Case Five

Mercy’s Big Data Project Aims to Boost Operations

Mercy’s Big Data Project Aims to Boost Operations Making the most of the
data it collects is a challenge for any organization, and those in the healthcare
industry are no exception. Based in St. Louis, Missouri, Mercy health system
includes 46 acute care and specialty hospitals, with more than 700 outpatient
facilities and physician practices in Arkansas, Kansas, Missouri, and Oklahoma.
With more than 40,000 employees, including over 2,000 physicians, Mercy’s
vision is to deliver a “transformative health experience” through a new model of
care. With such ambitious goals, Mercy has a compelling interest in harnessing the
power of the data it collects. To do so, the health system needed to overhaul is
data-management infrastructure and move into the world of big data.

To make that move, Mercy partnered with software provider Hortonworks to

create the Mercy Data Library, a Hadoop-based data lake that contains batch data
as well as real-time data (stored in HBase, a distributed nonrelational database
structure) from sources such as the Mercy’s ERP and electronic health record
(EHR) systems. According to Paul Boal, director of data engineering and analytics
at Mercy, “The blending of base batch data and real-time updates happens on
demand when a query is run against the system.” Mercy’s new Hadoop
environment, which contains information on more than 8 million patients, holds
over 40 terabytes of data housed on 41 servers spread out over four clusters.

Outside of improving patient care, a primary motive for the move to Hadoop
was to improve Mercy’s administrative efficiency, particularly in the areas of
medical documentation and claims generation. Ensuring that physicians, nurses,
and lab staff complete the necessary documentation for a patient prior to discharge
improves the chances that the hospital will generate an accurate and complete
claim-reimbursement request. Prior to its Hadoop implementation, the health
system had already initiated an automatic-documentation-review process. Now,
Mercy plans to make use of real-time data along with the power of Hadoop to
further improve upon this process. For instance, documentation specialists can
generate reports that help them follow up with physicians regarding missing
documentation during each morning’s clinical rounds. The hospital expects the
new system will generate more than $1 million annually in new revenue based on
claims that accurately reflect hospital patients’ diagnoses and treatment.

Mercy is also focusing the power of its new technology on areas directly
related to clinical care. “What we’re building out is a real-time clinical applications
platform, so we’re looking for other opportunities to turn that into decision
support,” says Boal. One such project involves leveraging the Hadoop environment
to make better use of data generated by the electronic monitors in the intensive
care units (ICUs) across the health system. Mercy now gathers 900 times more
detailed data from its ICUs than it did before its implementation of Hadoop. The
previous database system was only capable of pulling vital sign information for
Mercy’s most critically ill patients every 15 minutes; the new system can do it
once every second. The goal is to use the real-time data for better analysis, such as
refining the health system’s predictive models on the early-warning signs of life-
threatening medical problems in the ICU setting.

Like all healthcare providers, Mercy is required to maintain an audit trail for
its EHR system. The audit trail keeps track of everyone who accesses any piece of
patient information via the EHR. In addition to satisfying this regulatory
requirement, Mercy expects Hadoop will help it put that audit trail data to a new
use—analyzing staff behavior patterns and developing a better understanding ofow
processes actually get done. And in another Hadooprelated project, lab staff are
now able to quickly search through terabytes worth of lab notes that were
previously inaccessible.