ADVICE FROM MILLIONS OF PATIENTS
The availability of millions of claims records produced by doctors, clinicians, hospitals, pharmacies, and others presents a unique opportunity for providing decision support to individual physicians, who often have less and less time to treat patients whose conditions are more and more complicated.
Finding information useful to doctors within claims records — and electronic health records — offers a challenge much greater than the proverbial needle in a haystack. For one thing, the decision-support system must find that needle quickly enough — in a matter of seconds — to give doctors the information they need while they’re working with patients.
To address that challenge, Associate Professor Jimeng Sun and his graduate students in Georgia Tech’s School of Computational Science and Engineering are using advanced algorithms, machine learning, and high-performance computing to find subtle signals in the data sets. But before they can apply these powerful tools, they must confront the fact that the data they’re using was gathered to help medical providers gain reimbursement — not to aid in diagnosis.
“Every clinic and every hospital has this data, so the benefit of using electronic health records and claims records is that you don’t have to put in extra effort to collect it,” Sun noted. “But it’s very difficult to get the data into a high-quality state that will allow you to use it.”
Once the data is clean, Sun’s lab uses neural networks — modeled on the brain — to teach computers to find useful similarities among patient records. Finding those connections requires access to millions of records: some to train the system, and the rest to analyze. The researchers use high-performance computers based on graphics processing units (GPUs), originally developed for the game industry, to run their algorithms.
Based on factors such as a patient’s age, gender, medical history, previous medication results, and other information, the system may suggest a treatment — perhaps a set of drugs to try — supplementing the doctor’s own training and experience. “Even for experienced clinicians, it can be quite challenging to figure out which treatment or drug is likely to work best for a given patient,” Sun said. “Using the signals we find in the data sets, we are able to improve the clinician’s accuracy. There can be a dramatic improvement in the disease risk prediction and treatment recommendations.”
Sun’s team has worked with Children’s Healthcare of Atlanta to develop models for treating asthma and medically complex patients using electronic health record information. Sun’s team has also worked with Sutter Health in predicting heart failure, and with Vanderbilt University and Northwestern University on automatic phenotype discovery.
WHAT WORKS FOR WORKERS
Maintaining a healthy and productive workforce is a top priority for many major companies today. One of the leaders of that effort is Southwire, North America’s foremost manufacturer of wire and cable used in electricity distribution and transmission.
With the title “Director of Living Well,” Lisa Evans is responsible for everything that relates to health and wellness for Southwire’s more than 7,000 employees at locations around the country.
EmployersLikeMe, facilitated by Georgia Tech, helps major employers identify trends and best practices for the health care services they provide their employees. The company offers broad-based programs for its employees, and its headquarters in Carrollton, Georgia, includes a pharmacy, wellness center, and fully certified primary care medical facility.
For Evans, the challenge is to measure what works so she can guide the company’s investment into new initiatives. That’s one reason she is a member of EmployersLikeMe, a Georgia Tech-facilitated initiative that brings together the state’s major employers to discuss common issues such as health care – and share data that could help participants identify trends and best practices.
“Our people are what differentiates us in the marketplace, and it’s important for us to create and sustain an environment that allows people to be the best they can be,” Evans said. “We want to make sure we can glean information from our health care data to help us take action or create awareness that could facilitate more healthy behaviors in the people we serve.”
EmployersLikeMe (ELM) began as a roundtable for representatives from top Georgia companies to share concerns and best practices. Because health care is a major cost today — one that is rising faster than other costs of doing business — ELM has moved into health care informatics.
“We are working to get data from dozens of private companies, all of whom have different pieces of data in different formats with different third-party administrators,” said Don Betts, an extension specialist who leads ELM in Georgia Tech’s Enterprise Innovation Institute. “Employers have a lot of data, and their data is from the private-pay, real-world that’s very different from Medicaid or Medicare information.”
Bringing that information together could help employers identify trends affecting their work force and get feedback on programs designed to help prevent and control such chronic issues as high blood pressure, diabetes, heart disease, and obesity — medical concerns that affect most companies across the board.
“The potential and the power that this knowledge could unleash is amazing,” Betts said. “Most of the ELM employers have self-funded health care programs, so they have an interest in looking at how they can improve access, ensure the best quality of care, and test new approaches for having healthy and productive people.”
In non-metropolitan areas of Georgia, finding and retaining the best workers is a challenge, and access to health care can be among the reasons. Wellness initiatives — sometimes as basic as teaching nutrition and exercise — can be part of attracting people and helping them remain productively on the job. The cost of health problems goes beyond medical claims; costs related to lost productivity, retraining, and other issues also add up, Betts noted.
“If there were any other cost that was going up 10 to 15 percent a year, the company would wrestle it to the ground and figure out what to do,” he added. “But health care is seen by many companies as something they can’t do anything about. The ability to get good data could change that. We want to give executive leadership the information they need to make good decisions.”
Besides Southwire, EmployersLikeMe has representation from major Georgia employers including Fieldale Farms, the Georgia Power Company, The Langdale Company, Mohawk Industries, Newell Brands, Procter & Gamble, Rollins, Inc., Sunset Foods, and The Savannah Business Group. In addition to facilitating sharing among the companies, Betts helps them collaborate with outside initiatives in areas such as telemedicine and addressing chronic health issues.
With its statewide extension presence, Georgia Tech is in a unique position to provide real value for these companies, noted Dahl. “What these companies are most interested in is Georgia Tech’s ability, as a neutral and trusted source, to take their patient data and claims data and aggregate it in a way that will inform them about trends and what works,” she said.