American College of Emergency Physicians

Emergency physicians deal with life and death on a daily basis and need to be able to interpret patient data and make critical clinical decisions in real-time. By harnessing the power of data, emergency physicians and other healthcare professionals can make informed decisions, track performance, and continuously strive for better patient outcomes. Together with ACEP, we have developed a digital platform that will transform patient care, support clinical innovation, and empower emergency physicians with actionable, data-driven insights.

Running an accelerated timetable

ACEP, the largest professional membership association representing emergency physicians, advocates for its members, patients, and the public. It wanted our help marshalling its data resources to enhance their value and utility. With a better grip on its data, ACEP and its participating emergency departments (EDs) would bolster empirical support for their advocacy and policymaking activities, and EDs would be able to report their performance under Medicare’s Merit-based Incentive Payment System (MIPS) programme. Good performance under MIPS can result in bonuses which can fund facilities expansion, medical equipment purchases, and additional hiring.

Those payments, as well as the need to corral terabytes of ED data, were what prompted ACEP to approach us with a request not long after the engagement kicked off in February 2022. Could we deliver on our assignment by October 2022, to better serve patients and physicians while allowing time to meet the next deadline for submitting MIPS applications to Medicare?

The request triggered efforts to build and implement the Emergency Medicine Data Institute (EMDI), a fully automated, cloud-based data platform populated with healthcare records from hundreds of EDs and more than 16,500 physicians and other healthcare professionals across the U.S.

Unravelling complex data

Healthcare data is complex, made more so by the complexity of the healthcare industry in the United States. For example, there are large variations in electronic health systems, diverse coding standards, and a wide variety of documentation styles. This diversity of technologies and approaches must be factored into any system like EMDI.

“ACEP is capturing millions of patient visits every year”, explained PA architecture engineering and DevOps expert, Joseph Ellis. He continued, “data at this scale needs to be handled by automated means as it is simply impossible to manually look at this many cases.” Our task was to ingest all this data via automated routines, while handling all this data complexity.

The data engineering challenge was made more difficult by the sheer variety and volume of data. To simplify the task, we used a metadata-driven approach to create a highly scalable engine to automate data ingestion. Our ingestion engine automatically absorbs, standardises, and analyses data from over 4,000 different schemas, across hundreds of feeds, with almost 40 different date/time formats and the full variety of file formats including structured and unstructured data.

A must-have for emergency departments

The EMDI platform we created is secure, scalable, robust, and is designed to evolve as technology evolves and new use cases emerge. It equips ED professionals with the information they need to address emergency medicine’s many pressing challenges. These challenges range from physician burnout to the country’s ongoing mental health crisis to the alarming increase in boarding – a practice where patients are held in the ED because no inpatient bed is available. Data is a crucial asset in tackling these problems – and in persuading Congress to adopt new policies that drive improvements in health care and access to services.

Our end-to-end ingestion-to-measure calculation process can now be completed in hours, allowing ACEP to rapidly turnaround updates to dashboards once we receive new data or onboard new clients. In 2022, we captured 13 million unique ED visits, which is roughly one in ten ED visits in the United States, in addition to billions of rows of supporting clinical data.

While we were still in the process of building out the platform, ACEP’s participating EDs were able to access it to glean better insights that will deliver enhanced outcomes for patients and enable them to complete their applications for MIPS bonuses. In other words, to meet ACEP’s need, we achieved in seven months what would ordinarily take two to three years.

And the project with ACEP isn’t finished. Now that EMDI is up and running, ACEP is partnering with us to make the platform so powerful and effective that emergency departments will demand to connect to it and gain access to its insights and detailed reporting to improve patient care. The future of healthcare is data, and together with ACEP, we’re helping to bring it about.