BIG

DATA AND CANADIAN HEALTHCARE 1

Big Data and Canadian Healthcare

Andrea McDonald

Western University

MIT 2157

Professor Grant Campbell

April 8, 2016

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Table of Contents

Executive Summary....3

Summary of Commitment..4

Big Data....5

Predictive Analytics.....6

Incorporating Big Data in Canadian Healthcare........6

Real-time Benefits...7

Patient Treatment Plans.8

Management Techniques......9

Limitations...9

Standardization..10

Generalizations and False Prediction.11

High Fixed Costs....11

Conclusion and Recommendations.12

Bibliography.13

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Executive Summary

This report proposes the integration of big data analytics into Canadian

healthcare systems to improve overall patient satisfaction and decrease patient wait

times. This paper will specifically address patient care and potential techniques that

could benefit Canadian healthcare systems. This report will cover both the possible

advantages and limitations of incorporating big data techniques into Canadian

healthcare systems.

Big data analytics can generate real-time results, manageable overbooking

techniques, and specific patient treatment plans to reduce Canadian wait times and

provide increasingly effective overall health coverage for Canadian citizens.

The limitations of big data will be addressed, specifically in regards to the

proposed big data implementations in healthcare systems.

In conclusion, this report recommends including big data techniques into

Canadian healthcare to lower patients wait times. Using big data analytics will increase

the accuracy and efficiency of Canadian healthcare systems to decrease medical

complications and insure patient satisfaction.

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Summary of Commitment

As mentioned in December 2015 Speech from the Throne, the Federal

Government is now working with provinces and territories to develop a new Health Care

Accord (2015). This paper addresses an investment in social infrastructure to integrate

wait time reduction strategies into the new Health Care Accord.

Wait times are becoming increasingly important issue facing patient care. A 2012

Report on Wait Times published by the Canadian Institute for Health openly

acknowledged Canadas poor performance in patient wait times claiming:

A 2010 survey ranked Canada lowest among 11 countries for wait times

in the following areas: Seeing a doctor or nurse when sick: 33% of

patients surveyed reported waiting six days or more for an appointment,

5% more than the country ranked second-lowest; Seeing a specialist: 41%

reported waiting two months or more, 7% more than the country ranked

second-lowest; and Having elective surgery: 25% reported waiting four

months or more, 3% more than the country ranked second-lowest.

(Canadian Institute for Health information, 2012, p. 2)

Medicares official website states wait times are often caused by poorly organized

services, shortage of healthcare workers, and cuts to hospital services (Medicare,

2016). Figure 1 describes the high average wait times in Ontario for specialist

appointments organized by specialty. This paper specifically addresses the reduction of

wait times to increase overall patient satisfaction and increase overall healthcare

efficiency.

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Figure 1. Ontario wait times by specialty. (Thind et al., 2012)

Big Data

Big Data involves the analysis of large datasets to determined relations and

trends. Big data analytics uncovers inferences which cannot be found by human

inspection alone. The datasets act as a representation as a whole population, rather

than a sample of a population. Big data does not necessarily require big sets of

information, but is rather about using as much of an entire dataset as feasible (Mayer-

Schnberger, & Cukier, 2013, p.28). Meaning, big data can be interpreted as shot in

the dark technique where inferences are created by using all available information

without any preconceived/biased outcomes.

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Predictive Analytics

Predictive analysis is the analysis of large data sets to seek possible outcomes,

results or events. Predictive analytics uses a dependent variable to find possible

independent variables and can be used for multiple fields of study to predict future

trends or current happenings specific to the industry. Predictive analytics determine

correlations, not causations.

Incorporation of Big Data in Canadian Healthcare

The Canadian healthcare industry accumulates vast amounts of data that when

applied to big data techniques can benefit specific aspects of healthcare. According to

Sundar Ram, Vice President of Technology and Sales at Oracle, the healthcare industry

is the optimal realm for big data analytics:

The healthcare industry generates zettabytes of data every day in terms

of patient care records, prescriptions, lab tests, pharmacy sales, electronic

patient records, insurance claims data, machine-generated sensor data

from monitoring vital signs etc. Big Data solutions can help the industry

acquire organise & analyse this data to optimise resource allocation, plug

inefficiencies, reduce cost of treatment, improve access to healthcare &

advance medicinal research. (2015)

Data collection is imperative within healthcare for individual patient benefits, yet

can also be reused to act as large datasets for big data analytics.

This report explores the specific implications of integrating big data to the

Canadian healthcare industry, particularly, in reducing wait times. As mentioned

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above, wait times are a pressing current issue in Canadian healthcare and can

be significantly reduced to increase patient overall satisfaction.

Real-Time Benefits

Big data, when incorporated into healthcare systems, can decrease wait times

with real-time predictive analytics. Big data analytics holds the ability to predict events

as they occur, rather than after they occur. Big datas ability to dissect a large data set

to produce quick yet meaningful results could be essential for healthcare systems. As

wait times decrease, Canadian healthcare system can increase treatment efficiency

while reducing cost.

General Electric (GE) researches are working to create a software system using

big data to create what they refer to as no wait states in hospital care, where patients

can get efficient healthcare without waiting. They are developing software that uses big

data real-time analytics to ultimately reduce a patients wait for healthcare resources.

The system uses predictive software, analytics and modeling to help hospital staff

make better judgments about where to put a patient. It can make these decisions in

real-time, identifying real-time bed availability to help hospital operators cope with

higher demand (GE Global Research, 2016).

The real-time benefits associated with big data analytics when integrated into

healthcare can increasingly reduce the time a patient wait times between appointments,

diagnosis, and on-location treatment as information is constantly being analyzed and

updated. GEs innovative hospital management systems were reported to reduce

hospital wait times while reducing costs. A hospital in Florida, using GE healthcare

management solutions was able to use the real-time benefits of big data analysis to
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reduce discharge times for patients by more than 3,150 hours over a nine-month

period (GE Global Research, 2016).

Patient Treatment Plans

Reducing the return rate of a patient is a standard way to reduce wait times: the

less a patient requires Canadian health services, the increased likelihood of available

services for new patients. Reducing patient return rates not only benefits patients, but

lowers costs to healthcare services. Reducing return rates involves increasing the

accuracy of diagnosis, and treatment plans. Using emerging predictive analytic

software, big data has been confirmed to increase accuracy of diagnosis and treatment

plans to reduce return rates.

Personalized medicine is a developing trend in healthcare which involves using a

patients DNA along with data analysis to predict illness and create personalized

treatment plans. An article published in Forbes Magazine describes this method as

comparing a persons genetic blueprint and data on their lifestyle and environment

alongside thousands of others to predict illness and determine the best treatment

(Marr, 2015). This system could be beneficial in a number of ways. For example, a

doctor could input patients symptoms, DNA, lifestyle, age, and other traits to compare

with a large dataset of patients who have similar symptoms to predict possible patient

illnesses based on trends within the data. Once a diagnosis has been made, a doctor

can then compare treatment plans with potential thousands of others who share this

diagnosis. A treatment plan can then be specialized according not only to specific traits

and successful outcomes of previous patients, but to a patients genetic makeup.

Personal treatment plans have the potential to limit the number of visits before and after
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diagnosis by increasing the accuracy of a diagnosis and the potential effectiveness of a

treatment plan.

Management Techniques

Proper management of appointment booking, and the management of patient

no-shows can also decrease wait times for Canadians. For example, according to a

study conducted at the University of South Florida patient no-show is one of the most

serious operational issues facing nearly all primary-care clinics (Zeng, Zhao,& Lawly,

2012, p. 3). While overbooking patients may seem like an optimal solution, the study

proves overbooking is often a poor solution. However, big data analytics can discover

trends in patient no-shows and allow for a prepared overbooking.

A 2007 report published in the International Journal of Dermatology shows a

significant decrease in wait times when using managed overbooking techniques. By

analyzing no-show data, big data analytics can have determined how to managed

overbooking to provide quicker care to patients and ultimately lower costs of service.

The study was shown to use these overbooking management techniques, predicted

through analytics, to reduce the average wait time for a dermatologist appointment from

29.3 days to 6.8 days (Bibi et. al, p. 47). While the results of these predictive measures

cannot tell you the cause of the trends, it acts to provide valuable information that could

decrease wait times by managed overbooking.

Limitations

Viktor Mayer-Schnberger and Kenneth Cukier in their book Big Data: A

Revolution That Will Transform How We Live, Work, and Think describe the many

advantages and disadvantages of big data. They describe a phenomenon known as

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messy data. Messy data will naturally occur as the dataset increases in size. As big

datasets increase beyond the scope of capable human inspection, errors within the data

will often go unnoticed. Increasing the volume [of data] opens the door to inexactitude.

To be sure, erroneous figures and corrupted bits have always crept into datasets

(Mayer-Schnberger, & Cukier, 2013, p. 33). These mistakes in big data become

apparent when data is not standardized, when generalizations are made, and when

false predictions occur.

Standardization

While healthcare presents a large amount of raw data that is ideal for big data

analytics, it is imperative that there are uniform measures of encoding this data. Data

must be consistent in its units of measurements and word choices. When data is not

standardized, one must program analytic systems to recognize equivalent data points.

For example, when encoding data on Attention Deficit Hyperactivity Disorder one must

program all possible names and acronyms such as ADD, ADHD, hyperactive disorder,

hyperactivity Attention Deficit Disorder etc. If a data analytics program was not encoded

to recognize the synonyms it could miss possible correlations. Additionally, it is

important to avoid synonymizing words that may have minor nuances to avoid

generalizations.

Organizing data, creating standardized units of measurement, and labeling data

is, therefore, a major challenge when incorporating big data systems into healthcare.

However, The Center for US Health System Reform Business Technology Office

revealed that over 200 businesses created since 2010 are developing a diverse set of

innovative tools to make better use of available healthcare information (2011, 1).
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Therefore, while standardization is a current limitation, there are multiple current

progressive forces in providing accessible healthcare information.

Generalizations and False Prediction

False predictions and generalizations can occur through big data analytics. It is

important to recognize that big data analytics do not always lead to conclusive results;

particularly when looking at patient treatment plans and predictive measures in

personalize medicine. For example, while a patient may be showing signs of heart

attack (pain in their arms, shortness of breath, and pressure in their chest), this does not

necessarily mean a patient is having a heart attack. There could be additional

undocumented patient symptoms that could lead to an alternate diagnosis. Therefore, it

is important when incorporating big data techniques to not rely solely on the data

analysis, but on human analysis. Big data techniques should not replace healthcare

professionals, but rather act as a guide when looking for trends.

False predictions can also occur due to messy data. Problems may occur

when reusing sets of data that were originally collected for other purposes. For

example, a dataset originally collected to analyze blood sugar levels of type 1 diabetics

would be problematic if reused to analyze the average sugar intake of a larger

population. Reusing data is a large aspect of big data analytics, yet can be problematic

when correlations and diagnosis can directly effect a patients health.

High Fixed Costs

An additional limitation is the initial cost of infrastructure when storing big data.

Hal Varian, chief economist at Google, claims big data systems have a high fixed cost

and a low marginal cost which can lead to an imbalance in the marketplace, where only
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a few companies can afford the costs of data storage procedures (2001). This limitation

is problematic as information storage is paramount in big data analytics. According to

Eric Savitz Web innovators, such as Facebook, Google and Yahoo, have developed a

massively scalable storage and compute architecture to manage Big Data (2012).

However, as stated on the Government of Canadas website, Health Canada is

currently exploring the use of big data to enhance aspects of healthcare systems

(Architecture Framework Advisory Committee, 2015), and therefore, is presently

functioning with the costs of big data.

Conclusion and Recommendations

When creating a new Health Care Accord, The Canadian Government should

consider using big data analytics to create a multi-faceted plan to increase efficiency

within patient care to then reducing wait times within the Canadian healthcare industry.

Big data analytics can be used to create real-time results, accurate patient treatment

plans, and manageable overbooking techniques to reduce current long wait times.

Investing in big data solutions within healthcare, while considering its limitations, would

benefit Canadian overall health and address the pertinent issue of Canadian

accessibility to healthcare services.

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Bibi, Y., Cohen, A. D., Goldfarb, D., Rubinshtein, E., & Vardy, D. A. (2007). Intervention

program to reduce waiting time of a dermatological visit: Managed overbooking

and service centralization as effective management tools. International Journal

of Dermatology, 46(8), 830-834. doi:10.1111/j.1365-4632.2007.03078.x

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evolving-reduce-wait-times
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