Ascribe, a leading provider of IT solutions for the healthcare industry, wanted to help clinicians identify trends and improve services by supplying faster access to information. However, exploding volumes of structured and unstructured data
hindered insight. To solve the problem, Ascribe designed a hybrid-cloud solution with built-in business intelligence (BI) tools based on Microsoft SQL Server 2012 and Windows Azure. The solution also includes apps that run on Windows 8 tablets. By simplifying
implementation with end-to-end Microsoft products, the company developed a proof of concept within six weeks. Now, clinicians can respond faster with self-service BI tools and gain actionable insight from a wide variety of data that includes clinical records,
emergency room notes, and social media feeds.
Based in Bolton, England, Ascribe is a leading provider of business intelligence (BI), consultancy, and clinically focused IT solutions and services for the healthcare industry. Ascribe estimates that 82 percent of National Health Service (NHS) trusts in
the United Kingdom use its products. With access to large volumes of data, the company wanted a BI solution that would help healthcare providers detect, predict, and respond more quickly to outbreaks of infectious disease and other health threats.
Healthcare analysts typically work from data collected and coded when patients receive treatment in clinics and hospitals. “By the time they get that information it’s usually out-of-date,” says Paul Henderson, Business Intelligence Division Head at Ascribe.
“The data has already been coded and stored in a record-keeping system, or it’s been collected from a hospital workflow and that doesn’t always happen in real time.”
In addition, huge volumes of potentially useful data exist in text files from sources such as unscheduled visits to emergency rooms, school attendance logs, and retail drug sales. The Internet offered another trove of untapped information including clickstream
analysis and social media such as Twitter. “If you think about each clinician that struggles with getting timely, accurate data, and you compound it on a national scale, then it becomes an immense challenge,” says Henderson. “You have lots of small pieces
of data coming in from multiple places, and it can be very difficult to aggregate and interpret. And that’s the job that a national infection control person has in any country in the world.”
Ascribe had previously worked on a solution to support the analysis of national emergency care attendance. The system was designed to monitor the daily number of people who visited emergency departments in the UK and raise an alarm when it identified unusual
levels of activity, such as a potential outbreak of an infectious disease.
However, unlocking the value of the solution proved challenging. For example, it was difficult to collect data from a rapidly growing number of healthcare providers, including mobile clinicians. In addition, clinicians were unable to use the exploding volume
of unstructured data from patient case notes and social media feeds. “The processing power you would need to handle all of that information is beyond the capability of most organizations,” says Henderson. “A hospital can’t just stand up a server farm to process
millions of case notes from an emergency care system in addition to other data.”
To solve these problems, Ascribe decided to design a syndromic surveillance proof of concept that would create a standardized approach to working with healthcare data. The company asked Leeds Teaching Hospitals, one of the biggest NHS trusts in the UK, to
participate in the project. Leeds can generate up to half a million records each year in its Accident and Emergency Department system. The hospital also generates approximately one million unstructured case files each month.
Ascribe wanted to create not just a proof of concept BI solution for monitoring infectious disease on the national level, but also a tool that could be used to improve operations for local care providers. “Our goal was to find a way to make data flow more
quickly in near real time,” says Henderson. “We also wanted to augment clinically coded data with data harvested from case notes.”
The company wanted to create a national knowledgebase that both syndromic surveillance analysts and local clinicians could use to improve healthcare. Ascribe needed a highly scalable, end-to-end solution that could work with multiple data types and sources,
as well as provide self-service BI tools for users.
||With a solution based on SQL Server 2012 and Windows Azure HDInsight Service, we can capture data written in plain English and use it to improve services…This will reinvent the way we work with medical records in the future.
| Paul Henderson
Business Intelligence Division Head
Ascribe decided to implement a hybrid-cloud solution based on Microsoft SQL Server 2012 Enterprise software and Windows Azure HDInsight Service running on the Windows Azure platform. Ascribe planned to take advantage of BI tools built into SQL Server 2012,
as well as multiple other products and services.
The company chose Microsoft both for the capabilities of individual products and because it offered a streamlined, end-to-end solution that it could implement quickly and easily. “We were dealing with a complicated business process with lots of moving parts,
all of which could be automated by a seamless Microsoft stack,” says Henderson. “We didn’t want to buy products from different vendors and try to make them work together. Microsoft figures that out for you.”
Ascribe began working on the proof of concept in November 2012 and completed the project six weeks later in mid-December. Leeds plans to run a pilot program with the new system in early 2013.
The company created an on-premises data mart with SQL Server 2012 running on the Windows Server 2008 R2 Enterprise operating system that included its own repository of clinical data and case files from Leeds Hospital. To protect patient privacy, Ascribe
and Microsoft partner Two10Degrees, a company that specializes in Windows Azure technology, filtered the records to remove names and other identifying information before sending the data to the Windows Azure platform. The company set up a data mart on HDInsight
Service that includes a natural-language processing engine created by Two10Degrees. HDInsight Service is a Microsoft Big Data offering that provides Apache-compatible Hadoop distribution. A platform designed to process large volumes of structured and unstructured
data, HDInsight Service also integrates with Microsoft BI tools and information sources such as social media feeds.
Ascribe worked with Two10Degrees to map unstructured text to a clinical taxonomy. Next, Ascribe looked at patterns in the data to identify potential outbreaks of infectious disease as well as trends that are typically more difficult to analyze, such as alcohol-related
visits to the emergency room and injuries from accidents in the home.
Ascribe also designed several applications that run on Windows 8 tablets, including a syndromic surveillance app. Active tiles on the Windows 8 desktop display real-time information. For example, users can look at the tile for the surveillance app and immediately
see if the system has sent an alert about a disease outbreak.
Tapping on the tile launches a Microsoft Office SharePoint dashboard, which includes Power View, an interactive data visualization feature in SQL Server 2012. Clinicians can use the tool to quickly correlate multiple types of information, such as population
density, family size, and the availability of local healthcare services.
In addition, the solution integrates with Bing Maps to show the geographic distribution of reported illnesses. Clinicians can touch the map to drill down to detailed information on each patient diagnosed.
If the clinician needs to collaborate with peers, the solution also incorporates Microsoft Lync technology for secure instant messaging and conference calls. The solution integrates with Microsoft Office 2013 as well, which provides multiple ways to share
information through documents, spreadsheets, and email.
For local healthcare providers interested in improving efficiency, the company created cubes in SQL Server 2012 Analysis Services that aggregate data from clinical databases, case files, and social feeds. Working with Microsoft SQL Server 2012 PowerPivot
for Excel, users can quickly analyze large data sets and predict trends such as an increase of alcohol-related accidents during the holiday season.
In addition to its surveillance app, the solution includes Ascribe Emergency Care software, a rich, clinical solution that helps clinicians deliver quality care services in the high-pressure accident and emergency environment.
||Our healthcare surveillance system based on SQL Server 2012 provides actionable insight. This isn’t about crunching statistics—it’s about compressing the time it takes to identify the problem and act on it the best way possible.
| Paul Henderson
Business Intelligence Division Head
By building a Big Data solution based on Microsoft technology, Ascribe is delivering healthcare tools faster, speeding response, and providing actionable insight into large volumes of data.
Transforms Healthcare with Faster Access to Data
By working with an end-to-end stack of software and cloud-based services, Ascribe quickly provided a Big Data solution that can improve healthcare at the local and national levels. “This is a new paradigm,” says Henderson.
“With a solution based on SQL Server 2012 and Windows Azure HDInsight Service, we can capture data written in plain English and use it to improve services, instead of waiting for a resource-hungry process to collect and code the information. This will reinvent
the way we work with medical records in the future.”
By taking advantage of HDInsight Service, Ascribe created a complex hybrid-cloud solution that can quickly process large volumes of data from multiple sources. The solution, which includes self-service BI tools and a dynamic, streamlined user interface,
will be an invaluable tool for healthcare providers in virtually any location. “With a solution based on SQL Server 2012, we can show our customers a Windows 8 tablet with apps that provide real-time access to healthcare data.” says Henderson. “We can immediately
provide them with a mobile clinical portal that can be used anywhere.”
Speeds Response to Health Threats
By using analytics capabilities and self-service BI tools, healthcare providers can respond faster and collaborate more easily with peers. “If you’re looking at the spread of infectious disease on the national level, you want to figure out what is happening
as quickly as possible,” says Henderson. “With our solution based on Microsoft technology, clinicians can jump from an alert on their Windows 8 desktop to a map in SQL Server 2012 Power View that shows the progression of a disease. The ability to analyze millions
of records in seconds is immensely powerful.”
Provides Actionable Insight
By using a distributed platform to aggregate and process information from disparate sources such as emergency room notes, school attendance records, and social media, Ascribe is unlocking the potential of huge volumes of data. As a result, clinicians can
identify trends faster and improve the quality of care. “Our healthcare surveillance system based on SQL Server 2012 provides actionable insight,” says Henderson. “This isn’t about crunching statistics—it’s about compressing the time it takes to identify the
problem and act on it the best way possible.”
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