My Experience

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Clinical Data Exchange

Director, Data Services

 

I lead a sizeable data integration team (full-time and contractor, on-shore and off-shore) that receives health information from various sources, partners, payers, and government agencies. Data is coallated into Snowflake for dashboards, analytics, and data dissemination. Focus areas include:

• Team Leadership and Mentorship to improve team cohesion and operational effectiveness
• Streamline development operational procedures (CI/CD) and improve release scheduling
• Identify system performance issues and determine resolutions to reduce infrastructure operational costs
• Scale current operational framework for anticipated 300% increased business capacity
• Ensure the team remains on task and schedule for multiple concurrent data integration projects
• Coordinate with other department heads and senior management to ensure smooth client implementations

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Operational Data Store (ODS)

Enterprise Data Architect, Senior Manager

 

I was the Lead Enterprise Data Architect for several enterprise-level projects:

• An Operational Data Store (ODS) to integrate claims (Medicare/Medicaid) and clinical data.
• A comprehensive provider management system for Healthcare Organizations, Facilities, and Professionals.
• A repository containing 20 years of data from a discontinued primary clinical system.
• Several analytics and data science projects involving health risk assessments, resolution, and mitigation.

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I was engaged in various Business Intelligence (BI) data warehouse projects for the missionary department, including prescriptive and predictive analytics, forecasting, reports, and dashboards.

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I designed an operational data store (ODS) for Healthfirst, Inc., using PostgreSQL (AWS). I mapped data from multiple disparate sources for claim authorizations to homogenize them into a single repository for reporting and analytics.

• I maintained the data model in ER/Studio for conceptual, logical, physical, and staging environments.
• I guided ETL developers, performed data profiling, and conducted various QA validations.

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I was the data architect for their flagship application, HC Standard™, which supported information sharing between healthcare workers, providers, and first responders, primarily in crisis and mass casualty events.

• I improved and streamlined the system to ensure flexibility for continued growth.
• I optimized the database architecture and all dynamic T-SQL generation procedures to improve response time.
• I reduced database query time and report generation to an average of 2% of the previous execution times.

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I designed data models, processes, and procedures to perform clinical quality measures (CQM) against data from disease, surgical, and other healthcare registries. I collaborated with end-users and provided strategic advice in converting registry-specific survey responses to viable clinical data for additional measures to support population health and clinical registries.

• I reduced the volume of data used in processing by 66% and reduced overall processing time by 75%.
• I created improvements and new CQM engine features to improve tracking health analytics.

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I designed solutions to replace aging data systems encompassing multiple departments and functions. I led a team to upgrade a process that identified, prevented, and recovered from incorrect or fraudulent billing practices. The improvements reduced analytics execution time by an average of 75%.

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I was the architect, development lead, and project manager for the industry’s first dynamic clinical quality measure (CQM) calculation engine to support population health. It allowed non-programmers to create/edit measure definitions and then compile and execute them. It was successfully implemented using SQL Server in a cloud environment as well as on-premises with Netezza:

• Numerous population health measures were supported (e.g., NQF, CQM, PQRS, HEDIS, Stars, CMS Utilization, etc.).
• The measure specification format allowed standard and custom measures to support various healthcare analytics.
• The solution allowed hospitals to report measure results to meet CMS requirements and receive incentive payments.

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I was the architect, development lead, and project manager for the Quality Health First® program, a clinical quality measure (CQM) project focused on population health. The project used preventative measures to reduce healthcare costs and improve patient care. The system aggregated large amounts of clinical and claims data from numerous sources. I also:

• Orchestrated clinical and claims data ingestion via HL7 from various sources into a clinical repository.
• Designed analytics that compared provider performance based on patient metrics against the community.
• Was a member of the Measures Committee, which included doctors and administrators from participating organizations.