Big Data Reveals Crucial Hidden Information in Healthcare
Systems
White Paper – Health Technology Use Case
Industry Challenge Technology leaders in healthcare know that managing risk for a population
requires a highly informed, data-driven approach to tracking the care of patients. The challenge is that
coded data from administrative sources falls far short of faithfully representing the clinical history of a
patient. Studies show that more than 63% of the key clinical information about patients is missing
from the coded data in Electronic Health Record (EHR) systems. What is needed is a way to harness
the entire clinical history of each patient, including the crucial information that is contained in
narrative and scanned documents. Furthermore, this information must be assembled from all sources
into a clear, seamless presentation, so that care managers can efficiently monitor their patient
cohorts, and clinicians can quickly and easily retrieve the results they need to make confident
decisions. Apixio Solution The solution is Apixio’s Clinical Knowledge Exchange (CKX), a “smart HIE”
that assembles clinical information from multiple sources and extracts key diagnoses, procedures and
results from text and scanned documents. The result is a complete, electronic view of the patient that
can be understood easily by both humans and quality reporting systems. Powered by the CKX, the
Apixio Patient Analyzer performs a clinically intelligent search of a patient's entire history, and
presents the results conveniently within the user's EHR. Big Data Analytics Under The Hood The Apixio
CKX uses Big Data technology to process all incoming data and make real-time querying of structured
data, textual documents, scanned documents and administrative data a reality. All incoming textual
data, including text extracted via Optical Character Recognition (OCR) from scanned documents, is
analyzed, structured and meta-tagged as soon as it comes into the Apixio Hadoop cluster, making it
immediately available for patient-level and population-level queries. With access to over 50 million
clinical documents, containing 5 billion discrete clinical findings, CKX is able to use Big Data Analytics
techniques to attach meaning to almost all incoming data, regardless of the source. The following case
study describes how the CKX and Patient Analyzer are being used by an ACO to reduce its risk and
increase its operational efficiency. Customer Success Story - Muir Medical Group, IPA
Muir Medical Group, IPA, (MMG IPA) in partnership with John Muir Health, act as both a Medicare
and Private Accountable Care Organization (ACO) with tens of thousands of enrolled patients. Care is
coordinated among several hundred employed and independent physicians spread across a large
portion of the San Francisco Bay Area. A team of thirteen care managers oversees the entire patient
population, tracking high risk patients and monitoring for important events, such as hospital
admissions, significant laboratory findings and high-cost procedures. The goal is to quickly and
proactively identify patients who are at risk, which would be impossible without timely, efficient
access to aggregated information from all providers within the ACO.
www.apixio.com
Page 1
CMS provided MMG IPA with very short notice that its ACO application had been accepted, requiring
a rapid deployment with minimal IT complexity. The challenge was that care managers did not have
access to EHR data for all of the patients in the ACO, and they were frustrated by the requirement to
toggle between multiple logins and information sources. Apixio’s cloud-based CKX, a smart HIE that
provides a unified longitudinal record from multiple sources, and which can be accessed both from
within the EHR and from any web-enabled device, was an ideal solution.
Apixio imported all the data for 50,000 Medicare beneficiaries, including coded EHR data, clinical
narrative, scanned documents and claims data into its scalable, cloud-based CKX analytics platform, in
approximately one month!
Care managers at the ACO now efficiently access the full longitudinal records of patients in a single,
seamless view in the Apixio Patient Analyzer. Even scanned documents are searchable, so that a query
for “influenza vaccine” retrieves all instances of the vaccine, including a scanned flu vaccine printout
from a pharmacy.
A care manager at Muir Medical Group describes Apixio as the “best tool we have to find consolidated
information!”
In addition to coordinating the efforts of different healthcare providers, ACO care managers are
tasked with identifying the correct patients to include in chronic disease management programs.
Unfortunately, structured data is insufficient to ensure accurate identification of disease cohorts.
Clinical narrative contains crucial information about patient care that is invisible to traditional disease
management and quality reporting systems. In the figure, a quality measure for coronary artery
disease (CAD) yields a more accurate and improved result when information from text mining is
included.
From care coordination with a complete longitudinal record to disease management enrollment using
results from text mining, Muir Medical Group demonstrates how Big Data Analytics can solve
real-world ACO problems.
www.apixio.com
Page 2