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7/22/2014
10:36 AM
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Optum Labs Translates Big Data Research To Clinicians

Big data shows lots of promise in researchers' hands. By getting this insight to clinicians, it can really improve and save lives, says Dr. Paul Wallace of Optum Labs.

Technology Declares War On Cancer
Technology Declares War On Cancer
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Big data is beginning to deliver on its promise of better healthcare, but to truly impact patients, quality, and spending, research results have to translate to clinicians' offices, not merely show up in labs and reports.

That is the impetus driving Optum Labs, a partnership between Optum Inc. and Mayo Clinic's Center for the Science of Health Care Delivery. It collaborates with academic institutions, commercial payers and employers, health-oriented foundations, life-science corporations, healthcare providers, technology businesses, government agencies, policymakers, and consumer groups to transform big data into enhanced patient care. (Optum is a wholly owned subsidiary of UnitedHealth Group.)

To date, Optum Labs has signed about a dozen partners, including AARP, with another dozen in the works, said Dr. Paul Wallace, chief medical officer at Optum Labs, in an interview.

"The vision for Optum Labs is to see it as being end-to-end, to take ideas relevant at the front line ... by researchers, but have them addressed in a way that creates actionable knowledge," he said. "One of the first questions we ask is, 'How would this be translated back into a practice?' We give the highest priority to items that have a destination, if you will."

[Ready to swim? See Healthcare Dives Into Big Data.]

Today, Optum Labs has about 20 initiatives underway, he said. Using a database of de-identified information about more than 150 million people, partners are conducting studies on areas such as knee replacement surgery, diabetes, and hepatitis C. For example, in an observational study using the Optum Labs database, researchers compared different approaches to diabetes 2 medication management across 37,501 patients, according to a paper Wallace and colleagues wrote for Health Affairs. Although metformin is consistently recommended as the initial medication for newly diagnosed type 2 diabetics, doctors have other options such as sulfonylurea drugs or oral agents and insulin, they wrote. The study found similar effects for all medications in attaining "glucose control, longevity, and overall quality of life," the article said. Yet the cost was lower for patients prescribed sulfonylurea -- and it took longer for these patients to need insulin than those patients who used oral medications, the research found.

Paul Wallace
Paul Wallace

Findings like this are exciting, but it's vital that this type of information doesn't get lost in journals, whitepapers, and labs, Wallace said. That's one reason why Optum Labs wants such an extensive span of partners, he noted.

A diverse partnership ecosystem expands the type of questions Optum Labs asks, said Wallace. Early partner AARP, for example, brings more of a consumer perspective than its pharmaceutical or academic associates, he said.

It's also critical to springboard from de-identified big data to empower clinicians to resolve individual patients' health problems, Wallace said. Too often, clinicians' opinions are forged by their own experiences, not the patient they're examining, and medical professionals have an incomplete picture of the patient, he said. Big data gives clinicians access to experiences from other medical professionals and patients in the same situation, especially those facing multiple chronic conditions, Wallace said.

"We're at a really exciting time where we can personalize care to levels that previously we have not been able to do. It also means we have to be very mindful of the need to protect privacy and confidentiality," he said. "In some levels that's a very difficult juxtaposition. There is an appropriate tension about how data is used and how data is made available."

Data sanctity is crucial, he said. Optum Labs built stringent controls over data access, said Wallace. Some information comes from an electronic health record (EHR) of de-identified data on 30 million patients from EHR analytics vendor Humedica. Other information is traditional administrative or claims data reflecting insurance and pharmacy claims, he said, which comes from various companies. Using natural language processing, data is extracted, curated, and normalized, and then linked to claims data. Optum Labs houses the information at a separate location, preparing a separate research enclave for each project, Wallace said. Data, some of which dates back 20 years, is de-identified to meet HIPAA standards, and researchers cannot download patient-level data, he said. Optum Labs uses its Natural History of Disease software to navigate the database and accelerate the research process, said Wallace.

"The approach we take is what we believe is certainly compliant with regulations, but going beyond that because we hold the trust not only of patients but also the clinicians who care for them. We won't allow information to be added to the sandbox," Wallace said. "We think this is about trust and it's about trust on the part of the patients we serve, the clinicians we serve and the organizations we work with. In many ways, big data has the potential to change just about everything... but nothing's going to change overnight so we've got to ensure everything we do retains fidelity."

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Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek, Baseline Magazine, Redmond Channel ... View Full Bio

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MedicalQuack
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MedicalQuack,
User Rank: Moderator
7/24/2014 | 11:10:28 AM
Almost same at FDA Sentinel Program
The FDA Sentinel Program does the same thing although the queries and what is being mined relative to what they are searching for could be different.  It's also a lifeline for hospitals needing money as they join as "owners" they get to share in money that is made here too.  So in addition for contributing patient medical data they get to participate in profits earned. like Boston Scientific who signed on to mine data about their products.  With the latest Mayo app with Apple, patients were disappointed they could not "get" their data, in other words download and take it with them from the app, so I assume patient inupt data goes over the labs as well.  You do see the Mayo CEO almost doing commercials as they too saw this as a revenue stream. 

http://ducknetweb.blogspot.com/2014/05/boston-scientific-joins-optum-united.html

The diabetes study, same stuff that comes out of the FDA data mining and their knee and hip recent report, same thing that was done by Kaiser a while back.  McLaren hositals signed up here a while back as they were on dire straights for needing income too.  Again selling studies and allowing data mining for a fee is the way it makes money from one standpoint. 

I'm not sure if the MedQuest data (another subsidiary of Optum/United)that is collected at PBM sites is entered here or not but I would suspect it would be and that's a big data selling operation of Optum and you even seen Express Scripts using the Optum software at the PBMs to do behaviorial analycis too so when you get a prescription you are being scored there too. 

There could also be some revenue cycling data in here too with Dignity, another partner who is pesently in busness with Optum in another subsidiary with putting 3000 people in place in their hospitals. 

Shared Clarity, another subsidiary that Optum bought does kind of the same thing with mining data at hospitals and I would assume some of that data makes it over there too as the Labs take it beyond just beyond the one hospital system, again it creates revenue streams for thos hospital system sending their EMR data and so far nothing that big but wait and see if there's anything of more substance than the FDA Sentinel program doing the same thing I guess.

http://ducknetweb.blogspot.com/2014/02/united-healthcare-adds-mclaren-care.html
PedroGonzales
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PedroGonzales,
User Rank: Ninja
7/23/2014 | 4:05:31 PM
bring big data to the front lines
Great article. I agree that such effort is exactly what is needed to effectively push technology and big data to into the health care setting.  I agree of the gap that although technology can bring many positive changes health.  In actuality its adoption remains low.  Such collaboration will further expand the need to using technology in the health field.  
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