Data-Omnivorous Platform for Healthcare

03/19/2022 Compiled by Valmeek Kudesia; accumulated from real experience

Why a Platform?

See below for design for specific real experience and generalized design

Wish to Reach and Inform Every Clinical Decision

- Numerous daily clinical decisions in varied settings, different member, patients, care-givers, & staff
- Must address pain-points & needs that prevent analytics and prediction for day-to-day-use
  - Silos; teams on operating on similar but different datasets i.e. Conway's Law
  - Distinct dev/test/prod environments for datasets/data assets ⇨ additional overhead ⇨ lengthy iteration cycles, data validation & governance
  - Need faster iteration for analytics/data science/ML
- Therefore, need capability that is flexible, extensible, and can "absorb" variety inherent to reality of clinical care

Imports Abilities of a "Data-Company"

Healthcare organization needs some but not all skills of data-savvy tech-company i.e must be "data-smart" not necessarily "database-smart". Therefore, must "import" following "data-smart" capabilities:

Quickly reach front-line end-users and addresses [[who-makes-decisions]]
Cost-effective ways to harness vast amounts of existing data
Quickly combine data domains to enhance value of data and give full view of business
Quickly improve data quality and expand utility of data
Provide “logical” layer to support data many diverse analysts vs only limited few
Rapidly learn and implement feedback from end-users (e.g. A/B testing, model dev)
Treat data as pluripotent asset; not “just a data warehouse/lake”
Separate storage from compute→supports many uses/service (not just fast reads and aggregations)

Critical Importance of Information Model

NOT building a warehouse, more like lake-house vs highly-organized lake
encodes subject matter expertise
integrated at patient/member and temporal granularity
Opinionated re "what is good" e.g. converge teams' actions, maximize work not done

Philosophy

[[data-ops]], CI/CD, open source
Data pipelines, transforms, models are “data applications”
No costly infrastructure/tooling
Incrementalism - accelerate with every new piece of work i.e. [[remove-causes-failure-better-job-with-less-effort]] and [[maximize-the-work-not-done]]
Deploying “new” is easy and controlled
- Full architecture is replicated in “Dev place” and “Prod place“
- Deploying to PROD is as simple as changing a config
- Integrate w/ existing assets; engineer our own PRN
- Data from all systems with speed, scale, reliability
- Cohesive/contiguous data environment, warts included
- High reliability and availability
Operate with the minimum amount of resources; encourages agility and efficiency; keeps things lean and pro-automation

Goals

Make all data (faults included) usable together to maximize scope of decisions inform-able
Accelerate use of data to generate insights/hypothesis to inform decisions at (or at nearly) continuous cycle time i.e. promote a learning organization and improve along things that never change
Reach every decision regardless of users’ skill to access and use insights
Accomplish the above with
- High quality work
- Minimal burden on data science and engineering

Objectives

Deploy a cloud-based advanced data platform that supports following capabilities via by modern rapid iteration and quick-to-value practices
Functional data pipelines & high quality data engineering
Descriptive analytics
Advanced analytics (e.g. ML, expert rules, rapid system learning)
Iterative data-to-information/concept modeling
Clinically-informed expert rules
Framework for A/IAI+human centaur system
Democratized self-service access as primary delivery vehicle for insights

Outcomes

Implements [[use-of-data-at-a-data-informed-org]]
Facilitates adoption of [[characteristics-of-data-informed-culture|characteristics of data informed culture]]
Aligns with [[identity-and-behaviors-clinical-organization | identity of clinicians]] thereby enables [[high-performing-clinical-model]]
Achieves [[vision-for-use-of-data-clinical-org]] and [[data-informed-compassion-guided-healthcare-org|data informed and compassion guided healthcare organization]]

Specific Design

Generalized Design

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