How Amara Health Turned Big Data into Big AnswersChristopher Rosin, Ph.D. and Chief Scientist, Amara Health AnalyticsSeema Haji, Director of Product Marketing, DataStax

All attendees placed on mute

Input questions at any timeusing the online interface

Webinar Housekeeping

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Agenda• About Amara Health• Selecting the right database technology for real-time decisions• Evaluating NoSQL for Healthcare applications• Amara – real-time predictive analytics for patient-centric

excellence• Integrated analytics with DataStax Enterprise 4.5• Q&A

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About Amara Health

• Real-time predictive analytics to support clinicians in the early detection of critical disease states

• Early detection enables rapid response, driving better patient outcomes and lower healthcare costs

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Clinical Vigilance™ for

Sepsis

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Sepsis, and the Challenge of Early Identification • 800,000+/year contract sepsis in the U.S.; 250K-300K sepsis

deaths/year• $20+ billion annual cost to U.S healthcare providers• Mortality rate for septic shock exceeds 50%… and, untreated, grows

7.6% per hour“Evidence unwaveringly suggests that early administration of appropriate antibiotics reduces mortality…” (Surviving Sepsis Campaign)

"Lack of early recognition is a major obstacle to sepsis bundle initiation." (Surviving Sepsis Campaign, 2012 Guidelines)

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Real-time Decision Support• Clinical decision support software• Primarily a SaaS solution• Connects to existing hospital information

systems and analyzes all patient data 24/7• Supports early sepsis detection/prediction• Provides clinical alerts to smartphone/tablet• Technology:

• Machine Learning• Natural Language Processing• Auto-filtering of physiological signals

• Unique combination of early alerting with very low false positives

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Antibiotic Timing and Mortality• Retrospective study data: 36 months from 2 hospitals• Mortality & LOS for varying delay from Clinical Vigilance™ for Sepsis alert to IV

antibiotics For 2217 patients with moderate initial severity (PIRO score 5-

14)

0-3 hours 3-6 hours 6-12 hours 12-24 hours

24-48 hours

5

10

15

20Mortality %

0-3 hours 3-6 hours 6-12 hours 12-24 hours 24-48 hours456789

Median Length of Stay (days)

Earlier antibiotics after Clinical Vigilance™ for Sepsis alert are associated with better outcomes.

(Preliminary data from work by Dr. Ryan Arnold, Christiana Care Health System)

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The Challenge

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• Expanding and ever-changing data volumes and formats• A complex mix of structured and unstructured real-time data• Strict requirements on:

• Security and privacy (HIPAA)• Application uptime and response times • Real-time decision support• Reliability and data integrity

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Key Database Requirements

Strong real-time search and query capability

Support high reliability and security

Structured & unstructured real-time data

Flexible data model with affordable scalability

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Why NoSQL, Apache Cassandra, and DataStax Enterprise• Schema can change at run-time in real-time; dynamic columns• Strong search & real-time query capability on unstructured data (Solr

integration)• Supports 100% uptime through replication and rolling upgrades• Enterprise level security• 24x7 support• Open-source foundation• Community

Clinical Vigilance™ Input

DataAggregator

Hospital DataOver VPN

Cassandra

HL7 Interface Engine

ack

ack

HL7 Sources

Non-HL7 Sources

Raw & Transformed Data

Clinical Vigilance™ Server VM

…

Hospital data is extremely diverse and changes rapidly in structure and usage.

Clinical Vigilance™

dynamically adds new columns in real-time, in response to new fields observed in incoming data.

Data Protection and Replication

HIPAA-Compliant Data CenterOffsite Cassandra

VM A

Hospital A Hospital B

VM B

Cassandra 1

KSA

KSB

Cassandra 2

Authenticated

Authenticated

Hospital VPN terminates inside hospital-dedicated virtual machine

Each hospital has a separately authenticated Cassandra keyspace

On-site and off-site redundancy supported via Cassandra replication.100% uptime during rolling upgrades

VPNVPN

KSA

KSB

 

What is Apache Cassandra?

San Francisco

Stockholm

New YorkC*

C*C*

Open Source NoSQL DatabaseIndustry Leading Performance Predictable Scalability Geographical Data DistributionOperational Simplicity Business Flexibility

Security Analytics Search VisualMonitoring

ManagementServices In-Memory

Dev. IDE & Drivers

ProfessionalServices

Support & Training

Integrated analytics, OLTP, SearchIn-memory analytics and OLTPBuilt-in data protection

Production-ready CassandraMulti-workload, use case capableAutomated management services

©2014 DataStax Confidential. Do not distribute without consent.

What is DataStax Enterprise?

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DataStax Enterprise 4.5Integrated 100x faster analytics and operational simplicity

1. New analytics options for any workload and size• 100x faster analytics on real-time data with Spark• Seamless integration with Hadoop analytical systems • Hive compatible SQL-like language

2. New Performance Service drives operational simplicity3. Enhanced OpsCenter supplies greater ease of use and security

Modern online Web and Mobile applications have outgrown legacy RDBMS transactionsToday’s OLTP is more of an “interaction” needing customization via analyticsThe end goal is to influence the next action a customer takes on a website or mobile app

©2014 DataStax Confidential. Do not distribute without consent.

Transactional Analytics Transforms Businesses

OS Cassandra

DSEStandard

DSEPro

DSEMax

DATABASE MANAGEMENT / SERVICES

Advanced Security Option ✔ ✔ ✔In-Memory Option ✔ ✔ ✔Automatic Management Services ✔ ✔ ✔Enterprise Search ✔ ✔Integrated Analytics (Real-time and Batch via Hadoop) ✔MANAGEMENT

OpsCenter Basic Advanced Advanced AdvancedSUPPORT AND PROFESSIONAL SERVICES

Expert 24x7x365 Support ✔ ✔ ✔Platform certification ✔ ✔ ✔Certified service packs ✔ ✔ ✔Hot fixes ✔ ✔ ✔Bug escalation ✔ ✔ ✔Health checks/Performance reviews ✔ ✔ ✔Custom builds Option

Easy Upgrade Path with DataStax Enterprise

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Apache Cassandra

DataStax Enterprise

1) View Use Cases: /customers2) Attend Monthly Customer Webinars: /webinar3) Attend an Internet Enterprise Event: /events

1) Download DataStax Enterprise: /download 2) Get Trained: academy.datastax.com3) Attend a Tech Day: /events

Management IT

Technical IT

1) Download DataStax Community /cassandra2) 10 Minute Cassandra Walk Through /trycassandra3) Attend a Meet Up /join-your-local-meetup

Community

C*

On planetcassandra.org

On datastax.com

On datastax.com

How to Get Started?

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Thank You!