Welcome!

Linux Containers Authors: Elizabeth White, Pat Romanski, Amit Gupta, Liz McMillan, Yeshim Deniz

Related Topics: Linux Containers, Microservices Expo, @CloudExpo, @BigDataExpo

Linux Containers: Blog Post

The Taming of the Skew | @CloudExpo #Cloud #BigData #Analytics

Two types of skewness: the statistical skew impacts data analysis, and the operational skew impacts operational processes

The Taming of the Skew
By Dr. Laura Gardner, VP, Products, CLARA Analytics

In the famous comedy by William Shakespeare, "The Taming of the Shrew," the main plot depicts the courtship of Petruchio and Katherina, the headstrong, uncooperative shrew. Initially, Katherina is an unwilling participant in the relationship, but Petruchio breaks down her resistance with various psychological torments, which make up the "taming" - until she finally becomes agreeable.

An analogous challenge exists when using predictive analytics with healthcare data. Healthcare data can often seem quite stubborn, like Katherina. One of the main features of healthcare data that needs to be "tamed" is the "skew" of the data. In this article, we describe two types of skewness: the statistical skew, which impacts data analysis, and the operational skew, which impacts operational processes.

The Statistical Skew
Because the distribution of healthcare costs is bounded on the lower end - that is, the cost of healthcare services is never less than zero but ranges widely on the upper end, sometimes into the millions of dollars - the frequency distribution of costs is a skewed distribution. More specifically, in the following plot of frequency by cost, the distribution of healthcare costs is right-skewed because the long tail is on the right (and the coefficient of skewness is positive):

This skewness is present whether we are looking at total claim expense in the workers' compensation sector or annual expenses in the group health sector. Why is this a problem? Simply because the most common methods for analyzing data depend on the ability to assume that there is a normal distribution, and a right-skewed distribution is clearly not normal. It fails to conform to the assumption of normality. To produce reliable and accurate predictions and generalizable results from analyses of healthcare costs, the data need to be "tamed" (i.e., various sophisticated analytic techniques must be utilized to deal with the right-skewness of the data). Among these techniques are logarithmic transformation of the dependent variable, random forest regression, machine learning, topical analysis and others.

It's essential to keep this in mind in any analytic effort with healthcare data, especially in workers' compensation. To get the required level of accuracy, we need to think "non-normal" and get comfortable with the "skewed" behavior of the data.

Operational Skew
There is an equally pervasive operational skew in workers' compensation that calls out for a radical change in business models. The operational skew is exemplified by:

  • The 80/20 split between simple, straightforward claims that can be auto-adjudicated and more complex claims that have the potential to escalate or incur attorney involvement (i.e., 80 percent of the costs come from 20 percent of the claims).
  • The even more extreme 90/10 split between good providers delivering state-of-the-art care and the "bad apples" whose care is less effective, less often compliant with evidence-based guidelines or more expensive for a similar or worse result. (i.e., 90 percent of the costs come from 10 percent of the providers).

How can we deal with operational skew? The first step is to be aware of it and be prepared to use different tactics depending on which end of the skew you're dealing with. In the two examples just given, we have observed that by using the proper statistical approaches:

  • Claims can be categorized as early as Day 1 into low vs. high risk with respect to potential for cost escalation or attorney involvement. This enables payers to apply the appropriate amount of oversight, intervention and cost containment resources based on the risk of the claim.
  • Provider outcomes can be evaluated, summarized and scored, thus empowering network managers to fine-tune their networks and claims adjusters to recommend the best doctors to each injured worker.

Both of these examples show that what used to be a single business process -managing every claim by the high-touch, "throw a nurse or a doctor at every claim" approach, as noble as that sounds - now requires the discipline to enact two entirely different business models in order to be operationally successful. Let me explain.

The difference between low- and high-risk claims is not a subtle distinction. Low-risk claims should receive a minimum amount of intervention, just enough oversight to ensure that they are going well and staying within expected parameters. Good technology can help provide this oversight. Added expense, such as nurse case management, is generally unnecessary. Conversely, high-risk claims might need nurse and/or physician involvement, weekly or even daily updates, multiple points of contact and a keen eye for opportunities to do a better job navigating this difficult journey with the recovering worker.

The same is true for managing your network. It would be nice if all providers could be treated alike, but in fact, a small percentage of providers drives the bulk of the opioid prescribing, attorney involvement, liens and independent medial review (IMR) requests. These "bad apples" are difficult to reform and are best avoided, using a sophisticated provider scoring system that focuses on multiple aspects of provider performance and outcomes.

Once you have tamed your statistical skew with the appropriate data science techniques and your operational skew with a new business model, you will be well on your way to developing actionable insights from your predictive modeling. With assistance from the appropriate technology and operational routines, the most uncooperative skewness generally can be tamed. Are you ready to "tame the skew"?

Read Dr. Gardner's first two articles in this series:

Five Best Practices to Ensure the Injured Workers Comes First

Cycle Time is King

As first published in Claims Journal.

###

Laura B. Gardner, M.D., M.P.H., Ph.D., is an expert in analyzing U.S. health and workers' compensation data with a focus on predictive modeling, outcomes assessment, design of triage and provider evaluation software applications, program evaluation and health policy research. She is a successful entrepreneur with more than 20 years of experience in starting and building Axiomedics Research, Inc.

Dr. Gardner earned her bachelor's degree in biology (magna cum laude) from Brandeis University, her M.D. from Albert Einstein College of Medicine and both an M.P.H. in health policy and a Ph.D. in health economics from the University of California at Berkeley. As a physician, she is board certified in General Preventive Medicine and Public Health and is a fellow of the American College of Preventive Medicine.

For more information, visit http://www.claraanalytics.com/ and follow CLARA Analytics on LinkedInFacebook and Twitter.

More Stories By CLARA Analytics

Laura B. Gardner, M.D., M.P.H., Ph.D., is an expert in analyzing U.S. health and workers' compensation data with a focus on predictive modeling, outcomes assessment, design of triage and provider evaluation software applications, program evaluation and health policy research. She is a successful entrepreneur with more than 20 years of experience in starting and building Axiomedics Research, Inc.

Dr. Gardner earned her bachelor's degree in biology (magna cum laude) from Brandeis University, her M.D. from Albert Einstein College of Medicine and both an M.P.H. in health policy and a Ph.D. in health economics from the University of California at Berkeley. As a physician, she is board certified in General Preventive Medicine and Public Health and is a fellow of the American College of Preventive Medicine.

@ThingsExpo Stories
SYS-CON Events announced today that mruby Forum will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. mruby is the lightweight implementation of the Ruby language. We introduce mruby and the mruby IoT framework that enhances development productivity. For more information, visit http://forum.mruby.org/.
Elon Musk is among the notable industry figures who worries about the power of AI to destroy rather than help society. Mark Zuckerberg, on the other hand, embraces all that is going on. AI is most powerful when deployed across the vast networks being built for Internets of Things in the manufacturing, transportation and logistics, retail, healthcare, government and other sectors. Is AI transforming IoT for the good or the bad? Do we need to worry about its potential destructive power? Or will we...
SYS-CON Events announced today that B2Cloud will exhibit at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. B2Cloud specializes in IoT devices for preventive and predictive maintenance in any kind of equipment retrieving data like Energy consumption, working time, temperature, humidity, pressure, etc.
In his session at @ThingsExpo, Greg Gorman is the Director, IoT Developer Ecosystem, Watson IoT, will provide a short tutorial on Node-RED, a Node.js-based programming tool for wiring together hardware devices, APIs and online services in new and interesting ways. It provides a browser-based editor that makes it easy to wire together flows using a wide range of nodes in the palette that can be deployed to its runtime in a single-click. There is a large library of contributed nodes that help so...
What is the best strategy for selecting the right offshore company for your business? In his session at 21st Cloud Expo, Alan Winters, U.S. Head of Business Development at MobiDev, will discuss the things to look for - positive and negative - in evaluating your options. He will also discuss how to maximize productivity with your offshore developers. Before you start your search, clearly understand your business needs and how that impacts software choices.
SYS-CON Events announced today that NetApp has been named “Bronze Sponsor” of SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. NetApp is the data authority for hybrid cloud. NetApp provides a full range of hybrid cloud data services that simplify management of applications and data across cloud and on-premises environments to accelerate digital transformation. Together with their partners, NetApp em...
SYS-CON Events announced today that SIGMA Corporation will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. uLaser flow inspection device from the Japanese top share to Global Standard! Then, make the best use of data to flip to next page. For more information, visit http://www.sigma-k.co.jp/en/.
Agile has finally jumped the technology shark, expanding outside the software world. Enterprises are now increasingly adopting Agile practices across their organizations in order to successfully navigate the disruptive waters that threaten to drown them. In our quest for establishing change as a core competency in our organizations, this business-centric notion of Agile is an essential component of Agile Digital Transformation. In the years since the publication of the Agile Manifesto, the conn...
There is huge complexity in implementing a successful digital business that requires efficient on-premise and cloud back-end infrastructure, IT and Internet of Things (IoT) data, analytics, Machine Learning, Artificial Intelligence (AI) and Digital Applications. In the data center alone, there are physical and virtual infrastructures, multiple operating systems, multiple applications and new and emerging business and technological paradigms such as cloud computing and XaaS. And then there are pe...
Real IoT production deployments running at scale are collecting sensor data from hundreds / thousands / millions of devices. The goal is to take business-critical actions on the real-time data and find insights from stored datasets. In his session at @ThingsExpo, John Walicki, Watson IoT Developer Advocate at IBM Cloud, will provide a fast-paced developer journey that follows the IoT sensor data from generation, to edge gateway, to edge analytics, to encryption, to the IBM Bluemix cloud, to Wa...
SYS-CON Events announced today that MIRAI Inc. will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. MIRAI Inc. are IT consultants from the public sector whose mission is to solve social issues by technology and innovation and to create a meaningful future for people.
While some developers care passionately about how data centers and clouds are architected, for most, it is only the end result that matters. To the majority of companies, technology exists to solve a business problem, and only delivers value when it is solving that problem. 2017 brings the mainstream adoption of containers for production workloads. In his session at 21st Cloud Expo, Ben McCormack, VP of Operations at Evernote, will discuss how data centers of the future will be managed, how th...
SYS-CON Events announced today that Keisoku Research Consultant Co. will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Keisoku Research Consultant, Co. offers research and consulting in a wide range of civil engineering-related fields from information construction to preservation of cultural properties. For more information, vi...
SYS-CON Events announced today that Fusic will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Fusic Co. provides mocks as virtual IoT devices. You can customize mocks, and get any amount of data at any time in your test. For more information, visit https://fusic.co.jp/english/.
SYS-CON Events announced today that Enroute Lab will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Enroute Lab is an industrial design, research and development company of unmanned robotic vehicle system. For more information, please visit http://elab.co.jp/.
SYS-CON Events announced today that Mobile Create USA will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Mobile Create USA Inc. is an MVNO-based business model that uses portable communication devices and cellular-based infrastructure in the development, sales, operation and mobile communications systems incorporating GPS capabi...
SYS-CON Events announced today that Interface Corporation will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Interface Corporation is a company developing, manufacturing and marketing high quality and wide variety of industrial computers and interface modules such as PCIs and PCI express. For more information, visit http://www.i...
SYS-CON Events announced today that Ryobi Systems will exhibit at the Japan External Trade Organization (JETRO) Pavilion at SYS-CON's 21st International Cloud Expo®, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. Ryobi Systems Co., Ltd., as an information service company, specialized in business support for local governments and medical industry. We are challenging to achive the precision farming with AI. For more information, visit http:...
SYS-CON Events announced today that N3N will exhibit at SYS-CON's @ThingsExpo, which will take place on Oct 31 – Nov 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA. N3N’s solutions increase the effectiveness of operations and control centers, increase the value of IoT investments, and facilitate real-time operational decision making. N3N enables operations teams with a four dimensional digital “big board” that consolidates real-time live video feeds alongside IoT sensor data a...
Internet of @ThingsExpo, taking place October 31 - November 2, 2017, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 21st Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The Internet of Things (IoT) is the most profound change in personal and enterprise IT since the creation of the Worldwide Web more than 20 years ago. All major researchers estimate there will be tens of billions devic...