IEEE Sponsored 2nd International Conference on Innovations in Information Embedded and Communication Systems
ICIIECS’15
Big Data Solutions in Healthcare:
Problems and Perspectives
Prabha Susy Mathew1
School of Computing Sciences
Hindustan University
Chennai, India
prabhasm@hindustanuniv.ac.in
Abstract- Data in the healthcare sector is growing beyond
dealing capacity of the health care organizations and is expected
to increase significantly in the coming years. Majority of the
Healthcare data is often unstructured, exists in silos and resides
in imaging systems, medical prescription notes, insurance claims
data, EPR (Electronic Patient Records) etc. integrating these
heterogeneous data and factoring it in to advance analytics is
critical to improve healthcare outcomes. Either because data are
isolated in disparate or incompatible formats or due to the lack in
processing capability to load and query large datasets in a timely
fashion the Healthcare organizations are not in a position to
leverage the benefits of the vast data they have. With
convergence of advanced computing and numerous Big Data
technological options like commercial solutions, Open Source,
Cloud etc. it is now possible to attain high performance,
scalability at a relatively low cost. Big data solutions often come
with set of innovative data management solutions and analytical
tools, when effectively implemented can transform the healthcare
outcomes.
Index Terms: Analytics, Big Data, Cloud, Data Management,
Healthcare, Open Source.
I. INTRODUCTION
Till the recent past the health care industry had been using
the conservative approach for diagnosis and treatment, where
most doctors depended on their individual knowledge and
skills in diagnosing diseases in patients resulting in a less
precise and patient centric. Digitization, rising rates of chronic
diseases, increased population, advancement in technology,
need for evidence based medicine, inability to process and get
insight from ever increasing heterogeneous medical data are
some of the drivers for adopting Big Data solutions.
Adoption of Big Data solutions will play an important role
in transforming the outcomes of the health care industry by
promoting evidence based reasoning in treatment, providing
patient centric treatment by enabling a 360-degree view of each
patient. Now most of the stakeholders are starting to embrace
the concept of evidence based medicine a system where
treatment decision are based also on the scientific evidence
available rather than just the doctors skill and knowledge
providing a measurable outcome towards treatment.
978-1-4799-6818-3/15/$31.00 © 2015 IEEE
Dr. Anitha S. Pillai2
School of Computing Sciences
Hindustan University
Chennai, India
anithasp@hindustanuniv.ac.in
Digitized data in the health care sector is growing
massively with data coming in from internal as well as external
sources, from mobile devices, wearable sensor devices[1,3],
Electronic Health Records (EHR), Radiology images, Videos,
clinical notes, social media, blogs, remote health monitoring
devices etc. newer forms of big data such as imaging, sensor
reading is also fueling to the need of Big Data solutions to
manage these massive and silos of data available in the
healthcare industry. The health care industry need to work on
prediction, prevention and personalization to improve their
outcomes.
Numerous amounts of data-structured, semi-structured and
unstructured data are a characteristic that makes the health care
data most challenging. Most of the data in health care comes
from various sources like X-Rays images, MRI Scan reports,
Blood test value, hand written prescriptions, real time data such
as OT room monitors for anesthesia, heart monitors, blood
pressure readings [8] etc. The health care data has large amount
of data coming from internal and external sources these data
majorly comes from:
1. Providers: medical data (EHRs, EPRs)
2. Payers: claims and cost data
3. Researchers: academic, independent
4. Consumers and Marketers: patient behavior and
sentiment data
5. Government: population and public health data
6. Developers: pharmacy and medical device R&D
The five key characteristics that define big data are:
1. Volume: Data is continuously generated in large volumes
from real time health monitoring systems, EHRs, EPRs, Labs,
sensor devices etc.
2. Velocity: The need to process the data in real time
coming from streaming data like Remote Patient Monitoring,
data from sensor devices, Telemedicine etc.
3. Variety: Data can be structured, semi-structured or
unstructured collected from different sources like
Patient/Member conversations, Health Community Blogs,
Social Media etc.
4. Veracity: Deals with the quality of data being captured.
5. Value: It is the most important V of big data, deals with
extracting value from the data.
 IEEE Sponsored 2nd International Conference on Innovations in Information Embedded and Communication Systems
ICIIECS’15
This paper focuses on big data problems, perspectives and
solutions with respect to health care industry. Different big data
solutions as well as a framework for handling heterogeneous
clinical data has been discussed which if implemented
effectively could prove helpful in decision making for patient
care and overall health care outcomes.
II. RELATED WORK
The role of Big Data in several sectors such as banking,
retail etc. has been witnessed but in the recent times even
health care systems have shown the preparedness to bring the
transformation and leverage on the benefits that Big data
solutions provides for the health care systems.
Ping Jiang et al. [1] presented a system of using wearable
sensors capable for continuous monitoring of the elderly and
forwarding the data to the big data systems. A big data system
manages high volume, velocity and variety of information from
different sources, so as to address this challenge a wearable
sensor system with intelligent data forwarder was introduced
adopting Hidden Markov model for human behavior
recognition for feeding meaningful data to the system. The
sensor readings and states of a user are sent to Big Data
analytics for improving and personalizing the quality of care.
Abdelhmid Salih Mohmed Salih et al. [3] evaluates the
ensembles design and combining different algorithms to
develop novel intelligent ensemble health care and decision
system to monitor the health using wearable sensors. New
Novel Intelligent Ensemble method was constructed based on
Meta classifier voting combining with three base classifiers
J48, Random Forest and Random Tree algorithms.
Varun Chandola et al. [12] in his work did analysis of the
health care data using social network analysis, temporal
analysis and text mining and higher order feature construction
to understand how each of these areas contributes to
understand the domain of healthcare. Temporal Analysis
methods are used as they do not require trained classifier to
identify anomalies and it can be used as a timely technique for
detection of transient billing practices that are anomalous.
Keith Feldman et al. [2] in his paper focuses on the
performance limitation of the prediction engine CARE
(Collaborative Assessment and Recommendation Engine). In
order to solve the computation time issue of care algorithm two
methods have been devised, in first method single patient
version of CARE is taken to perform disease risk ranking on
demand and with high degree of accuracy and second method
is distributed computation of the care algorithm for nightly
batch job on large patient datasets.
Gautham vemuganti [13] has discussed about importance
of Meta data management to leverage on big data analytics.
Framework of Meta data management and its importance is
briefed in the paper.
Muni Kumar N et al. [4], discusses how Big Data Analytics
are beneficial to transform the rural healthcare by gaining
insights from their clinical data and to effectively make the
right decisions.
III. BIG DATA TOOLS AND TECHNOLOGIES
Big data domain has two options, to use open source
solution or the commercial solutions available. Some of the key
products are: Hadoop based analytics, Data warehouse for
operational insights, Stream computing software for real time
analysis of streaming data. Apache Hadoop framework is an
open source solution, followed by NoSQL databases such as
Cassandra, MongoDB, DynamoDB, Neo Technologies and
couch base. [5], [8], [9], [16], [22]
• HDFS is Hadoop distributed file systems attempts to
enable storage of large files and does this by distributing data
among pools of data nodes.
• MapReduce is a programming model that allows for
massive job execution scalability against cluster of servers.
• Apache Hadoop YARN (Yet another Resource
Negotiators) separates resource management and processing
components.
• HBase is another example of a non relational data
management solution that distributes massive datasets over the
underlying Hadoop framework. HBase derived from Google’s
BigTable, is a column-oriented data layout and provides fault
tolerant storage solution.
• Hive is a "SQL-like" bridge that allows conventional
BI applications to run queries against a Hadoop cluster.
• Zookeeper and Chukwa are used to manage and
monitor distributed applications that run on Hadoop.
• PIG consists of a "Perl-like" language that allows for
query execution over data stored on a Hadoop cluster, instead
of a "SQL-like" language.
• Sqoop is used for transferring data between relational
database and Hadoop
• Mahout is an Apache project used to generate free
applications of distributed and scalable machine learning
algorithms that support big data analytics on Hadoop
framework.
• SkyTree is high-performance machine learning and
data analytics platform focuses specifically on handling Big
Data.
• Storm can be used for stream processing of
information coming from social media feeds or sensor data.
• Apache Solr can be used for searching semi structured
data and documents.
• Apache Drill is a distributed system for interactive ad-
hoc analysis of large-scale datasets. Designed to handle data
that spread across thousands of servers, the objective of Drill is
to respond to ad-hoc queries in a low latency manner.
• SAP HANA and Hadoop can be used to manage
massive and complex data volumes at high speeds.
• Visual analytics tools are Splunk, Datameer,
Jaspersoft, Tableau, Karmasphere, Pentaho, Hadapt, HP
Vertica, Teradata Aster solutions etc.
• Predictive Analytics tools are Revolution analytics R,
Zementis with datameer, Spotfire Miner, Mahout, Rapid
Miner, Oracle data miner, Statistica, IBM SPSS, SAS
enterprise miner etc
 IEEE Sponsored 2nd International Conference on Innovations in Information Embedded and Communication Systems
ICIIECS’15
• NoSQL Databases: Database to handle unstructured
and semi-structured data is NoSQL. Some of the NoSQL
databases are
Key Value Pair Databases: It stores data as a record
structure comprising of a key and content. They are used for
applications that involve large volumes of data, flexible data
structures and high-speed transactions. Some of the most
widely used key value pair databases include Redis,
MemcacheDB, Berkeley DB, Voldemort, Amazon’s Dynamo,
and Riak.
Document Stores Database: It specializes in storing,
parsing and processing objects, typically using a lightweight
structure, like JSON. As document style databases are schema
less adding fields to JSON can be done easily. CouchDB and
MongoDB are the most popular document based databases.
Column Store Database: The columnar databases store data
in columns instead of rows. The advantages are that data can be
highly compressed and it is self indexing and uses less space
compared to RDBMS. Examples of some of the columnar
databases are HBase, Cassandra and Google’s Big Table.
Graph Base Database: This database does not follow rigid
formats of SQL or the tables and columns representation. This
database uses edges and nodes to represent and store data.
Some of the popular Graph Based Databases are Neo4j,
FlockDB, Alleograph, and Infinite Graph. Graph based
databases are perfect for Internet of things.
Unified information access: UIA is a technology that
allows ad hoc interrogation of multiple content sources in a
highly target and specific manner. It is a paradigm to query
structured and unstructured data. UIA technology converges
and integrates previously isolated structured and unstructured
data enabling better insights from the data available.
Other: There are several other NoSQL databases that vary
in how they store and process data or the different types of
applications they are intended to support.
Many tools for data mining and analysis are available in the
market because of the constant demand to analyze large set of
data and to gain valuable insights from it. This section gives a intended for computation compatible with MATLAB
brief review of top analytics tools as specified by KDNuggets
[24] and predictive Analytics Survey [25]
R Tool: is a language and environment for statistical
computation. It is free and open source software. R has very
power graphics capabilities and works very well with Hadoop.
It compiles and runs on a wide variety of platforms such as
UNIX, Windows and MacOS and performs complex data
analysis at a cheaper price.
Rattle GUI: a data mining suite based on open source
statistical language R includes graphics, clustering, modeling,
and more. Rattle package allows data miners to use R without
the need to know the associated programming language.
Excel: Excel, a core component of Microsoft Office, provides
powerful data processing and statistical analysis capabilities.
Many data mining tasks can be accomplished in Excel with
the help of suitable add-on, some of the add-on tools for Excel
are:
Ant Model Builder is one such add-on that can be used with
minimum training and can be used to predict patterns in data.
Alyuda ForecasterXL implements neural networks in Excel
and various graphical and analytical displays are also
provided. DataMinerXL tool is a right option for people
familiar with data mining techniques; it supports creation of
predictive model using a wide variety of techniques. XLMiner
an add-in for Excel provides a complete data mining
capability with data preparation tools, support for times series
analysis and visualization tools.
Rapid Miner: it is written in java programming language. It
provides template based framework to do advanced data
analytics. It is a code free advanced analytics platform that can
execute in-memory, in-cloud, in-database, in-stream and in-
Hadoop.
Weka: collection of machine learning algorithms for solving
data mining related problems. It is based on Java and can run
on almost any platform. It supports many of the Data Mining
tasks such as Preprocessing, Clustering, Classification,
Regression, Visualization etc.
KNIME: Konstanz Information Miner is an open source data
analytics, reporting and integration platform. KNIME does all
the main components of data preprocessing like extraction,
transformation and loading written in java and works on
eclipse.
Orange: is a Python based tool. It is component based data
mining and machine learning software. It supports add-ons for
Bioinformatics and text mining.
Apache mahout: used to generate free applications of
distributed and scalable machine learning algorithms that
support big data analytics on Hadoop framework
NLTK: Natural language toolkit is a suite of libraries and
programs for symbolic and statistical natural language
processing for Python language. It extends support for
research and teaching in areas such as Machine Learning,
Cognitive Science and Artificial Intelligence.
Graph Lab: is a graph based high performance, distributed
computation framework written in C++.
GNU Octave: is a high level programming language, primarily
IBM SPSS Modeler: a visual and powerful data mining
workbench.
GhostMiner: is a complete data mining suite, including k-
nearest neighbors, neural nets, decision tree, neurofuzzy,
clustering, and visualization.
Python: Python is a leading general scripting and a web
development language. Data analysis and scientific
programming are developed with the help of packages such as
Numpy and Scipy along with Visualization package
Matplotlib.
IV. BIG DATA ANALYTICS IN HEALTHCARE
The usage of the data generated and the need to get
valuable insights for making effective decisions have lead to
usage of analytics tool that does analysis on the data from
which inference can be made. Analytics can be classified in to
three types they are: Predictive Analytics, Descriptive
Analytics and Prescriptive analytics [18, 10, 23].
 IEEE Sponsored 2nd International Conference on Innovations in Information Embedded and Communication Systems
ICIIECS’15
Predictive Analytics can be used to forecast what might
happen in the future, it uses statistical approaches to search
through large patient data sets and does analysis of those data
to predict individual patient outcomes. In health care the
predictions can range from medication to readmission rate of a
patient.
Descriptive Analytics is generally used to summarize what
happened; it uses the past and current healthcare data to make
quality healthcare decisions. Some of the examples of what
descriptive analytics can do in healthcare are to identify high-
risk patients, to target patients for promotional trial of drug,
provides insights to carry out health management programs.
Prescriptive analytics is a type of predictive analytics used to
prescribe actions for the decision makers to act upon. In
healthcare prescriptive analytics is used in evidence based
medicine to improve patient care, to prescribe better business
practices.
Evidence Based Medicine is the intersection of individual
clinical expertise, external evidence, and value to the patient.
Evidence can be generated from both extant medical literature
and practice-based evidence. Practice-based evidences are
generated from the day-to-day data collected in the hospital
through treating the patients (electronic health record).
Additional sources of practice-based evidence include claims
data, insurance, and other administrative hospital data.
V. OPPORTUNITIES FOR BIG DATA SOLUTIONS IN
HEALTH CARE
The big data solutions can be used in the health care to get
innovative outcomes in the following areas:
• Clinical decision support - BDA technologies can be used
to predict outcomes [6] or recommend alternative
treatments to clinicians and patients at the point of care.
• Personalized care - Predictive data mining or analytic
solutions may offer early detection and diagnosis before a
patient develops disease symptoms. Pattern detection
through real time wearable sensors for elderly or disabled
patients to alert the physicians if there is any change in
their vital parameters or post-market monitoring of drug
effectiveness can be done.
• Public and population health - BDA solutions can mine
web-based and social media data to predict flu and predict
the future trends.
• Fraud Detection – Fraud in medical claims can increase
the burden on the society, Predictive models like decision
tree, neural networks, regression etc. can be used to
predict and prevent fraud at the point of transactions [17].
• Secondary usage of health data [8] - Deals with
aggregation of clinical data from finance, patient care,
administrative records to discover valuable insights like
identification of patients with rare disease, therapy
choices, clinical performance measurement etc.
• Evidence based medicine [8]: evidence-based medicine
involves the use of statistical studies and quantified
research by doctors to form diagnosis. This practice
enables doctors to make decisions not only based on their
own perceptions but also from the best available evidence.
VI. ADOPTION CHALLENGES OF BIG DATA
SOLUTIONS IN HEALTH CARE ORGANIZATIONS
Some of the adoption challenges of Big Data in healthcare
industries are [14]:
• No Fixed standards are followed for health care data -
There is a vast amount of healthcare data that is generated
and collected by different agents in health care today,
from insurance claims to general practitioner notes within
the medical record, images from patient scans,
conversations about health in social media, and
information from wearable sensors and other health
monitoring devices.
• Integration of heterogeneous data sources - Spread across
labs, hospital systems, operation theaters, financial IT
systems, and electronic health records (EHRs),
fragmentation is a significant obstacle to merging data
into an integrated database system.
• Skilled resources - To handle big data solutions certain
skills sets and competencies are required. As such
globally there is shortage for the data scientist and data
analyst roles.
• Privacy and security - Traditional privacy and security
measures works on a smaller data set, ability to enforce
the same measures on massive and streaming data set is a
concern especially when dealing with patient’s health
information.
• Infrastructure Issues - Hospitals already have a Legacy
system and their compatibility with new technologies
always remain an issue.
• Insufficient real time processing - Time delay in
processing complex data models could lead to less quality
patient care.
• Interpretation of the analytical results - The analysts must
get the right clinical support for interpreting the result
after the clinical data is analyzed as right interpretation is
very essential for the getting the desired outcomes.
• Data Quality - to get reliable insights from the data for
making patients health care related decisions, the quality
of the data is very important.
VII. ARCHITECTURE TO HANDLE HEALTH CARE
DATA
Health care industry has become extremely data intensive
with data coming from multiple sources. Data integration
across heterogeneous data sources is the biggest challenge
being identified which would otherwise contribute to greater
insights on the data available [15, 20]. There are some viable
solutions for dealing with heterogeneous data in health care
they are:
Implementing three-tier architecture [15] with client tier
providing access to system, middle tier for the defining rules
and processing that can be implemented using XML following
SOAP protocol & HL7 Reference Information model (RIM).
The implementation enables the user to retrieve and search
information that has been integrated using HL7 v3-RIM
technology from disparate health care systems [21] and
 IEEE Sponsored 2nd International Conference on Innovations in Information Embedded and Communication Systems
ICIIECS’15
database tier with NoSQL which provides schema less
database design [27,19] and is also more scalable option
compared to traditional RDBMS.
Steps for Integration of heterogeneous clinical data and to
get meaningful insight from it can be attained by modifying
and adapting the architecture proposed by [21].
DATA INTERPRETATION
Client
tier
DATA ANALYSIS
STANDARDIZATION OF
DATA XML & HL7V3 RIM Middle
tier
DATA EXTRACTION - NOSQL
Database
DATA COLLECTION
Tier
PATIENT RECORD LAB REPORTS IMAGE DATA
Fig 1 : Three Tier Architecture for handling Heterogeneous
data
• Data collection - Heterogeneous health care data from
different sources are collected.
• Data extraction - The data that is extracted from multiple
sources are extracted and stored on a single NoSql
database.
• Converting the data extracted in to a standard format -
XML and HL7 Reference Information Model is used for
converting clinical data into standard format.
• Data analysis - Analysis on the data is done to gain
valuable insights from the healthcare data using various
analytical methods and technologies such as using data
mining algorithms, SAP HANA with in-memory
computing etc. to increase the data processing speed.
• Data Interpretation - Interpreting the result of
analytics on healthcare data needs to be done with
appropriate clinical support otherwise the inference drawn
from the result could be misleading.
VIII. CONCLUSION
The health care industry is all set for transformation in order
to improve patient care and to make it cost effective by
leveraging on latest technologies. Digitization has lead to
large amount of digital data especially in health care industry.
This paper proposes a method for handling heterogeneous
health care data using the right technology and architecture
which has the potential to transform healthcare outcomes and
the quality of patient care at optimal cost. This paper also
presents various analytical tools that can be used to leverage
benefits from the huge set of healthcare data. Proper selection
of tools to do analytics on health care data can provide
promising results. The different adoption challenges
highlighted in the paper are some of the open issues and can
be considered as an area of research for future work.
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