The Cathedral And The Data Bazaar

Enabling Lean Data

@vaibhavb

Who is Vaibhav?

DIRECTOR OF PRODUCT MANAGEMENT, OPTUM

AUTHOR, O’REILLY MEDIA

TWITTER – @vaibhavb

BLOG – http://healthblog.vitraag.com

ME – http://about.me/vaibhavb

Hobbies: Interactive Furniture, Mixology,

Cycling, Mountaineering

Associations: United States Cycling

Federation (USCF) Referee

Agenda

• The Cathedral model for Healthcare Data

• The Bazaar - Lean Data

• Clinical Data Connectivity

– Purpose

– Access

– Security

– Sharing

Problem with current model(s)

• Central Monolithic design with too many interdependencies

• Hard to see value when doing data aggregation

• At scale & adoption issues for data sets released

– Open Data

– Meaningful Use Mandated data

• Design by committee

ONC “Learning Health System” Roadmap

• 10 years!

• Over 50 use cases

• A standards advisory issued every year

Picture

Bazaar – Lean Data

• A bare bones simple platform

• Participants can create and absorb value independently

• Data is judged and consumed by value!

Lean Data – A Case Study

Value Based Consumers

Paper Charts

EMRsLabs

Clinical Data

Aggregation

Purpose First!

• Drive Measures

– ABA: Adult BMI Assessment

– CDC-LDL: Comprehensive Diabetes Care & LDL screening

– ..

Pillars of Access

• Transport

• Format

• Semantics

Data Transport

• Secure FTP

• XDS.B

• Direct

• Proprietary REST API

• FHIR REST API

Format

• Proprietary CSV Files

• HL7 V2 (ADT, ORU etc.)

• C32

• CCDA

• FHIR JSON

Semantics

• Problems

– ICD 9/ 10

– SNOMED-CT

• Procedures

– CPT

• Labs

– LOINC

• For example BMI values require SNOMED-CT codes

Security

• Self Signed X509 Certificates

– SFTP

– SSL Mutual Authentication (XDS.B/ REST API)

• Direct Certificates & Identity Proofing

– Direct

• O-Auth2

– FHIR

16

Sharing – Data Access

• Data Access

– Simple

• Member Demographics (First Name, Last Name etc.) shared with Data Provider

• Data Shared only on a full match!

– Standards Based

• IHE PIX/PDQ

17

Sharing – Data Use

• Data Use established per use-case / measure

• Eventual standards based – XACML

• Data shared with HEDIS engines through network share in flat files –Lean!

18

Data Value == Data Freedom

• When you are freeing the data make sure there is immediate value!

• Choose Lean vs. end all be all

• Establish valid crawl, walk run approaches for

– Access

– Security

– Sharing

Thank You!

Questions?

TWITTER – @vaibhavb

BLOG – http://healthblog.vitraag.com

ME – http://about.me/vaibhavb