The above is from a series of algorithms I developed . . . .

a GIS-like representation . . .  without the use of GIS!

STATUS:  DISSERTATION WRITING 

Full CV for download:   brianaltonen_cv_msmphphdabd_projlist.

Extracts from :

BRIAN L. ALTONEN, MS MPH

Beacon NY 12508
303-503-0845

altonenb@yahoo.com

http://www.researchgate.net/profile/Brian_Altonen/   [Academic biography]
http://www.linkedin.com/in/brianaltonen      
[Employment outside academia]



BUSINESS/POPULATION HEALTH ANALYST

2002 – Present.   Businesses/Research/Surveillance specialist and spatial epidemiology consultant.  Seasonal, repeated and/or institutional grant-defined contracts only.   Federal, State, regional, county, town, agencies/groups, education institutions, npos, etc. preferred. 
  SPATIAL ANALYST.

–Responsible for DB development and analytics applied to small and large area disease mapping programs (EPA, DEC, SHP, HIT).
–Developed comprehensive risk assessment & survey tools for profiling and predicting health behaviors and physical and social disease risks based on mixed datasets, multiple resources (EPA, SHP)
–Invented algorithm for hexagonally mapping state data, producing more accurate contours of areal health & economics (SHP, CHP).
–Developed a combined linear-cuboid 3D algorithm for flood plain risk analysis using DEM modeling and point-ras conversion techniques; redefines stream and floodplain as a flat surface, not slanted towards the ocean edge (SHP, CHP).
–Field epidemiologist responsible for surveillance and detection of local disease sources, ecological requirements (SHP, CHP, NEDS).
–Redesigned formulas to more accurately report on local ID, demographic and SES health concerns for small areas, including health/rx crimes, abuse, age-gender specific terrorist acts, psych non-compliance, in-migrating disease patterns (HS/ABU, CDC, NEDS).

August 2015 to Present.  Population Health Analyst, NYCHHC.

1.7M patients per year, 5 boroughs, 8 networks, 11 acute care hospitals, Bellevue emergency, 2 special care hospitals, 2 long term care facilities, prisons, schools.  20+ years of EMR/EHR.  Evaluated 10-12M patient rows for 20+ year period, 8.8-9.5 for 10 year period.  Estimate rate of growth (3k/mo); 40,000 analyses per year.

  • Evaluate the rarest of conditions, inherited diseases
  • Focus on specific culturally-bound ICDs, culturally-linked ICDs, culturally-linked behavioral ICDs.
  • Foreign infectious disease migration patterns within the city
  • Child/Spouse Abuse indicators (EHR ICD algorithm)
  • Culture-Race-Religion-Socioeconomic Status-health studies
  • Specialize in spatial analysis of most important E and V codes such as child abuse, sexual abuse, spouse/elder violence, suicide, sexual behaviors, childhood violence and related misbehaviors.
  • Birth defects, malformations, suspected intrafamilial communities.
  • Rare Genetic disease patterns, culture and neighborhoods
  • Terrorism and unique acts of violence in the city
  • Poverty and starvation, malnutrition disorders in the Big Apple
  • Injury, Fracture, Dislocation,  by Age and Gender

Projects (as of 2016):

  • WTC 911 Population analysis for Long Term epidemiology, Primary, Secondary and Advanced Secondary disease patterns
  • NYC Population analyzed for genomic disease patterns and new Precision Care Program
  • NYC Muslim population Public and Population Health analysis
  • Design of Simulated Training Modules for NYC H+H program, Jacobi Hospital office, Harlem Special Population project
  • Culturally-linked and cultural-bound ICDs analysis of NYC
  • Rare International/Foreign Born ICD analysis of NYC
  • Infectious Disease Patterns and Surveillance Tactics for NYC setting (A new Legionnaires disease review)
  • Zika population health monitoring, and previous mosquito related zoonotic disease patterns (West Nile, Chikungunya, St Louis Encephalitis, etc.)
  • Religion-defined Spouse abuse patterns in NYC
  • Child Abuse/Sexual Abuse V-codes analysis for NYC
  • Complex Chronic Disease Indices algorithms development, NYC
  • Developed traditional population pyramid based evaluation technique for analyzing age, gender, ethnicity, race, region differences
  • Redefining the single Race/Ethnicity column into two columns: Race, Ethnicity (ca. 65%-70% could be reclassed; with only one of 8 networks producing most of the unclassed, mostly for the race column.)
  • Developed a 135 ICD groups classification
  • Developed a 303 ICD groups classification
  • Developed algorithm for charting the Top 20 ICD groups by Race, Ethnicity Groups, merged into a single table, for each of 8 regions, with n and percentage columns for each and totals combined (1000 lines, 53 subprograms, in SAS).
  • Developed algorithm for merging regional data, reclassifying ethnicity and race, analyzing race/ethnicity changes, and differences between regions
  • Developed algorithms for evaluating health risk for patients with multiple comorbidities: Charlson Comorbidity Index (CCI), Federal Chronic Disease Score (CDS) and Elixhauser (Elix) Score; merged these with demography data risk assessment (age groups, gender) to define a new “Comprehensive Health Risk Index”. (This formula successfully reproduced the OptumHealth Risk Score “black box” results).
  • Developed algorithms for mapping the NYCHHC data at the small area level (zip code and small area grid).
  • Develops algorithm and tools for analyzing LTC and senior population living facility populations, for use in defining the least health patients in need of the most monitoring, and for predictive modeling purposes (producing regular lists of flagged patient records related to EMR defined increased mortality potential).
  • Developed algorithms for mapping culture and health, based upon 7 world regions (ICDs or medical events linked to those regions)
  • Developed algorithms for mapping genetic and development diseases at any area level, for 10 organ system groups.
  • developed ICD9 ###.** 15750 rows dataset, added CCI, CDS and Elix column, added foreign country columns indicating sources for rare to infrequent diseases.
  • developed ICD9 data set for genetic, birth, development, functional/morphological ICD codes, for use in genomic monitoring.
  • mapped a number of the most controversial, culturally sensitive or linked diseases, for a ten year period; identified peak areas (centroids) at the small area level.
  • mapped a number of the most controversial in-migrating disease patterns
  • mapped and evaluated antibiotic resistance strain histories for a several year period
  • mapped wife abuse histories, total, and by ethnicity, religion and race.

June 2013 – May 2015.   Business Analyst.

–Contracted EMR/EHR analyst for therapeutics and pharma HealthHelp, Inc., McKesson/US Oncology, Humana, Bayer, Celgene.
–Cost Prediction analyst, Survival analyst for highest risk Cardiac Surgery patients requiring transplants and defibs/pacemakers.
–Survival Analyst focused on prediction modeling and lifespan analyses of previously diagnosed cancer cases with secondary metastasis diagnosis.
–Logcost tree modeling of most expensive diagnoses and therapeutic regimens.
–Quasi-Experimental Cohort analysis of end of life/quality of life treatment programs for cancer patients.

June 2010 – November 2012. Business Analyst, Express Scripts, Inc., formerly Medco, Inc. 
POPULATION STATISTICIAN/DATA MINER & ANALYST

–Responsible for analyzing and reporting on 90+ million people with electronic records, for $10B/yr industry.
–Designed standardized SAS, SQL, and other macro queries for standard consumer behavior metrics.
–Invented new population statistical modeling techniques for populations of n>1M+ people, at 1 yr age-gender level.
–Performed federal, regional and gatekeeper required review of census records, income, SIC and local history.
–Performed client-driven adhoc queries in SQL and SAS on Terabyte stored data.

June 2007 – May 2009. Postgraduate Institute for Medicine, Jobson, Inc. Denver CO.
STATISTICIAN, Education Outcomes Manager

–Invented grounded theory text analysis technique and semi-automated tool quantifying survey generated open end text responses.
–Responsible for analyzing and reporting on teacher and student performance for continuing education programs.
–Analyzed satisfaction surveys for more than 250 programs, with 60 end-of-year summary surveys, 80,000 students/contacts per year, 3500 end-of-year participants with a 2-3% response rate.
–Developed, implemented and maintained automated/semi-automated reporting tools for all standard queries and reports.

July 2004 to May 2007 Denver Health Managed Care Denver CO
MEDICARE/MEDICAID PROGRAM ANALYST/COMPLIANCE SPECIALIST

–Biostatistician responsible for analyzing and reporting on the performance of approximately 60,000 members, and 400+ care givers for four Medicaid and Medicare health plan programs.
–Regularly reviewed more than 25 standard health measures, performed 7 special studies and 3 service industry studies per year, producing related databases and reports.
–Created a variety of statistical tools and SQLs used to calculate and graph descriptive data, and evaluate statistical significance in a timely fashion.
–Periodically produced summaries and reports for internal departments and committees, periodic reports for state and regional offices, and focus study reports targeting special interests in order to meet outside agency needs.
–Responsible for storage, upkeep and maintenance of databases and datasets developed for unique member/demographic studies.

EDUCATION

–PhD (diss. only), Business, Healthcare Administration, Northcentral University, Phoenix, AZ
–MPH, School of Community Health, 2003. Portland State University, Portland, OR
–MS, Geography Department, 2000. Portland State University, Portland, OR
–Post-Baccalaureate, Chemistry (12 years).
–MD, D/R (3 years), SUNY at Stony Brook, Stony Brook, NY
–BS, Biology, 1982. SUNY at Stony Brook, Stony Brook, NY
–BS, Earth and Space Sciences, SUNY at Stony Brook, Stony Brook, NY

RESEARCH/WRITING SKILLS

–Medical Geographer, Spatial Analyst and Population Specialist.
–IT-data quality analyst; SQL, SAS, Terabyte writer; Medicaid, Medicare, Institutional QAs for NCQA and HEDIS
–Quantitative Researcher: advanced skills in Excel, Access, SPSS, S-Plus, Stat-Plus, VB, SAS, vector and raster GIS.
–Qualitative Researcher: completed 15 month training program offered by School of Education, Portland State University
–Survey Analyst and tool developer; SurveyMonkey, SurveyWriter.
–Community/Focus Group leadership experience.
–Grantwriter (local agency letters, federal/national agency submissions)
–Institutional Review Board/Human Subjects Review compliance.


TECHNICAL SKILLS

–“Big Data” demographics analyst, with expertise in Teradata, Perot Systems, Caremark, National and Census datasets.
–SAS, SPSS v9, StatPlus, VB, Visio, SATSCAN, ClusterSeer
–Quattro Pro, Paradox, dBase 5-7. Oracle 7-8; Teradata certified.
–ATLAS/TI, NUDIST, ETHNOGRAPH
–ArcGIS, IDRISI. MapInfo, EpiMap. ESRI Avenue extension writer; MrSID, GeoTIFF, dlgv32, MultiSpecW32, ERDAS, GeoMedia, MapInfo.
–Crystal Reports, Adobe Illustrator, Photoshop, Acrobat Writer, Corel Draw
–Dreamweaver, Frontpage Web Design
–Publisher, Power Point, Access, Excel, Word, Office; WordPerfect
–Trained in TierMed.com; ManagedCare.com; Perot Systems

.
ADJUNCT PROFESSORSHIPS/INSTRUCTORSHIPS 


–2005–2006 Arapahoe Community College Denver, CO. Introductory, Intermediate GIS.
–1988–2003 Chemistry Department, PSU Portland, OR. OTC/Nutritional Supplements analysis; Pre-Med, Pre-Allied Health, Pre-Pharm student advisor/mentor. Handicapped Student Services mentor/tutor; ADA Rights and epilepsy.
–1997–2001 Geography Department, PSU Portland, OR. Population health monitoring, disease ecology, epidemiologic surveillance, remote sensing, spatial analysis.
–1982–1985 SUNY at Stony Brook Stony Brook, NY.  MOLINS.

CORPORATE PROJECTS

Managed Care. Developed and analyzed population datasets; regularly produced in-depth reports (var. 50-300 pp each) for:

–State-required Performance Improvement Projects (PIPs) (3)
–National Committee for Quality Assurance (NCQA)-required Quality Improvement Activity (QIA) reports (4-6)
–Annual Reports on Quality Assurance for Medicaid, Medicare and Employee health programs reviewed by administrative teams (2-3)
–Annual Review of the Denver Health Managed Care Program for approval by internal administrative committees, annual corporate report, and public presentations (2-3)
–Annual Health Care Access/Availability Reports for the three programs
–Monthly-Quarterly utilization statistics for all services and members
–Quarterly Demographic Reviews, with 1- and 5-year population pyramids and graphs depicting populations served

Regularly produce numerous databases and reports for:
–Customer satisfaction and complaints lines
–Monitoring population office activities and products utilization for various State and Regional offices.
–Performing ad hoc Focus Studies on special needs populations for Medicaid and Medicare programs
–Evaluating successes, benchmarks and statewide goals pertaining to special medical community projects.
–Monitoring and evaluating Management team customer/member contact and follow-up activities
–Regularly reported to national npos regarding program successes and goals.

STATISTICAL ACCOMPLISHMENTS

National Population Grid Map.

‘The next generation of consumer reporting.’

Invented methodology for evaluating any and all population-based metrics in the U.S., using a grid map with variable cell size and area. Developed a 3D algorithm for mapping results on the US, with the continent portrayed at various angles and/or as a rotating image; applied to more than 1000 metric-specific studies. Processing speed is fast due to use of non-GIS software for map production, producing up to 30,000 maps per day, merged to form 50-100 videos per day. Applicable to all metrics pulled from a standard hierarchical database system, including median income data, age-gender-ethnicity, log-cost analyses, standard family income-product purchasing power relationships, prediction modeling, as well as the generation of standard sums, averages and frequency analyses, compliance/non-compliance metrics, and individual/group activities scoring.

Hexagonal Grid Analysis. Invented and published unique ArcInfo/ArcView/ArcGIS algorithms and SQLs used to produce hexagonal grid overlays for maps. These are applied to standard high level GIS methods for implementing new areal and temporal population health analytic programs.

Population Pyramid Comparison Algorithm. Invented formulas for incremental 1-year age-gender testing technique for comparing two populations with possible statistically significant differences at the 1-year age level using a new algorithm.

SPECIAL STUDIES


Smoking behavior and QUITLINE use. Reviewed Denver Health Managed Care Medicaid and Employee 2001 to 2004 QUITLINE activities.

OIHM. Studied an adult summer camp generating $3.5M annually from 22,000 participants; interviews, surveys, analysis of demographics, income ranges, profits per program in relation to course type and lecturer; interviewed local community. Summer 2001. (INTERNSHIP. 140 pages, 7 chapters).

Diagnosis, Treatment, and Prevention of Prostate Cancer. A Combined Short-term Watchful Waiting Program, and Long Term Nutrition Based Prevention Program. [MPH FINAL PROJECT]

Pregnancy Counseling and Testing activities by the Student Population. Six-year summary of monthly and quarterly utilization reports for counseling center and clinics, SUNY Stony Brook, EROS group.

PRESENTATIONS

Are Older People (>65) using herbal supplements at High Risk for Complications? Consumer marketplace survey and analysis of National OTC Nutritional Stores and Chains. OASIS, Portland, OR, 2001.

Use of GIS in Predicting West Nile Disease Patterns. Study of High. Middle and Low-income community Settings with likelihood for disease penetration. Presented at Colorado State University, School of Bioagricultural Sciences, Fort Collins, CO. April 27, 2004.

Asiatic Cholera and Dysentery along the Oregon Trail. 2000. [MS THESIS]. The geography of diarrhea, dysentery and cholera, 1849-1856, from Platte River, Nebraska to the Columbia River. An historical epidemiology study.

Defining Exposure Risk in the State of Oregon. Developed innovative algorithm and program used to produce grid maps depicting high risk areas for chemical exposure, based on income, census and case data, with contour maps produced depicting exposure risk in relation to median income status, ethnicity, age and gender at the block and block group level.

West Nile Host-Vector Ecology, Dutchess County, NY. Use of demographic and field data in relation to aerial photography, kernel density mapping, and modified grid and cluster techniques for identifying and predicting risk areas. October 2006 ESRI Health GIS Conference “GIS Solutions Today for a Healthier Tomorrow”, Denver, CO.

AWARDS & ACCOMPLISHMENTS

My SBasic DBASE program TOXIDROM is probably one of the first personal PC databases produced that is still out there and in use on the internet.  Developed in Fall of 1982 on a Sanyo MBC, it has been continuously used for 33 years, the last 23 years as a diagnostic/clinical recommendation tool.  (The word “toxidrome” is the signature for it and for finding it on the web; see also http://ouribis.com/)

First individual to ever obtained a perfect score for my federal report required for a required QA program.

Received communications award for 2000-2003/4 GIS work at 2006 ESRI Healthy GIS Conference.

http://brianaltonemph.com, approximately 1000pp receives more than 6000 hits/3000 individuals per month, mostly by students, teachers and Medical GIS professionals.

.

This algorithm takes 20 to 30 minutes to run on the national data.  Semi-automated/semi-manually, this process produces 20 videos per day, 15sec to 4 mins/video (avg 45-60sec),  at 400-2000 images per video, averaging 20,000 images per day, with a 1:3 ratio of run:production/view time.   Automating the last process triples productivity, to 60 videos/day, 60,000 images/day.  I demonstrated to several potential vendors that when fully automated (running in the background in a good Teradata system), it is capable of doubling to quadrupling productivity, more if you apply it into the evening.  Production rates calculated per person over the past several years have been:  100,000 images per week (100 videos), more than 5 million images (5000 1minute videos) per year, for the semi-automated processing technique. Reporting for each single metric, without the video, requires one tenth the time or less!  A daily surveillance report of hundreds of potential in-migrating foreign born diseases can be accomplished using this technique, within a standard public IT work setting. 

More importantly  . . .

Any company with the right basic software package can do this ! !

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