Dr. Stephan Fihn is sitting on the edge of a revolution at the Department of Veterans Affairs, where big data is becoming easily accessible for clinicians and analysts throughout its 160 hospitals.
Fihn (pictured above) is director of Business Intelligence and Analytics for the Veterans Health Administration and a practicing physician at the VA Puget Sound Health Care System in Seattle, where he is helping to develop as well as benefiting from the VA’s big data warehouse.
The massive project, expanded in November 2011, is growing every day with new data, giving 20,000 clinicians the tools to track medical trends, anticipate outcomes and delve into 80 billion data files searching for ways to improve healthcare and the delivery of services to 25 million veterans.
“The excitement of having the warehouse allows us to have all the data in one place potentially linked together. It’s populated in real time and gives us a look at what’s going on right now,” Fihn told Breaking Gov.
It is just the beginning of a new age for the VA, which can tap into millions of records to analyze more and more data in real time across many different populations and issues, including homeless veterans, suicide risks, disease trends and drug usage.
“Who are the veterans most at risk for becoming homeless? Who are the folks who will have deterioration of their physical or mental health? And how do we target resources for them?” Fihn asked.
Fihn said the data warehouse is filled with information on primary care outcomes , prescriptions, lab results, diagnoses and hospital admissions, surgeries, outpatient visits, blood and urine cultures, infection rates, and financial information such as billing and revenue data. With sophisticated analysis, the VA can create a picture of what’s happening to the nation’s veterans and what they need.
VHA, for example, can use the data to identify which patients are at high risk of having clinical problems, and it is in the process of developing other kinds of prediction models.
The agency has also converted over one billion pages of clinical notes into text that can now be searched and analyzed.
VA’s big data initiative is “certainly part of a trend in government and industry on how to best harness data,” said William Regli, associate dean for research and professor of computer and information science at the iSchool at Drexel University in Philadelphia.
“This is very much a great federal project, integrating real time data sources from the field that the government already has and improving patient care,” Regli said.
The VA project consolidates the data into four regional centers that had previously been isolated in silos with the master center located in Austin, Tex.
“There are huge opportunities that require sophisticated and high power tools. We can run models on millions of patients,” said Fihn.
The National Academy of Sciences, for example, concluded that a potential complication of Agent Orange exposure is coronary artery disease. The VA used its big data platform to identify every individual exposed to Agent Orange during the Vietnam War for a health follow up.
Harnessing big data has become a major goal across the federal government. In March, President Obama announced a $200 million big data project for research and development into technology to “access, store, visualize, and analyze” massive and complicated data sets.
It includes commitments from several federal agencies to develop new technologies to manipulate and manage big quantities of data and use those technologies in scientific discovery, environmental and biomedical research, education, health care and national security.
The VA’s experience is a lesson for other agencies struggling to deal with the challenge of using data analytics to break down barriers , improve service delivery and reduce costs.
To make its mission a success, the VA hired Microsoft five years ago to make their big data warehouse work. The agency just renewed the five-year $500 million contract that gives the VA access to all Microsoft’s current and emerging technologies to run the warehouse.
“It used to take 10 to 15 different computer screens, a lot of navigation and time to find answers,” Greg Myers, vice president of Microsoft Federal, told Breaking Gov. “It’s now down to one screen and questions are answered more quickly.”
Jack Bates, the VA’s Director of Business Intelligence Service Line, said the ultimate goal is to improve the quality of care and patient safety.
In expanding VA’s big data arsenal in the last 18 months, Bates said 35 domains of data with 53 billion rows of data were expanded to 51 domains and over 80 billion data files last year. The increased capacity has given the VA a big bang to find data and new ways to use it.
“The system has never been hacked. It has privacy and security of data,” Bates said. “I would like to think we’re an example for other agencies.”