Demystifying Big Data and Machine Learning for Healthcare

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Advance Reviews

Data is quickly emerging as the greatest asset of the healthcare industry. The trend in our
industry is to drive many decisions supported by data. The authors have done a great job put-
ting together the issues, challenges and benefits of adopting a long view of Big Data. It is a walk
of maturity with the real gold nuggets coming in Analytics 3.0 and beyond. This will not be
solved with a product or purchased off the shelf. Big Data needs to be part of the DNA of an
organization. Thanks to the authors for putting this together for us.
—Chris Belmont, MBA
Vice President and Chief Information Officer
MD Anderson Cancer Center

Intelligent decisions are best made with data that gives us rich context and a fuller view of all
parameters and possibilities. However, how do we not drown in all this data we’re generating?
How do we stay afloat, swim, and surf—harnessing the tremendous power of this valuable
resource? The authors attempt successfully to separate myth from reality with regard to the
potential for big data and machine learning in healthcare. Great read!
—Rasu B. Shrestha, MD, MBA
Chief Innovation Officer, UPMC
Executive Vice President, UPMC Enterprises

This book is a must-read for any provider of healthcare services interested in practical recommen-
dations and best practices about leveraging big data in its many ways and formats. The authors
draw on their extensive practical experience to separate myths from realities and provide useful
insights into the handling of the related challenges through the usage of real-world case studies.
—Prof. Dr. Diego Kuonen
CEO and CAO, Statoo Consulting, Switzerland
Professor of Data Science, University of Geneva, Switzerland

iii
iv Demystifying Big Data and Machine Learning for Healthcare

Big data has become so ubiquitous a term that its use conveys very little of value, particularly
in healthcare. For those who want to actually understand this exciting area in meaningful way
and how in turn it can add considerable value to their organisation’s success, I would strongly
recommend this book.
—Jonathan Sheldon, PhD
Global Vice President, Healthcare
Oracle Health Sciences

As the leader of analytics at a large national IDN of primarily community hospitals, our “small
data” analytic needs alone can seem overwhelming at times. At the same time, we are seeing the
greater value of advanced analytics and beginning to realize the promise of machine learning pre-
dictive algorithms. We are admittedly just beginning our journey into true “big-data” use cases,
and I found this book to be an extremely useful overview of big-data and machine-learning ana-
lytic techniques and applications in healthcare. The book is written in an engaging format with
simple definitions and descriptions leading to real-world applications. I recommend this book for
healthcare leaders interested in a book that cuts through the hype of big data and effectively com-
piles the vast landscape of big-data analytic topics and terminologies into a single, practical volume.
—Nick T. Scartz
Corporate Chief Analytics Officer, Adventist Health System

Payers—not the least of which are Medicare and Medicaid—are demanding better value. Stuck
with one foot in the past, policy makers think we might cut our way out of spiraling health costs.
At the same time, Congress and the Administration are aggressively moving to at-risk, value-
based models. Reimbursement economics has never been quite so precarious.
It is into this environment the authors insert important new insights, with key takeaways
and action steps. Big data and machine learning are transforming how real-world evidence is
collected and leveraged to enable data-driven transparency, collaboration, and improved patient
outcomes. Written for a broad audience of healthcare stakeholders, this “first of its kind” book
offers illuminating strategies, concepts, and best practices. The authors write in remarkably
jargon-free language that makes this book an engaging and thought-provoking read for non-
technical—and technical—readers alike. Highly recommended for those seeking not just to
stay afloat, but to operationalize strategies and succeed in the new world of value-based care.
—Joel White
President, Council for Affordable Health Coverage
Co-author, Facts and Figures on Government Finance

This is the book that finally brings together in one volume the definitions and tools to understand
big data, AI, and machine learning for the busy clinician, hospital administrator, or policy maker
without requiring them to go back to school and take a graduate-level course curriculum to learn.
—Oscar Streeter, Jr., MD, FACRO
Chief Medical & Scientific Officer, CA Division of American Cancer Society
Radiation Oncologist, The Center for Thermal Oncology
 Advance Reviews v

The discipline of managing and analyzing big data continues to evolve at a rapid pace. The authors
do a solid job of recognizing this growing complexity and offering an accessible introduction to the
discipline in its increasing breadth. Presented is a discussion of both the art and science of big data;
including the different sub-classes of big-data management and analysis, approaches to solve each
challenge, and how these challenges map to healthcare problems of importance. Highly recom-
mended for healthcare leaders interested in data-intensive advances for care delivery.
—Zeeshan Syed, MD, PhD
Director, Clinical Inference and Algorithms Program, Stanford Health Care
Clinical Associate Professor, Stanford University School of Medicine

It’s my belief that the next dimension of clinical research and precision medicine will be built
off the ability to not only access the vast amounts of data available but to be able to identify
and quickly assess the valuable insights buried within. This book does a great job providing the
perspective needed in practical terms to understand how far we’ve come and where we are in the
access to and use of big data. It’s a must read for those from health-care providers to data scien-
tists looking to understand the tremendous potential and practical applications that machine
learning and advanced analytics can and will bring. We have truly come to a point where
health care has exceeded the capabilities of an individual person and must be augmented with
machines that allow us to understand and apply health care appropriately. I strongly recom-
mend this book to those who plan to be part of the analytically driven health-care environment.
—Matt Gross
Chief Solutions Officer, Duke Clinical Research Institute
Former Director of the Health and Life Sciences Global Practice, SAS

A comprehensive, timely, and truly invigorating book about machine learning, artificial intel-
ligence, and big data in health care. These are topics that are shaping research and the practice
of medicine—today. The authors show us the promise and potential pitfalls of this important
topic and how this information will shape our future. Enjoyable and understandable—you will
not need an MD or degree in computer science to gain a deep understanding of the future of
big data and AI in healthcare. The handy “Common Uses in Healthcare” sections in Chapter
7 drive home the saliency of the topics.
A must read for health-care providers and patients alike.
—Phillip J. Beron, MD
Assistant Professor, Department of Radiation Oncology
David Geffen School of Medicine at UCLA

This is a deep dive into Big Data and Machine Learning for healthcare, yet these complex
and challenging topics are made clear and comprehensible in this engaging exposition. It is a
must-read for those who wish to understand these dominant forces that are rapidly reshaping
medicine and to learn how best to apply them to their own healthcare enterprise.
—Pratik Mukherjee, MD, PhD
Professor, UCSF School of Medicine
vi Demystifying Big Data and Machine Learning for Healthcare

Learning algorithms are as essential for extracting information from big data as a transmission
is for a car to leverage the horsepower created by an engine. These algorithms have the poten-
tial for revolutionizing the healthcare industry by identifying new patterns and information
in data, continuously adjusting themselves to changes, automating many aspects of big-data
analysis, and operationalizing information extracted from big data.
This book demystifies machine learning algorithms by providing a solid overview of the
state of the art and by presenting the relationship of big data and machine learning algorithms.
The authors describe how machine learning can be used in the healthcare industry to support
physicians’ decisions, to improve the quality of care, and to detect new trends in healthcare data.
This book is a must-read for healthcare professionals who are entering the new world of
big-data analysis.
—Michael Sassin, Dr. techn.
Director of Software Development, GBU Architecture
Oracle

The future of healthcare will be built on the back of data. Organizations that don’t acknowl-
edge and prepare for this are going to be left behind. This book serves as the perfect foundation
for organizations that want to make sure they’re prepared for that data-driven future. What
makes this book particularly excellent is that it does a great job acknowledging past experiences
and infrastructure, providing practical applications of what can be done today, and then looks
to the future of where big data and machine learning are headed. The cherry on top are the case
studies where they show how the concepts are working in actual healthcare situations.
—John Lynn (@techguy)
Founder of HealthcareScene.com

Global healthcare challenges and trends such as aging populations, increasing costs, patient
engagement, ubiquitous devices and sensors, personalized medicine, changing reimbursement
and economic models demand a new approach to informatics. This approaching tsunami of
data, including clinical, financial, genomic, wearable, and device- and patient-generated data
will overwhelm any clinician, patient, or researcher, as well as any traditional decision-making
system. Machine learning and AI are going to be critical components of these new models,
and this book will serve as a solid foundation for anyone attempting to rise to this challenge.
—Steve Jepsen
Vice President, Healthcare Integration Services
Global HealthSuite Lab Lead
Healthcare Transformation Services, Philips
Demystifying Big Data
and Machine Learning
for Healthcare

Prashant Natarajan • John C. Frenzel • Detlev H. Smaltz

CRC Press
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Dedications

To my wonderful parents, Saraswati and Dr. V.N. Iyer, my loving wife, Vishnu,
and my darling daughter, Shivani. —Prashant Natarajan

To Elizabeth and Alexandra, my two beauties. —John Frenzel

To my wife Sandy, for her patience, love, and support

throughout my career. —Herb Smaltz

To Tenne, my wonderful wife and dedicated, loving mother of our four

amazing sons, who tragically died during the writing of this book.
She will always be my inspiration. —Bob Rogers

ix
The purpose of computing is insight, not numbers.
—Richard W. Hamming
Contents

Advance Reviews iii

Dedications ix

Preface xvii

Acknowledgments xxi

About the Authors xxiii

About the Contributors xxv

Chapter One: Introduction 1

Herb Smaltz
1.1 The Case for Leveraging Big Data Now 1
1.2 Business and Clinical Intelligence, Analytics, and Big Data—
An Evolutionary Perspective 3
1.3 Conclusion 9

Chapter Two: Healthcare and the Big Data V’s 11

Prashant Natarajan
2.1 Introduction 11
2.2 Big Data and the V’s: A Primer 14
2.3 Sources of Big Data in Healthcare 21
2.4 Two More V’s that Matter in Healthcare 21
2.5 How to Use Big Data 27
2.6 Summary 29

xiii
xiv Demystifying Big Data and Machine Learning for Healthcare

Chapter Three: Big Data—How to Get Started 31

John Frenzel
3.1 Getting Started Within Your Organization 31
3.2 Assessing Environmental and Organizational Readiness 33
3.3 Data and Use Cases 35
3.4 Effects of Organizational Structure 36
3.5 Conclusion 37

Chapter Four: Big Data—Challenges 39

John Frenzel
4.1 Building Your Strategy 39
4.2 The Need for Data Governance 40
4.3 Role of Master Data Management 44
4.4 The Skills Gap 51
4.5 Conclusion 52

Chapter Five: Best Practices: Separating Myth from Realty 55

Prashant Natarajan
5.1 Debunking Common Myths 56
5.2 Best Practices 60
5.3 Conclusion 66

Chapter Six: Big Data Advanced Topics 67

John Frenzel and Herb Smaltz
6.1 The NLP Toolbox 68
6.2 Healthcare Use Cases 69
6.3 The Knowledge-Enabled Organization 70
6.4 Knowledge Management and the Learning Organization 70
6.5 Building the Knowledge-Enabled Healthcare Organization 72

Chapter Seven: Applied Machine Learning for Healthcare 77

Prashant Natarajan and Bob Rogers
7.1 Introduction 77
7.2 Chapter Overview 78
7.3 A Brief History 78
7.4 What’s Different About Machine Learning Today? 79
7.5 How Do Machines Reason and Learn:
A Crash Course in Learning Algorithms 81
7.6 Mastering the Basics of Machine Learning 83
7.7 Artificial Neural Networks: An Overview 87
7.8 Deep Learning 87
 Contents xv

7.9 A Guided Tour of Machine-Learning Algorithms in Healthcare 89

7.10 Machine Learning and the Contextually Intelligent Agent 98
7.11 Some Best Practices for Successful Machine Learning 100
7.12 Conclusion 103

INTRODUCTION TO CASE STUDIES 107

Prashant Natarajan
1. Introduction 107
2. How Did We Get Started? 107
3. Methodology 108
4. Making the Final Cut 108
5. Conclusion 108

Penn Medicine: Precision Medicine and Big Data 111

Brian Wells
1. Introduction 111
2. Toward Precision Medicine 111
3. Conclusion 115

Ascension: Our Advanced Analytics Journey 117

Tony Byram
1. Introduction 117
2. Advanced Analytics Journey 119
3. Conclusion 123

University of Texas MD Anderson: Streaming Analytics 125

John Frenzel
1. Introduction 125
2. The Analytics-Enabled EHR 128
3. Conclusion 129

US Health Insurance Organization: Financial Reporting Analytics with Big Data 131
Marc Perlman, Larry Manno, and Shalin Saini
1. Introduction 131
2. Big-Data Strategies 133
3. The Big-Data Analytics Solution for Financial Reporting 134
4. Impact 134
5. Challenges Faced, Lessons Learned 135
6. Conclusion 137
xvi Demystifying Big Data and Machine Learning for Healthcare

CIAPM: California Initiative to Advance Precision Medicine 139

Elizabeth Baca
1. Background 139
2. Initial Demonstration Projects 141
3. Next Steps 144
4. New Demonstration Projects 144

University of California San Francisco: AI for Imaging of

Neurological Emergencies 149
Pratik Mukherjee
1. Introduction 149
2. Project Goals 150
3. Conclusion 151

BayCare Health System: Actionable, Agile Analytics Using Data Variety 153
Apparsamy (Balaji) Balaji
1. Strategic Plan 153
2. Building the Foundation 154
3. Collaboration and Partnership with Business Groups 162
4. Implementation 165
5. Conclusion 166

Arterys: Deep Learning for Medical Imaging 169

Carla Leibowitz
1. Early Development 169
2. Roadblocks to Early Adoption 170
3. Building a Clinical Product 171
4. Key Learnings 172
5. Conclusion 173

Big Data Technical Glossary 175

Shalin Saini

Index 179
Preface

The Plot
Big data, machine learning, predictive analytics, and AI are maturing in the hype cycle. In a
short period, these emerging technologies have evolved from being novelty terms in e-commerce
to ubiquitousness. By now, there are a few books on big-data technologies, methodologies, and
management; however, the majority tend to be too generic (i.e., don’t account for application to
a specific domain, such as healthcare) or too technical. Business, clinical, and executive users in
healthcare are looking for answers to fundamental questions, tailored recommendations, and
domain-specific best practices. More important, they want to learn how to leverage current
resources, data sources, and investments—without making each big-data or predictive-analytics
effort a custom one-off or an a priori science project.

Intended Audience
Our audience for this book is intended to be diverse and includes
1. Clinicians, domain experts, and clinical/financial analysts
2. Managers, IT developers, consultants, and vendors
3. Policy makers
4. Patients and consumers
5. Executives and lines-of-business leaders
6. Researchers and academia

The Skeptical Questioner

The need for this book was driven by three catalysts, beginning in late 2013. The first of these
catalysts occurred at a Q/A session following a conference panel discussion. I was moderating

xvii
xviii Demystifying Big Data and Machine Learning for Healthcare

this panel on the coming applications of big data in healthcare and life sciences—and how we
could replicate the successes in e-commerce and retail. The questioner (an experienced physi-
cian and über geek) expressed her keen interest—and her skepticism—in equal measure. She
was already dealing with lots more new digital EHR data, regulatory reporting, and new BI
dashboards and scorecards, and she was justifiably apprehensive about having to deal with
more data (and more noise) coming out of new un- and semi-structured sources.
She asked a few important questions:
1. What is big data in healthcare beyond volume?
2. Had we accounted for the different types of semi- and unstructured data in healthcare,
such as images, audio, video, and clinical narratives? What were the connections between
these new data types and business value?
3. Were we ready with validated best practices that are domain specific and based on success-
ful real-life case studies?
4. Given the increasing costs of care and reducing reimbursements, how could we ensure bene-
fits for patients, clinicians, and organizations?

The Transformer
The second catalyst, in 2013, that led to this book was the successful analytics-driven trans-
formation at MD Anderson: the FIRE program, which was built upon Oracle’s healthcare
analytics and translation research products. In the preceding years, I had many opportunities
to collaborate closely with MDACC CMIO and dear friend, Dr. John Frenzel. As we were
harnessing old and new structured and annotated healthcare data for the next generations of
analytics, we were recognizing that the developments in big data in other verticals needed to
be leveraged to bring new value and informed collaboration to healthcare.

The Visionary
Following discussions at HIMSS 2014, Herb Smaltz agreed to join us on this project. We were
thrilled when Herb, an acknowledged leader and visionary in health informatics, agreed on the
need for this book. His enthusiastic decision to join us was the third catalyst for me.

The Choreographer
We agreed that I’d choreograph this effort and also serve as case-study recruiter. To cut a long
story short, we jointly submitted our proposal in mid-2015 and received an enthusiastic accep-
tance from HIMSS and CRC Press.

The Plot Thickens: Research and Interviews

Among the three of us, we performed several rounds of completed formal literature review
of published papers, Internet resources (articles and videos), and conference submissions as a
 Preface xix

part of our proposal submission and throughout the writing process. In addition, I conducted
interviews with 25 world-class executives, innovators, scientists, and practitioners in medicine,
healthcare, and data science to both validate our ideas and to invite contrarian feedback. What
you see here is an objective work that accounts for the still evolving nature of this field and
current debates, but focuses on providing practical solutions instead of admiring the problems.

Keeping It Real
Any effort that involves new and still rapidly changing technologies requires practical, real-life
experiences in order to connect text to practice. The book wouldn’t have happened but for the
enthusiasm and support of our contributing and case-study authors.

What’s New?
In keeping with the theme of demystification, this book focuses on teaching you how to
1. Develop the skills needed to identify and demolish big-data myths
2. Become an expert in separating hype from reality
3. Understand the V’s that matter in healthcare and why
4. Harmonize the 4 C’s across little and big data
5. Choose data fidelity over data quality
6. Learn how to apply the NRF Framework (see page 26)
7. Master applied machine learning for healthcare
8. Conduct a guided tour of learning algorithms
9. Recognize and be prepared for the future of artificial intelligence in healthcare via best
practices, feedback loops, and contextually intelligent agents (CIAs)

How Is This Book Organized?

This book has seven chapters and eight case studies. Given our broad intended audience, it is put
together in a way that appeals to different reader types and interests. While we strongly recom-
mend reading the book sequentially, you have the flexibility to start with the chapters that interest
you more than others.

• Chapter 1 provides an introduction, makes the case for big data in healthcare, reviews evo-
lutionary analytics, and creates a rich tapestry of high-value information sources that may
be linked to an individual for healthcare.
• Chapter 2 describes the V’s that matter in healthcare, makes a case for using data fidel-
ity (as defined here) and the NRF Framework approach in addition to looking at data
quality (as we do currently). The chapter also discusses how to use healthcare big data in
current and next-generation analytics.
• Chapter 3 helps you get started in your organization while keeping the end in mind.
The chapter makes important connections between Analytics 1.0/2.0/3.0. Key areas of
xx Demystifying Big Data and Machine Learning for Healthcare

discussion include use-case selection, assessing your business and technical readiness,
organizational optimization, and building a skills roadmap.
• Chapter 4 recognizes, identifies, and provides practical solutions to challenges specific to
big data in healthcare. This chapter reviews how to apply what you know on data gover-
nance, MDM, and stewardship —and makes new connections to big data. The concept
of data fidelity is discussed in the context of this chapter and why it is a more appropriate
option than mere data quality.
• Chapter 5 lists and debunks common and uncommon myths related to big data and
analytics, including the refutation of the existence of the “McNamara Effect” in health-
care quantitative analytics. Validated best practices collected via experience, research,
and interviews are listed here for your immediate use.
• Chapter 6 covers the following advanced topics: NLP in healthcare and how to build a
living, breathing knowledge-enabled healthcare organization.
• Chapter 7 introduces you to both essential foundational concepts and intermediate to
advanced topics in machine learning, artificial neural networks, deep learning, and
contextually intelligent agents in healthcare. It makes a compelling case (we think) for
connecting big data to machine learning to AI. Other key topics covered here are the
very useful “guided tour,” best practices, and all-important discussions on healthcare
jobs, policy, and ethics.

We recommend you read the case study overview to get a bird’s eye view of each case study’s
problem space and solutions. The case studies don’t follow any specific order, and you can read
them in any sequence.

The Sequel
Thanks for purchasing this book. We hope you will enjoy reading it as much as we enjoyed
writing it. Given the evolving nature of these topics and still developing technologies and solu-
tions, we will support this print edition with blog updates and select curated resources on this
book’s website, www.bigdatacxo.com. We invite you to join us in ongoing conversations, share
your thoughts, provide answers, and learn together.
—Prashant Natarajan
Acknowledgments

It takes the efforts of many to bring a book to life, and the current zeitgeist encourages chapter-
length acknowledgments.1 As a result, it was tempting to keep up with the times and expand
the list here by name-dropping and assorted publishing tricks. In addition, while I will always
appreciate the efforts of my haircutter, my makeup artist, and the other individuals who keep
me looking good, frankly, they had little to contribute directly to the writing of this book. So,
despite the risks of fewer pages and not looking cool, I will keep it relatively short and acknowl-
edge the people who did contribute in a meaningful way.
I thank co-authors John Frenzel and Herb Smaltz. Their leadership, vision, and passion
in healthcare are legendary. The opportunity to learn from and collaborate with them for this
book will remain one of my career highlights.
My parents, Saraswati and Dr. V.N. Iyer, continue to teach me how to enjoy scholarship,
reading, and writing. Their unconditional love and sacrifices influence this work. Vishnu, cer-
tainly my better half, is a fountain of patience and understanding. I couldn’t have written this
book but for her unflagging love, encouragement, and the family time she sacrificed over the
last two years.
To my little one, Shivani: “I wrote this story for you, but when I began it I had not realized
that girls grow quicker than books.”2 Someday, I hope you will excuse the moments we missed
that I spent writing this book instead.
Our contributing authors have boundless passion and enthusiasm for patients, wellness, and
healthcare. For sharing their knowledge so freely and for “keeping it real,” my everlasting
gratitude to Brian Wells; John Frenzel; Tony Byram; Elizabeth Baca; Pratik Mukherjee; Marc
Perlman; Larry Manno; Shalin Saini; Apparsamy Balaji; and Carla Leibowitz.
A very special thank you to Bob Rogers, who was one of my initial interviewees/sounding
boards and later joined us as contributor to this book (Chapter 7)—even as he was dealing

1 Malone, N. (2013). “Thank You to the Author’s Many, Many Important Friends: How the Acknowledgments
Page Became the Place to Drop Names.” New Republic [online]. Available at https://newrepublic.com/article/
112578/what-sheryl-sandbergs-acknowledgments-reveals
2 Lewis, C.S. (1949). “Dedication to Lucy Barfield, his goddaughter, for The Lion, the Witch, and the Wardrobe: A
Celebration of the First Edition. New York: HarperCollins (2009).

xxi
xxii Demystifying Big Data and Machine Learning for Healthcare

with personal tragedy. Bob was always generous with his time and his insights, and we have a
better book as a result.
The following individuals were generous with their time during interviews or reviews, made
introductions, or supported this book in significant ways: Brad Perkins, MD; Dave Chase;
Khan Siddiqui, MD; David Talby, PhD; Itamar Arel, PhD; Mitesh Rao, MD, MHS; Zeeshan
Syed, MD, PhD; Summerpal Kahlon, MD; Andy Alasso; Anjali Arora; Vikas Agrawal; Uli
Chettipally, MD; Reza Alemy, MD; Shawn Dastmalchi, PhD; Shankar Kondur; Oscar
Streeter, MD; Christoph Trappe; Joel White; Nardo Manaloto; Wen Dombrowski, MD,
MBA; Jim Blodeau; and others whom I may have inadvertently missed.
Thanks to Taylor & Francis, CRC Press, and HIMSS. Bringing a book to fruition—from
proposal to publishing to launch—is a complex process that involves many unseen hands.
The following individuals deserve special mention. Kris Mednansky, Senior Editor, Taylor &
Francis, was a pillar of support and then some. Her guiding hand, sage advice, and command
over every detail made the entire process easy. Gratitude is due to Alexandria Gryder (CRC
Press) for her efforts and help. Theron Shreve (DerryField Publishing Services) was a great proj-
ect manager—he deserves credit for making sure we met our milestones during the editing,
typesetting, and printing phases. And Marje Pollack, Production Coordinator at DerryField,
kept a tight watch on the details as we all hustled to meet our deadlines.
Susan Culligan, also at DerryField, is the kind of editor, who, until this book, I thought only
existed in fiction. She not only dotted our i’s and crossed our t’s but was also our reader-advocate
extraordinaire. Susan kept us on our toes with a collaborative spirit and passion that went beyond
the call of duty.
There are others who made introductions, answered specific questions, or acted as readers
to critique late drafts.
We’d like to acknowledge permissions granted by authors Ian Goodfellow, Yoshua Bengio,
and Aaron Courville to quote from their yet-to-be-published book, Deep Learning.3 We’d also
like to acknowledge the permissions granted by William H. (Bill) Wilson to quote from his
online resource, The Machine Learning Dictionary.4
—Prashant Natarajan

3 Goodfellow, I., Bengio, Y., and Courville, A. (2016). Deep Learning. Book in preparation for MIT Press.
Information available at http://www.deeplearningbook.org
4 Wilson, H.B. (1998, updated June 24, 2012). The Machine Learning Dictionary. http://www.cse.unsw.edu.au/
~billw/mldict.html
About the Authors

Prashant Natarajan Iyer is Product Director of Healthcare Solutions at Oracle in the Health
Sciences Global Business Unit. He has portfolio responsibility for precision medicine, popu-
lation health, translational research, and convergence products. He is passionate about help-
ing healthcare organizations maximize their technology investments to improve patient care,
provider satisfaction, personal wellness, and health policy. Prior to joining Oracle in 2008,
Prashant contributed in progressive career roles as product manager, emerging technologies
specialist, and consultant at Healthways, McKesson, Siemens, and eCredit.com.
Prashant received his master’s degree in technical communications and linguistics from
Auburn University (2005) and his undergraduate degree in chemical engineering from
Mangalore University (1999). He is also a Stanford Certified Project Manager. Prashant is
author or contributing author of three books on healthcare informatics, including this one.
Others are Multi-Disciplinary Approach to Head and Neck Cancer (2017) and Implementing BI
in your Healthcare Organization (2012).
Prashant is Industry Advisor for Data Science and AI at UCSF/Center for Imaging of
Neurodegenerative Disease in the San Francisco VA Center. He volunteers on the Board of
Advisors for the Council for Affordable Health Coverage, Washington DC, and is currently
serving as Co-Chair of HIMSS NorCal’s Innovation Committee. Prashant lives in Livermore,
CA, with his wife, Vishnu; daughter, Shivani; and Australian Cattle Dog, Simba.

John Frenzel, MD, is the Chief Medical Informatics Officer at MD Anderson Cancer Center
and a Professor in the Department of Anesthesiology and Perioperative Medicine. He received
his medical degree from Baylor College of Medicine and completed his fellowship training in
Cardiovascular and Thoracic Anesthesia at the Mayo Clinic in Rochester, Minnesota.
In 2001, he received a Master’s Degree in Informatics from the University of Texas Health
Science Center Houston, School of Information Science. Dr. Frenzel has been active in applied
Informatics throughout his career at MD Anderson.
In addition to several clinical leadership roles, in 2010 he was asked to lead the develop-
ment and installation of MD Anderson’s third-generation Clinical Data Warehouse, which
sought to bring together all institutional clinical and genomic data. In 2012, he was asked to
help lead the Institution’s effort to install the Epic EHR and integrate clinical data back into
the institutional warehouse.

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