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Description
Speaker: Terrell Deppe, CTO at HealthCare Anytime
Slides: http://www.slideshare.net/planetcassandra/7-terrell-deppe
HealthCare Anytime provides Web-based portal solutions that assist healthcare organizations in achieving meaningful use, optimized operations, and increased patient and staff satisfaction. During this speaking session, HealthCare Anytime CTO Terrell Deppe will discuss the challenges his company faced when processing an "avalanche" of patient records and how he utilized DataStax's Cassandra-based big data platform to improve their product's performance while reducing costs.
A
Now
we
do
that
through
something
called
a
patient
portal
or
a
health
portal.
We
address
not
just
the
needs
of
the
patient,
but
also
staff,
members
and
clinicians,
and
things
like
that,
and
if
any
of
you
are
familiar
with
healthcare
and
the
terms
Meaningful
Use
and
all
that
stuff,
that's
really
what
our
target
is.
You
know
we're
very
heavily
invested
in
solving
the
problems
of
stage
2
meaningful
use
in
the
event
that
you
are
not
in
healthcare,
and
none
of
that
makes
any
sense.
A
Don't
worry
about
it,
because
what
I'm
going
to
talk
to
you
about
here
has
pattern
implications
among
various
industries.
We
deal
with
both
clinical
and
financial
data
at
healthcare
anytime
and
pretty
much
whatever
else.
The
federal
government
seems
to
dream
up
in
terms
of
regulatory
compliance,
but
enough
of
the
boring
stuff,
let's
get
into
having
a
little
bit
of
fun.
Shall
we?
A
B
A
A
Well,
thank
you
very
much
for
offering
to
come
up
here
and
assist
me
with
the
presentation
this.
This
is
part
of
a
presentation
that
I
no
matter
how
hard
I
tried.
I
could
not
possibly
figure
out
a
way
to
make
this
a
part
of
the
presentation
and
not
having
any
assistance
and
I
will
I
will
make
it
up
to
you.
I
will
reward
you
for
your
efforts,
but
as
a
part
of
this
portion
of
the
presentation,
I
need
for
you
to
provide
me
with
something
in
return.
A
A
A
In
order
for
me
to
do
this
in
an
order
for
you
to
do
this,
we
have
to
put
some
constraints
around
it,
because
what
is
timely
right
so
in
this
case,
timely
was
90
seconds
from
the
time
that
you
accepted
the
challenge,
which
means
you
have
about
five
seconds
left
I
suggest
you
dump
the
box
bluenose
expensive.
What
do
we
have
here?
We
have
an
avalanche
and
how
Natalie?
What
is
the
tell
me
tell
me
exactly
what
the
valuable
contents
of
the
box
is.
A
A
A
A
Well,
as
I
mentioned
earlier,
timeliness
is
relative
right.
Sometimes
we
have
90
seconds
like
David
head.
Sometimes
we
have
only
seconds.
Sometimes
we
need
to
know
the
answer
immediately
before
we're
even
asked.
We
need
to
have
that
answer
ready
to
go,
and
that
is
a
that
is
a
big
data
problem
now,
when
it
comes
to
timeliness
and
the
importance
of
time,
one
of
the
industries
that
I
have
worked
with
that
places
a
much
higher
emphasis
on
timeliness
than
many
is
the
transportation
industries
auto
racing.
A
A
A
They
all
have
very
different
and
constantly
evolving
rules,
some
of
them
believe
it
or
not
even
have
speed
limits.
You
might
think
speed
limits
in
auto
racing.
What's
the
point
in
racing,
if
you
can't
go
as
fast
as
you
want
to
go
right
well,
one
of
the
venues
that
that
I
have
worked
with
is
is
an
open
road
racing
and,
in
particular,
I
worked
on
the
Big
Bend
open
road
racing
event
in
South
Texas.
A
A
Every
event
has
rules
and,
of
course,
every
state
has
rules,
and
in
Texas
we
do
have
a
couple
of
very
relatively
high
speed
highways.
In
fact,
the
highest
highest
highest
speed
highway
in
the
United
States
is
in
Texas
it
8
85
mile
an
hour
now,
most
of
the
West
Texas
towns
are
85
or
80
mile
an
hour,
some
of
the
state
highways
or
75
and
79
dove
thing.
Well,
it's
not
much
racing
if
you're
restricted
to
these
kind
of
constraints.
So
how
do
you
race
on
a
public
road
and
not
break
the
law?
A
A
A
Business
environment
is
that
we
can
still
have
fun,
even
if
we're
not
the
one
doing
all
of
the
fun
okay,
an
example
of
this
is
you
know,
standing
on
that.
Just
imagine
with
me.
For
a
moment,
I
was
standing
on
the
side
of
the
highway
in
on
the
Sanderson
side
of
this
of
this
event
and
we're
waiting
for
one
of
the
fastest
vehicles
to
come
come
down
the
course
and
off
in
the
distance.
There's
this
the
small
little
tuft
of
smoke
or
dust.
A
A
This
thing
came
back,
came
past
in
just
a
war
of
of
internal
combustion,
engine
goodness
and
spinning
twin
turbos,
and
then
this
rush
of
wind
and
dust
pelted
me
as
it
went
by
it
was
just
breathtaking
to
see
something
moving
that
fast
I
thoroughly
enjoy
seeing
people
have
fun,
but
what
I
didn't
expect
was
to
enjoy
watching
someone
else
watching
someone
have
fun.
Let
me
explain:
I
was
15
feet
away
from
the
Porsche
when
it
went
past
me,
but
15
feet
beyond.
That
is
a
state
patrolman
with
a
radar
gun.
A
Now
remember
it
is
illegal
to
speed,
and
can
you
imagine
the
speeding
ticket?
Fine
if
you
are
caught
doing
251
mile
per
hour
on
a
public
road
I,
don't
think
it
would
be
very
pretty
so
posted
along
this
course,
sometimes
hidden
behind
rocks
or
billboards
or
old
barns,
or
something
like
that.
Our
state
patrolman
with
their
radar
guns,
but
on
this
long
stretch
of
straight
desert
highway,
we
have
one
right
at
the
finish
line
and
he
just
about
jumped
out
of
his
skin
I'm,
telling
you
this
guy.
C
Oh,
oh
man,
I
can't
believe
it
I
can't
believe
it
he's
jumping
around
and
he's
all
excited.
He
goes
somebody
somebody
somebody,
somebody
get
a
camera,
somebody
get
a
camera,
oh
man,
and
he
spins
that
radar
gun
around.
He
goes
two
hundred
and
thirty-five
mile
an
hour
can't
believe
it
take.
My
picture.
I
mean
the
guy
is
just.
A
A
Year
old
man,
now
this
guy
gets
out
of
his
Porsche
and
he
is
cool
as
a
cucumber
hello,
wow.
It's
not
what
I
expected.
You
know,
I
expected
some.
You
know
middle-aged
goof
like
me
to
come
out
there
and
you
know
some
guy
that
won
the
lottery
or
something-
and
you
know
he's
he's
playing
with
fast
cars,
no
very
sophisticated,
very
calm,
gentlemen
steps
out
of
the
car,
and
then
one
of
the
other
rules
of
this
of
this
event
is
that
you
have
to
have
a
navigator,
a
co-pilot
to
go
along
with
you.
A
How
about
his
70
year
old
wife
and
she
gets
out
dressed
in
in
May,
tching
leather
driving
suit,
and
she
is
not
cool
as
a
cucumber
totally
unexpected.
My
wife
would
not
be
cool
as
a
cucumber
either
if
I
had
just
taken
her
235
mile
an
hour,
but
her
reason
was
different,
she's
out
of
car
and
she
finds
out
what
the
time
and
speed
wasn't.
She
says:
I
knew
it.
I.
A
And
she
turns
around
and
she
goes
and
gets
back
in
the
car.
It
wasn't
fast
enough.
I'm
thinking,
wow
I
had
no
idea
a
two-seater
high-performance
235
mile
an
hour
sports
car
could
have
a
backseat
driver,
I,
don't
head
anything.
The
important
thing
to
realize
here
is
that
this
information
is
absolutely
critical.
It's
very
important.
They
have
something
on
the
line.
They
have
their
reputation.
A
There
they're
actually
involved
in
building
cars
that
do
235
mile
an
hour
and
selling
them
to
other
people,
and
what
better
way
to
prove
that
the
car
that
you're
buying
that
the
dealer
claims
can
do
235
can
actually
do
235,
but
to
give
them
an
officer's
written
warning
of
going
how
fast
you
were
going
or
the
results
from
the
race
that
you
were
in
now.
Most
of
these
events
are
have
data
that
just
comes
pouring
in
at
an
alarming
rate.
Usually
this
is
the
result
of
an
antenna.
A
If
there
is
one
to
the
Internet
can
get
displayed
on
television
and
mine
for
statistics,
so
that
announcers
can
sound
more
knowledgeable
than
they
really
are,
because
when
the
caution
flag
waves,
the
fans
want
to
know
where
their
favorite
driver
is
who's
in
front
of
their
favorite
driver
who's
behind
their
favorite
driver
who's,
winning
and
who's
no
longer
in
the
race
and
for
some
people
what
danica
patrick
is
up
to.
But
you
get
the
idea.
It's
important.
A
Their
reputation
is
on
the
line
and
they
take
this
very
seriously.
It's
like
the
picture
you
see
here.
This
is
aj
foyt
and
re
lion
dyke,
shortly
after
a
indy
car
race
and
in
texas,
at
texas,
motor
speedway,
aj
foyt
and
his
team
with
billy
boat,
as
the
driver
were
declared.
The
winner
of
the
race,
and
I
rely
on
date,
comes
up
and
says:
no,
I'm
the
winner
of
the
race.
A
Well,
this
aj
here
is
he's
not
padding
re
on
the
back
and
he's
not
giving
off
giving
him
a
hug
for
a
job.
Well
done
he's
actually,
actually,
unless
you
consider
a
firm
grasp
around
the
neck
as
a
form
of
appreciation
or
acceptance
or
encouragement.
That
is
not
what's
about
to
happen
here
and
an
altercation
occurred.
Why?
A
Because
it's
important
their
livelihood
is
on
the
line.
It's
important
for
the
driver,
the
owner,
their
sponsor
the
sanctioning
body,
the
sanctioning
body,
sponsor
the
networks.
Everybody's
got
a
stake
in
this
thing,
the
advertisers
it's
their
livelihood,
that's
at
stake,
and
if
you
fail
to
properly
identify
access
process
and
report
on
this
information
correctly
in
a
timely
manner,
it
could
have
dire
consequences,
such
as
the
case
for
the
United
States
Auto
Club.
A
It's
not
always
our
livelihood,
that's
on
the
line,
though
sometimes
it's
our
very
life
and
in
health
care.
That
is
the
case.
Each
of
you
is
very
unique
and
very
different
from
the
person
sitting.
Next
to
you.
That
means
you
eat
different
things.
You
exercise
differently.
You
have
different
genetic
makeup.
The
information
that's
collected
on
you
when
you
go
to
the
doctor
when
you're
healthy
is
different.
Now
imagine
how
much
different
that
information
is
when
you're
not
healthy.
Most
of
the
time
we
only
go
to
the
doctor
when
we're
sick.
A
Collecting
all
this
information
and
putting
it
into
a
meaningful
form
is
very
difficult
and
an
organization
called
health
level.
7
has
put
together
an
XML
document
of
sorts
that
and
a
schema
behind
it
that
tries
to
structure
and
codify
this
information
in
a
meaningful
way,
so
that
can
be
passed
from
one
provider
to
another
to
another.
The
problem
is
because
you're
different
and
because
our
encounters
are
different
and
because
the
information
that's
being
collected
about
us
is
different.
A
A
Well,
we
were
initially
looking
at
this
problem
and
said
you
know
there
is.
There
is
no
way
we're
going
down
the
relational
route
with
this,
because
it
just
doesn't
make
sense,
it
doesn't
work.
So
what
are
our
options?
Well,
let's
see
what
does
Google
do
with
web
page?
You
know
if
I
can
transform
an
XML
document
in
HTML
and
if
Google
can
index
HTML,
then
don't
I
just
need
my
own
little
Google
to
be
able
to
process
these
documents.
Well,
that's
a
great
idea,
but
that
doesn't
work
out
real.
Well,
two
things
happened.
A
First
of
all,
it
fell
asleep
under
its
own
weight.
We
reached
a
maximum
throughput
of
about
20,000
patients
per
hour
and
throughput.
That
is
totally
unacceptable.
Think
about
the
millions
of
people
in
each
town,
the
hundreds
of
thousands
of
patients
in
in
clinics
and
hospitals,
and
you
get
an
idea
for
how
how
troublesome
this
can
be.
A
One
of
the
things
that
we
did
when
we
broke
this
apart
was
to
take
a
look
at
dealing
this
with
dealing
with
this
and
separate
in
separate
pieces,
and
let's
only
focus
on
the
information
that
we
know
we
care
about-
let's,
let's
start
with
regulatory
stuff,
so
we'll
break
it
down,
we'll
just
store
the
information
we
need.
But
what
do
we
do
when
we
need
all
of
that
extra
information?
A
And
when,
when
David
was
up
here,
sifting
through
his
through
the
box
and
picked
out
his
item
of
value,
you
can
see
that
he
he
grabbed
one
of
these
pieces
of
paper
thinking
there
might
be
something
of
valuable
in
it.
A
value
in
it.
Well
David's
very
he's
a
very
smart
man,
because
there
can
be
something
of
value
in
there
even
looked
in
one
of
these
and
happened
to
see
that
there
wasn't
anything
of
value
in
it,
but
sometimes
that's
not
necessarily
the
case.
A
Sometimes
there
is
something
of
value
in
there
and
in
this
case
I
you
happen
to
grab
one
of
them
that
didn't
have
any
twenty
dollar
bills,
but
some
of
them
do
have
twenty
dollar
bills
and
the
reality
is
had
you
taken
all
of
the
balls
instead
of
the
iPad,
you
would
have
had
something
of
worth
far
more
than
what
you
took.
How
do
we
avoid
this
mistake?
Well,
it's
simple.
A
We
siphon
off
only
the
information
that
we
know
we
care
about
shove
it
in
the
end
of
Cassandra
and
the
simplest
possible
form
think
key
value
pairs.
Here
we
stack
it
all
up:
blood
pressure,
cholesterol,
whatever
it
is
that
we
need
to
be
dealing
with
and
then
know
what
nowhere
to
go
when
you
need
more
information,
so
you
take
this
XML
document,
throw
it
off
into
long-term
storage,
and
then
we
come
back
when
you
find
out.
You
need
more
information,
which
always
happens.
Some
new
regulation
comes
in
and
boom.
A
We
reprocess
it
and
repopulate
our
Cassandra
database
with
the
additional
information
and
reduce
it
to
a
more
meaningful,
a
set
of
values.
But
what
about
all
of
that?
Those
doctors
notes
that
get
put
into
the
health
record.
They
have
abbreviations,
they
have
emoticons,
they
have,
you
know
their
own
language
and
we
need
to
get
to
that
information.
Fortunately,
that's
where
solar
comes
in
and
when
we
found
out
the
datastax
was
actively
involved
in
building
this.
This
technology
stack
that
satisfied
all
of
these
needs.
I
was
stunned.