Machine Learning in Healthcare: Now for Everyone

Machine learning is a part of everyday life for most Americans, from navigation apps to Amazon’s omniscient purchase recommendations. But in healthcare the use of machine learning has so far been limited to niche science projects in large and academic health systems – those able to afford the highly skilled data scientists and dedicated teams required to turn their data into meaningful performance improvements.
 
Health Catalyst is on a mission to change that by embedding the value of machine learning throughout healthcare. Last month, the company launched healthcare.ai to help make machine learning routine, pervasive and actionable for healthcare organizations of all sizes. The collaborative, open source repository of machine learning tools and expertise including topical blog content and weekly live hands-on machine learning educational broadcasts, makes it easy to deploy machine learning in any environment.
 
Now, to bring the life-saving technology to hospitals and patients everywhere, Health Catalyst  is embedding machine learning as a core capability across the company’s entire product line in an initiative called catalyst.ai.  With optimized machine learning models built into every Health Catalyst application, organizations can leverage the technology for predictions such as identifying patients who are most likely to acquire deadly infections; finding those who may have trouble paying their medical bills; spotting possible canceled appointments before they happen; or launching proactive medical interventions for patients who are at risk for dangerous complications.
 
Together, healthcare.ai and catalyst.ai represent the next generation of healthcare analytics. With these machine learning innovations now readily available to organizations large and small, American healthcare will be equipped to exchange today’s limited, retrospective analysis for a new era of powerful, predictive analytics driving an orders-of-magnitude improvement in outcomes. 
 
“Predictive analytics powered by machine learning has truly vast potential in healthcare, but we lag other industries by several years largely because early efforts were extremely expensive one-off models requiring an army of data scientists to write and test the algorithms behind the technology,” said Dale Sanders, Health Catalyst’s executive vice president of product development. “catalyst.ai solves that problem by lowering the bar for entry and enabling data architects and analysts to become ‘citizen data scientists.’”
 
“Another factor limiting the usefulness of machine learning is that healthcare data is far more complex than data in other industries and difficult to aggregate. Machine learning algorithms are only as good as the volume and quality of data that feeds them. We’ve invested tens of millions of dollars over the last few years to create high-volume high-quality data content that these algorithms thrive on, and we are embedding the results in the workflow of clinicians in every department across a hospital or health system,” added Sanders.
 
Reduce Hospital-Acquired Infections with Machine Learning
Health Catalyst machine learning has already been deployed at multiple client sites with promising outcomes. Indiana University Health (IU Health), a 17-hospital nationally recognized healthcare system, engaged Health Catalyst machine learning in an attempt to reduce healthcare associated infections (HAI) and achieve zero central line-associated blood stream infections (CLABSIs). Of the 41,000 patients who develop a CLABSI in US hospitals each year, one in four die, according to a Centers for Disease Control study. IU Health wanted to be able to predict which patients are most likely to develop a CLABSI so clinicians could proactively undertake prevention activities 100 percent of the time.
 
IU Health used Health Catalyst’s enterprise data warehouse (EDW) and catalyst.ai-driven analytics to bridge information gaps in its EMR data and to paint a complete picture of patients’ CLABSI risk.  Models on the data were developed and tested by Health Catalyst using machine learning algorithms such as logistic regression and random forest—the workhorses of the machine learning world. This led to the development of a CLABSI risk prediction model that is built into a unit-level dashboard used by nursing staff to identify patient-level care gaps. In addition to the risk score, the top three risk factors for each high-risk patient are displayed, providing immediate insight into specific actions that can reduce the CLABSI risk for these patients.
 
As a result, today IU Health can predict which patients with a central line will develop a CLABSI with an estimated 87 percent accuracy and a false positive rate of 0.16.
 
“We have quite a few initiatives centered on hospital-acquired harm events that are supported with analytics,” said Kristen Kelley, director of infection prevention at IUH, in a recent Scottsdale Institute report on the project. “We are on the cutting edge. In the past six months we’ve experienced a 20 percent decrease in CLABSI and a 30 percent drop in harm events overall. So we are headed in the right direction.”
 
Machine Learning + Data = Success
catalyst.ai’s effectiveness is closely tied to Health Catalyst’s proven ability to integrate high-volume data from virtually every internal and external source available. Because multiple sources of data are required for machine learning to develop the models that drive predictive analytics, the technology is more effective the more data is present. Most companies providing machine learning solutions require customers to figure out how to connect up to 100 different data sources to make the technology work. By contrast, Health Catalyst’s EDW integrates 120 different data sources, including the electronic health record (EHR), claims, key financial, operational and patient satisfaction systems.
 
“I want to acknowledge Eric Just, Dr. Levi Thatcher, and the rest of our Data Science team who are making breakthrough progress, unlike any vendor in the market, including the largest players,” said Sanders.  “At Health Catalyst we have a proven track record and know how to make outcomes improvement work. We know how clinicians use data to make decisions. We understand the context in which the machine learning insight needs to be delivered, and the right time and modality to deliver that insight. That knowledge is built into catalyst.ai, scaling machine learning and outcomes improvement for use by virtually any organization. The bottom line is that we believe our clients will save many more lives and improve the care process for everyone.” 
 
Machine Learning Models Available Today
In addition to its CLABSI risk prediction model, Health Catalyst has leveraged catalyst.ai to deploy numerous predictive models at launch that are useful for clinical, financial and operational decision support, including clinical decision support models for:
 

• Central line-associated bloodstream infection future risk (CLABSI)
• Chronic obstructive pulmonary disease (COPD) readmission risk
• Pre-surgical risk for bowel surgery
• Diabetes future risk
• Financial and operational decision support models such as propensity to pay and appointment no-show risk

 
In addition to predictive models, Health Catalyst is currently developing algorithms that use machine learning to identify treatment patterns that lead to better outcomes. These algorithms will be used to drive treatment decisions on patients by showing how ‘patients like this’ were treated and what the outcomes were for a cohort of similar patients.