A couple of weeks ago I attended HIMSS 2017 in Orlando (Healthcare Information and Management Systems Society), the largest annual Healthcare IT event in the US. One of the big tenets of the show was system interoperability. There are lots of different vendors, few standards, and vast amounts of data being collected. There is an emerging set of APIs (such as HL7 FHIR) to ensure data can be shared among systems and follows a patient properly through the various providers she encounters during her episodes of care.
Somewhat serendipitously I came across a booth which had large prints of beautiful data visualizations on it. The booth was from Arcadia Healthcare Solutions. Given my background on data visualization and my being employed at Rennova Health Technology Solutions and responsible for our healthcare IT products and services, I was drawn to interpret these prints. They are also featured in an online data gallery, which I encourage you to explore.
One of these visualizations created by Jeff Solomon is called “The Health IT Space“. It displays highly aggregated data from various EHR (Electronic Health Record) systems. From the gallery:
The Electronic Health Record is a data gold mine. Each patient you see generates millions of detailed records in real time that can be extracted and analyzed for improved predictive algorithms, increased operational efficiency, better care quality, and so much more.
These graphs are stylized Entity Relationship diagrams from seven different EHRs. Nodes are data tables, and edges are relationships between these tables inferred from shared attributes.
The color-highlighted nodes are referring to patient data. The size of the node corresponds to the amount of records in the respective table.
Again, from the gallery description:
In each cluster, the core patient entity – the nucleus around which the rest of the data revolve – can be identified by its contrasting color. The tables containing the bulk of the clinically and operationally valuable data tend to form clusters of large, interconnected nodes, while a larger number of satellite tables house system configurations and other low-volume metadata that has very few relationships to the nucleus.
At the large end of entire health systems, the graph starts to look very busy:
It is pretty amazing how much data is being aggregated into these graphs. Nearly 5,000 database tables – hence the black areas where there are too many dots to separate them at this resolution. A combined number of 18 billion records! Nearly 300,000 relationships between these tables (again, the lines are too numerous to be distinguishable).
I find it somewhat humbling to review these graphs. Our own MedicalMime EHR falls into the small category by these standards. Major and Large EHRs are at least one, maybe two orders of magnitude larger and more complex.
Interpreting the large amount of data contained in the EHR opens up many ways to improve healthcare, both medically for the patient as well as operationally for the providers. Visualizations can help us to better understand patterns and trends which otherwise would remain hidden.
The entire big picture of the above visualization is indicated on the right. For a Hi-Res version please contact the friendly folks from Arcadia Health Solutions directly from their website.
Another big trend at HIMSS’17 was Artificial Intelligence. Machine learning and predictive analytics received a lot of attention. Solutions like IBM’s Watson Health promise to bring world-class expertise into ordinary physician practices through subscription to hosted specialty knowledge in the cloud – whether curated by scientists or machine-learned using statistical techniques from big data. Health Catalysts healthcare.ai is an open platform to make machine learning techniques more accessible and bring them to small SW houses, not just the large companies with large R&D budgets. While certainly overhyped at the moment, acceptance for obtaining a “second medical opinion from the cloud / app” to improve clinical decisions is rising.