These are the slides from my VLDB 2018 presentation. Shares what we are doing in healthcare and also shares research opportunities in data and healthcare.

1. Anand Deshpande
Persistent Systems Limited
Pune, India
August 28, 2018,
Managing Healthy Communities
needs Data Collaboration
Personalized • Precise • Connected

2. It is a pleasure to
be at VLDB 2018.

3. Personal Bias
http://www.linkedin.com/in/ananddeshpande
3© 2018 Persistent Systems
Trained and practicing
Computer Science Engineer
Self-learnt entrepreneur
Have been at it for 28 years Organized VLDB 2016 in India
Part-time Member of UIDAI
Founding member of iSPIRT
Founding President ACM India
Family Foundation on a mission
to help 25,000 self-employed
businesses
B.Tech.(Hons) M.S. and Ph.D.

4. Publicly listed
in India since
2010
FY18 (Mar. ’18)
revenues
$ 470 M
Focus on
Data-Digital-IOT
Financial
Services,
Healthcare,
Industrial
9000+
employees
Global presence
17 countries
Persistent at a Glance
(www.persistent.com)
4© 2018 Persistent Systems
$
Product
Development
Enabling
software
driven business

5. We work with many US healthcare customers
5© 2018 Persistent Systems
We look forward to working with Persistent Systems related to Population Health Analytics, the
movement of patients throughout a Healthcare system and also leveraging sensory data from inside
houses, embedded along side patients and to collect this mass amount of data from the Internet of
Things (IoT) and link it to clinical and research records and be able to have an eco-system that is
flexible enough to receive data from these multiple sources and find actual clinical interventions
that save lives!
Tom Carton
Director of Health Services Research
Louisiana Public Health Institute (LPHI)
REACHnet Principal Investigator
People that I have, must be complemented by the people that I have externally in our
partners, so that my folks are always learning. They have to be insatiably curious, they’ve
got to be constantly wanting to see what’s the next thing, while they’re keeping things
stable; managing to move the things along that we’ve already put in.
Margaret Coughlin
Senior Vice President and
Chief Marketing Officer
Mount Sinai Health System

6. Midst of a
Transformation
Current system of
care – inefficient
and have to
change
Technology is
Available
New devices are
getting cheaper
and available
If you are looking for research problems …
Healthcare provides great commercial and research
opportunities.
6© 2018 Persistent Systems
Ripe for data
researchers
Medical
community
accepts they
need help with
data problems
Large Market
Global market in
excess of $7.5
Trillion Dollars.
Growing nearly
5% year on year

7. Healthcare is going through a major transformation in the US
(and the rest of the world)
© 2018 Persistent Systems 7
We have seen some very large healthcare
M&A activity in the recent times.

8. 8
Persistent and Partners Healthcare
are building an open-source data
platform for clinicians.
https://www.partners.org/Newsroom/Press-Releases/Partners-Persistent-Press-Release.aspx

9. 9© 2018 Persistent Systems
https://www.onebraveidea.com/
Dr. Calum MacRae

10. 10© 2018 Persistent Systems
Dr. Ramesh Jain
UCI Bren Professor
Dr. Howard Federoff
Ex-Vice Chancellor for Health Affairs
CEO, UC Irvine Health System
https://futurehealth.ics.uci.edu/

11. Lifestyle and environment have a major
impact on human health
© 2018 Persistent Systems
But spending is
not aligned!
http://bipartisanpolicy.org/wp-content/uploads/sites/default/files/5023_BPC_NutritionReport_FNL_Web.pdf
11

12. Helping individuals stay healthy
12© 2018 Persistent Systems
Birth Death
Disease
Health
Low Cost
High CostNo touch Low touch Mostly
Medication
Trial
Severe
Simple interventions at the right time can
help elongate the “Low Touch” stage
Apps to
manage diet
and exercise
Glucose
Monitoring
Time

13. How does one treat an individual when some of the
“parameters” are just off “normal?”
13© 2018 Persistent Systems
 The system and economics are
not well set to support such
cases
 You are very likely to be over-
treated or undertreated.
 Treatment protocol based on
gross generalizations of trials
based on a small population.
Specialist
Physician
Internist
Non-physician
provider
Pharmacist

14. Complex, precise, and personalized
14© 2018 Persistent Systems
 Our body is a complex system and
many factors determine the long-term
consequences of our health.
 Every individual is different, what is
appropriate for one person may
not be appropriate for another person.
 Must build individual-centric data
models for healthcare
Genome
Transcriptome
Proteome
Metabolome
Interactions
Monitoring
Testing,
Procedures
Physical
Activities
Fitness tracker
Exercise
Housing
Food
Security
Violence
Transportation
Healthcare System
Accessibility
Social
Factor

15. We are learning the multidimensional nature of disease
biology
15© 2018 Persistent Systems
MetabolomicsCytometricProteomicsTranscriptomicsGenomics
The cost of gene sequencing and
other related technologies is dropping exponentially.
The Carlson curve is a term to describe the rate of DNA sequencing or cost per sequenced
base as a function of time. It is the biotechnological equivalent of Moore's law. Carlson
predicted that the doubling time of DNA sequencing technologies (measured by cost and
performance) would be at least as fast as Moore's law.

16. How much data?
16© 2018 Persistent Systems
https://dhin.net.au/wp-content/uploads/2017/12/MacRae_DHIN_Final.pdf

17. Building the cadre of Health Navigators
17© 2018 Persistent Systems
 Expert treatment algorithms
 Algorithm implementation
supervised by Pharmacist, RNs
and MD
 Patient interactions / treatments
managed by Health Navigators
 Education platform for patients
and providers
 Research platform
Specialist Physician
Internist
Non-physician provider
Pharmacist
Navigator
Care giver
Patient

18. HealthCare System has to move
from Reactive Health to Proactive Health
18
Reactive Health Proactive Health
Individual looks for medical help when unwell
Data is captured continuously through medical-
grade wearables
Has to choose from different options, mostly
not an accurate choice
Systems continuously analyse the data and raise
alerts if needed
Tests are conducted and data collected to
for diagnosis
Nurse or physician monitor the data and reach out
in case of anomalies
Medication based on diagnosis
Provider has the historical data and genetic
information for personalized and precision care
© 2018 Persistent Systems

19. SaaS
Building a hosted data platform that
integrates data from known sources
Tools to build cohorts and attach careplans
Tools to quickly add new clinical applications
Tools to enable integrations
Reusable components, algorithms
Building an Open Source Platform with Partners Healthcare
19© 2018 Persistent Systems
Clinical applications for cardiology
Site specific data aggregation, user experience
Site specific integration with EHRs

20. Advanced analytics to improve stratification of patients with
similar risk profile
20© 2018 Persistent Systems
Machine Learning Clustering

21. What Personalized medicine means on the execution side?
21© 2018 Persistent Systems
Cohort Cohort Cohort
Algorithms Clinical Protocols
Individualized Care Plans
Low Touch Health Navigator

22. Platform-centric approach to innovate and improve care
22
Individual/Patient Payees Providers/Admins Clinicians
APIs: FHIR & Extensions
Ontology Security
Historical
Current
Streaming/Live
Derived
Cohorts
Views
Clinical Protocols
Machine
Learning
Business
Rules
⨍(i)
APIs Real Time Steaming HL7 Files
IoT Data
CHF CKD Nafld
Structured Data
(EHR, EMR, PHR, HIEs, etc.)
Census, Weather,
Community Data
Social DataUnstructured
Data
Individual Centric Data Model
© 2018 Persistent Systems

23. Data Curation, Integration to Insights
23© 2018 Persistent Systems
Message
File
Feed Reader
Algorithm
Interface
Data Pipeline
Staging
Area
Process
Staging Area
Data
Discovery
Channel
SI
Scripts
Sn
Indexer
Experiences
Key Value
M
a
n
a
g
e
m
e
n
t
A
P
I
+
HL7, FHIR,
EDI, CCD,
CSV, XML
Mirth Connect
JS Scripts
with Jar
dependencies
Flume/Kafka Java/Pig
Atlas
Apache
HDFS Oozie
workflows in
Java/Pig
Spark
Hue to
design
workflows
Data set store is
Hbase
Solr indexing
using HDP Search
Hue to browse
data Zeppelin
FHIR, EMPI,
Custom
Apigee
Import and try
widget from
any JS charting
library
Hue
dashboards for
indexed data
Genwi,
Cordova, Ionic
Native
ShareInsights
Falcaon
Workflow
Algorithms
AI An
Visualization

24. This is an ongoing project with
many open and challenging areas
for research and implementation.
24© 2018 Persistent Systems

25. Managing healthcare data has many complexities …
opportunity for a fresh look
25© 2018 Persistent Systems https://www.emc.com/analyst-report/digital-universe-healthcare-vertical-report-ar.pdf
Large volume of data that must
be preserved over a lifetime.
Data Silos
Data Integration challenge… EHR
and EMR data…
Compliance etc.
2,314Exabytes
153Exabytes
2020
annual growth
48%
2013
Legacy
Software
Q
D

26. Very rich area for machine learning
26© 2018 Persistent Systems

27. Blockchain
27© 2018 Persistent Systems
Numerous projects and companies are
working on blockchain algorithms in
healthcare.
• Personal health records
• Healthcare identity
• Care delivery
• Medicine and healthcare supply chain
• Monitoring and managing regulated drugs
• IOT etc.
https://blog.andreacoravos.com

28. @anandesh | anand@persistent.com
Anand Deshpande
Persistent Systems Limited
Thank you
and we are keen to partner.