and Predictive Analytics for Healthcare (ICPA) Helps transform healthcare clinical and operational decision making for improved outcomes by uniquely applying multiple analytics services to derive and act on new insights in ways not previously possible New IBM BAO Solution Services for ICPA Core Industry Strategy Solution services that enable 3 paths to solution value based on client needs leveraging a new UIMA center of competence • Consumable, repeatable, scalable offerings with solution assets built on a common industry framework New IBM POWER7 Workload Optimized for ICPA Deliver ICPA solutions faster, with higher performance and superior economics IBM Content and Predictive Analytics for Healthcare is the first “Ready for Watson” solution … to complement and leverage IBM Watson 10 BAO = Business Analytics and Optimization UIMA = Unstructured Information Management Architecture • Reduces integration costs and accelerates time-to-solution value © 2011 IBM Corporation IBM Content and Predictive Analytics for Healthcare An overview Extract medical facts and relationships from multiple clinical and operational information sources Analyze Visualize Analyze and Visualize past, present and future scenarios to create an evidence based corpus of information • Content Analytics with natural language processing to analyze trends, patterns, deviations, anomalies and more unstructured information – detect discrepancies in structured data • Predictive Analytics for predictive scoring and probability analysis • Healthcare Solution Accelerator enabling medical fact and relationship extraction through pre-built annotators – built from expertise in previous engagements • Planned integration to IBM Watson for Healthcare for deep question answering capability* Enable clinicians, executives and knowledge workers to Interact with information and derive insight in new ways Integrate and leverage other systems to turn insight to action 11 * Future optional capability © 2011 IBM Corporation IBM Content and Predictive Analytics for Healthcare How it works IBM Watson for Healthcare Raw Information Unstructured Data (Nurses notes, discharge notes, etc.) Structured Data (Billing data, EMR, etc.) Confirm hypotheses or seek alternative ideas with confidence based responses from learned knowledge* IBM Content and Predictive Analytics Analyzed and Visualized Information Content Analytics Predictive Analytics • Natural Language Processing • Medical Fact and Relationship Extraction (Annotation) • Trend, Pattern, Anomaly, Deviation Analysis • Predictive Scoring and Probability Analysis Health Integration Framework Dynamic Multimode Interaction Search and Visually Explore (Mine) Monitor, Dashboard and Report Question and Answer* Data Warehouse and Model Custom Solutions Master Data Management Advanced Case Management Partners (HLI) 12 * Future optional capability Specialized Research Business Analytics © 2011 IBM Corporation Seton Healthcare Family Reducing CHF readmission to improve care “IBM Content and Predictive Analytics for Healthcare uses the same type of natural language processing as IBM Watson, enabling us to leverage information in new ways not possible before. We can access an integrated view of relevant clinical and operational information to drive more informed decision making and optimize patient and operational outcomes.” Charles J. Barnett, FACHE, President/Chief Executive Officer, Seton Healthcare Family Business Challenge Seton Healthcare strives to reduce the occurrence of high cost Congestive Heart Failure (CHF) readmissions by proactively identifying patients likely to be readmitted on an emergent basis. What’s Smart? IBM Content and Predictive Analytics for Healthcare solution will help to better target and understand high-risk CHF patients for care management programs by: • Utilizing natural language processing to extract key elements from unstructured History and Physical, Discharge Summaries, Echocardiogram Reports, and Consult Notes • Leveraging predictive models that have demonstrated high positive predictive value against extracted elements of structured and unstructured data • Providing an interface through which providers can intuitively navigate, interpret and take action 13 Smarter Business Outcomes • Seton will be able to proactively target care management and reduce re-admission of CHF patients. • Teaming unstructured content with predictive analytics, Seton will be able to identify patients likely for readmission and introduce early interventions to reduce cost, mortality rates, and improved patient quality of life. IBM solution • IBM Content and Predictive Analytics for Healthcare • IBM Cognos Business Intelligence • IBM BAO solution services © 2011 IBM Corporation IBM Content and Predictive Analytics for Healthcare What’s so innovative? Patient Procedure A 42-year old white male presents for a physical. He recently had a right hemicolectomy invasive grade 2 (of 4) adenocarcinoma in the ilocecal valve was found and excised. At the same time he had an appendectomy. The appendix showed no diagnostic abnormality. Accurately extract buried medical facts and relationships with medical annotators Age: 42 Gender: Male Race: White Physicians Other Clinicians Care Coordinators Researchers hemicolectomy diagnosis: invasive adenocarcinoma anatomical site: ileocecal valve grade: 2 (of 4) Executives Business Analysts Claims Fraud Knowledge Workers Procedure appendectomy diagnosis: normal anatomical site: appendix Analyze compiled information for trends, patterns, deviations, anomalies and relationships in aggregate to reveal new insights with content analytics Model, score and predict the probability of outcomes with predictive analytics Other Systems and Applications Make insights accessible and actionable for all clinical and operational knowledge workers (and systems) Confirm hypotheses or seek alternative ideas from learned knowledge via Watson for Healthcare from the same user interfaces* 14 * Future capability © 2011 IBM Corporation The Healthcare Solution Accelerator explained Healthcare Solution Accelerator • Based on expertise drawn from previous solution engagements • Enables medical facts and information relationships (context) to be extracted from information sources through pre-built annotators designed accelerate time-to-value and shorten the solution development process • Example: Extraction of clinical notes by identifying types of clinical named entities including medications, dosages, diseases/disorders, signs/symptoms, lifestyle indicators and other contextually relevant information 15 © 2011 IBM Corporation Using Content and Predictive Analytics to Impact Outcomes Starting in 2012 … Hospitals will be penalized for having high readmission rates - Medicare discharge payments will be reduced in key areas such as Congestive Heart Failure (CHF) Use Information to Determine High Risk Profile Simple Theory, Harder Reality Identify Key Indicators What is accepted and known Examples: Smoking Status LVEF Levels Errors in Smoking Status Status Fixed, Unidentified Smokers Found LVEF Levels Found Only in Textual Reports LVEF Levels Extracted from Lab Reports Do we have all the answers today? What is unknown 16 Identify Patients That Match Profile What about any unknown factors? Can we improve outcomes even more? Analyzed Information Visually Explore Information in New Ways Coordinate Care to Prevent Readmission Predict High Risk of CHF Readmission with Accepted Indicators Intervene and Coordinate Care – Optimal Outcome? Predict High Risk of CHF Readmission with Optimal Indicators Intervene and Coordinate Care – Optimized Outcome Uncover new 2D Insights Not Possible Before • • • • Improve care Reduce readmissions Lower costs Avoid penalties © 2011 IBM Corporation ICPA Live Solution Demo © 2011 IBM Corporation Optimizing Insight Discovery End Users Content (NLP) Modeling Analysts Text Mining / Discovery Predictive Modeling Analyzed Information Step 1: Search and explore (or mine) information to understand source data Step 2: Customize by building content (NLP) and predictive models Step 3: Expose insights to multiple users and systems (e.g. custom apps, mobile devices, dashboards) © 2011 IBM Corporation Solution Demo © 2011 IBM Corporation The IBM Content Analytics User Interface Explained Search Query Exploration Views, Filters and Thresholds Automatically Extracted Facts and Relationships Analyzed Concepts, Entities, Meta Data, Classifications, etc. Visualization with Drill Down for Exploration and Mining © 2011 IBM Corporation Demo Scenario: Medical Device Manufacturer 2 Interactive Discovery (ex: trend & outlier analysis) 1 Source Content (ex: device incident reports, customer emails) Action 3 (ex: prepare for recall) 4 Advanced Case Management (trigger case process to manage intervention) Operational Reporting (ex: BI dashboard including content metrics) © 2011 IBM Corporation MedWatch: FDA Public Safety Information 1 © 2011 IBM Corporation 2 © 2011 IBM Corporation 2 © 2011 IBM Corporation 2 © 2011 IBM Corporation 2 © 2011 IBM Corporation 2 © 2011 IBM Corporation 2 © 2011 IBM Corporation 4 © 2011 IBM Corporation Demo Recap: Medical Device Manufacturer 2 Interactive Discovery (ex: trend & outlier analysis) 1 Source Content (ex: device incident reports, customer emails) Action 3 (ex: prepare for recall) 4 Advanced Case Management (trigger case process to manage intervention) Operational Reporting (ex: BI dashboard including content metrics) © 2011 IBM Corporation Tuesday May 4th, 2010 Baxter International Inc. said Monday it would recall the approximately 200,000 Colleague brand drug-infusion pumps that are on the market, after years of malfunctions with the device, along with patient injuries and deaths. The Colleague pumps have been widely used in hospitals, especially in the U.S., to deliver medication and other fluids to patients. Approximately 200,000 units recalled Estimated cost of recall between $400-600 million © 2011 IBM Corporation Building Solutions and Getting Started © 2011 IBM Corporation Content Analytics Reference Architecture with Watson Data Import Data Layer Structured Data DB Connect B2B Data Broker Federation ETL / Cleanse B2B Data Triple Store Data Warehouse OLAP NLP Content Analytics Index Watson Content Prep 33 Applications Social Media Analytics Social Biz Apps Sentiment Analysis Industry Apps Entity Analytics BI Reporting Database Unstructured Content Crawler Data Fusion Watson Content Business Analytics Predictive Analytics Other Analytics Watson Services Operational HC Apps Clinical HC Apps Rapid Insight Enterprise Search Watson Specific © 2011 IBM Corporation Content Analytics Reference Architecture with Mappings Data Import Data Layer Structured Data DB Connect B2B Data Broker Federation ETL / Cleanse B2B Data Triple Store Data Warehouse OLAP NLP Content Analytics Index ICPA for HC Applications Social Media Analytics Social Biz Apps Sentiment Analysis Industry Apps Entity Analytics BI Reporting Database Unstructured Content Crawler Data Fusion Watson Content Prep Watson Content Business Analytics Predictive Analytics Other Analytics Watson Services Operational HC Apps Clinical HC Apps Rapid Insight Enterprise Search Watson Specific Watson HC HIF Ecosystem 34 © 2011 IBM Corporation IBM BAO Content and Predictive Solution Services 3 paths to value based on your needs Start finding actionable insights in 6+ weeks OPTION 1: ICPA FAST PATH PILOT • UIMA Center of Competence • Business Value Assessments • Start with no charge strategy workshop Define and Implement Pilot 6-8 Weeks 1-4 Weeks OPTION 2: ICPA SOLUTION IMPLEMENTATION Start Here Strategy Workshop Evaluate Pilot Use Case Definition ½ - 1 Day Design and Build Solution Destination Complementary Deploy Solution to Production* Integrate Watson (Future) OPTION 3: BUSINESS CASE and ROADMAP Assess Requirements 35 Develop Roadmap and Business Case Incrementally Deploy to Production * Optionally expand to other use cases © 2011 IBM Corporation How to get started NOW Unique Value Delivered 1 Start with IBM Content and Predictive Analytics Address pressing clinical and operational issues today 2 Expand and integrate ICPA-based solutions Expand solution value by integrating other systems and capabilities • IBM BAO Enterprise Services Clinical Outcomes Operational Outcomes • IBM Content and Predictive Analytics for Healthcare • IBM BAO Solution Services – UIMA Center of Competence • Also available as a Workload Optimized System FUTURE NOW 3 Complement with IBM Watson for Healthcare Maximize solution value by extending with IBM Watson for Healthcare for real-time confidence based answers • Advanced Case Management • Business Analytics • Data Warehouse and Data Models • Master Data Management • Partner Solutions KEY Future Optional Capability ICPA for Healthcare Optional capabilities Value Maximized 36 © 2011 IBM Corporation New Healthcare solutions from IBM IBM Content and Predictive Analytics for Healthcare (ICPA) … a synergistic solution to IBM Watson Helps transform healthcare clinical and operational decision making by uniquely applying multiple analytics services to derive and act on new insights in ways not previously possible – also available as a Workload Optimized System The first solution designed to complement and leverage IBM Watson ICM Care Management for IBM Case Manager Extends IBM Case Manager with a patient-centric care management platform that empowers Care Coordinators to create personalized care plans for patients, coordinate the care of a patient as they move between care settings, monitor the progress of the plan and communicate / collaborate with providers and patients within a PCMH (Patient Centered Medical Home) at an Accountable Care Organization Data Model for Healthcare Provider Data Warehouse A single integrated Healthcare model for the Healthcare market that includes Provider, Payer, and Supply Chain content The data model comprises three tiers including a Business Data Model, Atomic Warehouse Model and a Dimensional Warehouse Model - also included are HL7 mappings to the model and supporting deployment methodology © 2011 IBM Corporation Turning insight into action for care coordination Patient and operational source data including paper based information IBM Content and Predictive Analytics identifies high risk patients for readmission improving patient care while reducing readmission frequency and costs Care based on IBM Care Management Clinical Outcomes Operational Outcomes • Identified patients trigger care coordination interactions • Care plan developed and implemented • Single view of interactions with the patient • Post-discharge follow-up proactively managed IBM Case Manager Solution Accelerator 38 A patient-centric care management platform that empowers Care Coordinators © 2011 IBM Corporation Next steps Find out more about IBM Content and Predictive Analytics for Healthcare http://www.ibm.com/software/ecm/content-analytics/predictive.html Conduct a content and predictive analytics strategy planning workshop Contact your IBM client representative 39 © 2011 Corporation © 2011 IBMIBM Corporation Use Case Discussion © 2011 IBM Corporation IBM is helping to transform healthcare Revealing clinical and operational insights in the high impact overlap between clinical and operational – enabling low cost accountable care IBM Content and Predictive Analytics for Healthcare Readmission prevention Diagnostic assistance Claims management Clinical treatment effectiveness Critical care intervention Research for improved disease management Fraud detection and prevention Clinical Outcomes Operational Outcomes Voice of the patient Patient discharge and follow-up care Improved patient satisfaction at lower costs Enhanced patient care with optimized outcomes 41 © 2011 IBM Corporation ICPA Clinical Use Cases Clinical Outcomes Operational Outcomes Diagnostic Assistance: Highly correlated symptom to health/disease analysis issues visualized with predictive guidance on diagnosis to improve treatment and outcomes … with predicted or forecasted costs. Clinical Treatment Effectiveness: Examine patient-specific factors against the effectiveness of a healthcare organizations specific treatment options and protocols … including comparisons to industry wide outcomes and best practices. Critical Care Intervention: Early detection of unmanageable or high risk cases in the hospital that leads to interventions to reduce costs and maintain or improve clinical conditions … including case based interventions. Research for Improved Disease Management: Perform analysis and predict outcomes by extracting discreet facts from text, such as: patient smoking status, patient diet and patient exercise regime to find new and better treatment options … use a mechanism for differentiation or to secure research grants. © 2011 IBM Corporation ICPA Operational Use Cases Clinical Outcomes Operational Outcomes Claims Management: All claims involve unstructured data and manually intensive analysis. Analyze claims information documented in cases, forms and web content to understand new trends and patterns to identify areas … perfect for process improvement, cost reduction and optimal service delivery. Fraud Detection and Prevention: Uncover eligibility, false assertions and fraud patterns trapped in the unstructured data to reduce risk before payments are made … usually represented by a word or combination of words in text that can’t be detected with just structured data. Voice of the Patient: Include unstructured data and sentiment analysis from surveys and web forms in analysis of patient and member satisfaction … this will be key as the industry moves to a value based model. Prevention of Readmissions: Discover key indicators which are indicative of readmission to alert healthcare organizations to these so that protocols can be altered to avoid readmission … this is key as new Medicare payment penalties go into effect in 2012. Patient Discharge and Follow-up Care: Understand and monitor patient behavior to proactively inform preventative and follow-up care coordinators before situations get worse. © 2011 IBM Corporation Unstructured Information Use Landscape Natural Language Processing is Needed to Search Deep QA Analyze / Visualize (Trends, Patterns, Relationships) Commerce Search eDiscovery, Legal Enterprise Search Expertise Locator Product Quality Care Care Consideration Consideration Analysis Analysis Safety, Defects, Maintenance Treatment Treatment Protocol Protocol Analysis Analysis What’s What’s New? New? Consumer Consumer Portal Portal Clinical Outcomes Operational Outcomes Risk, Fraud, Security Claims Analysis Research (Biz, Edu, Legal, Social Scientific) Media, Marketing VoC, Churn, Cust Svc Coding Coding Automation Automation Patient Patient Inquiry Inquiry Patient Patient Workup Workup Treatment Treatment Authorization Authorization Longitudinal Patient Electronic Health Information Differential Differential Diagnosis Diagnosis Treatment Treatment Options Options Specialty Specialty Diagnosis Diagnosis & & Treatment Treatment Options Options Caregiver Caregiver Education Education Population Population Analysis Analysis & & Care Care Mgmt Mgmt Second Second Opinion Opinion On-going On-going Treatment Treatment Specialty Specialty Research Research GenomicGenomicbased based Analysis Analysis Call Center, Help, Self Service Knowledge Mgt Semantic Understanding, Ontology Mgt and Big Data © 2011 IBM Corporation