1. HL7® FHIR® Applications Roundtable
Big Data on FHIR®
HL7® FHIR® Applications Roundtable
Pawan Jindal MD, MS(HI)
Founder & President, Darena Solutions

2. Agenda Big Data Overview Big Data in Healthcare Big Data on FHIR®
Implementing a Big Data Solution

3. What Is Big Data?
Big Data is often described as extremely large data sets that can’t be managed with conventional technologies.
The challenge is not just about the size of the data, but the latency involved in leveraging the data for any meaningful purpose.
The technologies used to implement a “Big Data Solution” utilize distributed computing and parallel processing techniques to help reduce perceived and actual latency in a scalable and cost-effective manner.

4. “Perceived Latency” With Big Data
Batch(bulk) Data
Batch Processing
Machine Learning Models
App (EHR)
Report and Research
Queries

5. Distributed Computing

6. Column Oriented Database
diagnosis
identifier
period
reason
Encounter
bodySite
identifier
code
severity
stage
Condition
gender
identifier
name
birthDate
Patient

7. Column Oriented Database Storage
diagnosis
Identifier : 1
period
reason
Encounter
Identifier
Property Name
Value 1
period
{value}
reason
diagnosis

8. Why Column Oriented? Schema independent Add columns as needed
Compare with relational database
Add columns as needed
How many?
Space usage optimization
We are talking “Big Data”

9. Column Oriented Database Technologies

10. Why Cassandra? Decentralized architecture – no single point of failure
Strong JSON support
Secondary Indexes
SQL like Query Language

11. Who uses Cassandra?

12. Don’t Reinvent the Wheel
Big Data on FHIR®
Don’t Reinvent the Wheel

13. Defining Requirements
Requirements for Distributed Computing
Leverage FHIR® “Resources”
Support Multiple FHIR Versions

14. FHIR in Column Oriented Database
diagnosis
identifier
period
reason
Encounter
Identifier
Property Name
Value 1
period
{value}
reason
diagnosis 1
resourceType
Encounter
fhirVersion
3.1
tin
123456
npi

15. FHIR DSTU 2
FHIR DSTU 2
Mapping Layer
Mapping Layer
FHIR STU3
FHIR STU3

16. ndjson EHR 1/a 1/b Provider OAuth OAuth REST API REST API 5 6 1/c
EHR FHIR API 4 2 7
CMS Blue Button
1/d 3
Apps
IoMT
1/e

17. Use Case
MIPS Reporting

18. Patient Bundle Patient Bundle Patient Medication Encounter Procedure
Observation
Medication
Procedure
Other Resources
Patient Bundle
Entry

19. Identifying FHIR Resources
US Core Implementation Guide
HQMF & QRDA-I Analysis
Registry Measures Definitions

20. https://www. mymipsscore

22. One more thing..

23. “Perceived Latency” With Big Data
Batch(bulk) Data
Batch Processing
Machine Learning Models
App
Report and Research
Queries

24. Machine Learning Models
Patient
Provider
Batch(bulk) Data
Real Time Data
Batch Layer
Speedy Layer
Machine Learning Models
Serving Layer
Streaming Analytics
Real Time Alerts
Queries
Report and Research

25. BIG

26. Founder & President, Darena Solutions
Thank You
Pawan Jindal MD, MS(HI)
Founder & President, Darena Solutions