Increasing regulations on patient data, expanding and ever-changing data volumes and formats, and the need for real-time analytics are adding new levels of complexity to database platforms, forcing Healthcare IT management to rethink legacy database environments. Join Christopher Rosin, Ph.D., Chief Scientist at Amara Health Analytics, as he shares his knowledge about implementing a real-time predictive analytics platform to support clinicians in the early detection of critical disease states. Based on years of research and hands-on experience, Chris provides practical steps for guiding DataStax Enterprise initiatives from evaluation to successful implementation. Watch to learn: - The challenges in selecting the right database technology for dynamic, real-time data without the rigidity of relational systems - How Amara’s SaaS model delivers real-time decision support, leveraging large amounts of unstructured and structured clinical data - How DataStax Enterprise helps meet strict requirements on patient data privacy, data integrity, and system performance

1. How Amara Health Turned Big Data into
Big Answers
Christopher Rosin, Ph.D. and Chief Scientist, Amara Health Analytics
Seema Haji, Director of Product Marketing, DataStax

2. All attendees
placed on mute
Input questions at any time
using the online interface
Webinar Housekeeping

3. Agenda
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• 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

4. About Amara Health
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• 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

6. Sepsis, and the Challenge of Early
Identification
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• 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)

7. Real-time Decision Support
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• 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

8. Antibiotic Timing and Mortality
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• 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)
5
10
15
20
0-3 hours 3-6 hours 6-12 hours 12-24 hours 24-48 hours
Mortality %
4
5
6
7
8
9
0-3 hours 3-6 hours 6-12 hours 12-24 hours 24-48 hours
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)

9. 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

10. Key Database Requirements
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Strong real-time search and
query capability
Support high reliability and
security
Structured & unstructured
real-time data
Flexible data model with
affordable scalability

11. Why NoSQL, Apache Cassandra, and
DataStax Enterprise
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• 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

12. Clinical Vigilance™ Input
Data
Aggregator
Hospital Data
Over 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.

13. Data Protection and Replication
HIPAA-Compliant Data Center
Offsite 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

14. What is Apache Cassandra?
San
Francisco
Stockholm
New York
C*
C*C*
Open Source NoSQL Database
Industry Leading Performance
Predictable Scalability
Geographical Data Distribution
Operational Simplicity
Business Flexibility

15. Security Analytics Search Visual
Monitoring
Management
Services
In-Memory
Dev.IDE&
Drivers
Professional
Services
Support&
Training
Integrated analytics, OLTP, Search
In-memory analytics and OLTP
Built-in data protection
Production-ready Cassandra
Multi-workload, use case capable
Automated management services
©2014 DataStax Confidential. Do not distribute without consent.
What is DataStax Enterprise?

16. DataStax Enterprise 4.5
Integrated 100x faster analytics and operational simplicity
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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 simplicity
3. Enhanced OpsCenter supplies greater ease of use and security

17. Modern online Web and Mobile
applications have outgrown legacy
RDBMS transactions
Today’s OLTP is more of an
“interaction” needing customization
via analytics
The 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

18. OS
Cassandra
DSE
Standard
DSE
Pro
DSE
Max
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 Advanced
SUPPORT 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

19. Apache
Cassandra
DataStax
Enterprise
1) View Use Cases: /customers
2) Attend Monthly Customer Webinars: /webinar
3) Attend an Internet Enterprise Event: /events
1) Download DataStax Enterprise: /download
2) Get Trained: academy.datastax.com
3) Attend a Tech Day: /events
Management IT
Technical IT
1) Download DataStax Community /cassandra
2) 10 Minute Cassandra Walk Through /trycassandra
3) Attend a Meet Up /join-your-local-meetup
Community
19
C*
On planetcassandra.org
On datastax.com
On datastax.com
How to Get Started?

20. Thank You!
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