ucsf informatics day 2014 - david dobbs, "enterprise data warehouse"

Enterprise Data Warehouse

Informatics Day Presentation

David DobbsInterim Executive DirectorNetworked Data Warehousing

June 10, 2013

Information Technology

Introduction

Interim Executive Director

Networked Data Warehousing

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• Expertise

• Leading large-scale data integration & analytic programs

• Understanding domain area needs

• Engineer practical, technology solutions using health technology standards

• Key Accomplishments

• Nationwide syndromic surveillance system with 500+ hospitals

• Developing community-based population health solutions

• Professional Qualifications

• Engineering background with a bachelor of arts in business administration in information systems.

• Certified Six Sigma and Project Management Professional

• Member HIMSS Clinical and Business Intelligence Committee

• Co-Chair of the HIMSS Data and Technology Task Force

Topic Flow

• Enterprise DW and Analytics Team

• UCSF’s EDW Strategy

• Epic Cogito DW

• Questions

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Enterprise DW and Analytics Team Objectives

• Create a team with a passion for understanding and managing enterprise data

• Partner with domain areas to understand their data and analytic needs

• Implement highly professional data management practices– Well managed data architecture– Comprehensive and high quality metadata management– Strong data security and controls

• Provide domain areas:– Easy and secure access to enterprise data– Expertise in developing analytic work products– Expertise on BI and analytic technologies

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Increase Analytics Maturity

OptimizeWhat is my best alternative?

Precision medicine

Forecast & Predict

What happens if trends continue?

Population management and value-based reimbursements

Decision Support

What should I do?Applying evidence-based guidelines at the POC

Statistical Analysis

Why is this happening?

Determining evidence-based guidelines

Metrics and Dashboards

Where is the problem?

Quality and safety KPIs and benchmarks

Reporting What happened? Standard retrospective reports

INC

RE

AS

ING

VA

LU

E

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Domains

Research

Patient Care Finance/Admin

Education HR/Payroll

• IDR / UCReX• RDB• Oncore / REDCap• Clinical data marts

• APeX, Clarity, Cogito EDW

• Axiom Dental• ACO data

• UCALL / OmniView• DART• Campus Fin DW

• Registration System• Course Evaluation• Grades Mgmt

• Peoplesoft HRMS• Peoplesoft Payroll• OLPPS

/ Integration

Data GovernanceMetadata

Management

Master Data Management

/ Management

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Epic Cogito DW

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Based on Epic Cogito DW PresentationDated 2014-05-27

Epic Cogito (ko-GEE-toe) DW

• An analytical database combining Epic and Non-Epic Data

– Pre-defined healthcare data model

– Seamless flow of Epic data from APeX Clarity database

– Extensible to include non-APeX data

• Common data model across Epic Customers

– Facilitates collaboration with other Epic customers (e.g., Other UCs, Children’s of Oakland, etc.)

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Uses for Cogito EDW

• Research

– Sophisticated cohort selection (RDB)

– Quality and clinical research

• Population Health

– Combining APeX clinical data with external clinical, claims and patient satisfaction data

• Performance Improvement

– Monitoring clinical and operational metrics for APeX and non-Apex data

• Streamlined reporting for APeX data

– Highly simplified version of Clarity

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Information Flow

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ChroniclesCache

ChroniclesCache

95,000+Data Elements

Reporting WorkbenchReal-time operational reporting

ClaritySQL Server

ClaritySQL Server

12,000+ Tables125,000+ Columns

Clarity ReportingEnterprise reporting

Cogito DWSQL ServerCogito DWSQL Server

19 Fact Tables76 Dimensions

Data Warehouse ReportingBI and Analytical Reporting

Data in Cogito EDW

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Admissions & Visits

Admissions & Visits

DemographicsDemographics

Providers & DepartmentsProviders & Departments

PatientRegistries

PatientRegistries

PatientSatisfaction

PatientSatisfaction

MedicationsMedications

Lab ResultsLab Results

DiagnosesDiagnoses

FlowsheetsFlowsheets

ProceduresProcedures

ImmunizationsImmunizations

AllergiesAllergies

Patients &Encounters

Clinical Financial

AccountsAccounts

TransactionsTransactions

CoveragesCoverages

DRGsDRGs

Paid ClaimsPaid Claims

Procedure & Encounter Cost

Procedure & Encounter Cost

Data in Cogito EDW

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Admissions & Visits

Admissions & Visits

DemographicsDemographics

Providers & DepartmentsProviders & Departments

PatientRegistries

PatientRegistries

PatientSatisfaction

PatientSatisfaction

MedicationsMedications

Lab ResultsLab Results

DiagnosesDiagnoses

FlowsheetsFlowsheets

ProceduresProcedures

ImmunizationsImmunizations

AllergiesAllergies

Patients &Encounters

Clinical Financial

AccountsAccounts

TransactionsTransactions

CoveragesCoverages

DRGsDRGs

Paid ClaimsPaid Claims

Procedure & Encounter Cost

Procedure & Encounter Cost

• Automated loading of APeX data

• Combine APeX and non-APeX data

Data in Cogito EDW

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Admissions & Visits

Admissions & Visits

DemographicsDemographics

Providers & DepartmentsProviders & Departments

PatientRegistries

PatientRegistries

PatientSatisfaction

PatientSatisfaction

MedicationsMedications

Lab ResultsLab Results

DiagnosesDiagnoses

FlowsheetsFlowsheets

ProceduresProcedures

ImmunizationsImmunizations

AllergiesAllergies

Patients &Encounters

Clinical Financial

AccountsAccounts

TransactionsTransactions

CoveragesCoverages

DRGsDRGs

Paid ClaimsPaid Claims

Procedure & Encounter Cost

Procedure & Encounter Cost

Prebuilt models for non-APeX data

Data Not Currently in Cogito*

• Ambulatory

– Provider metrics

– Order sets

• Anesthesia

• ED – Chief Complaint

• Inpatient

– Clinical Notes

– Medication Administration

• Operating room administration

• Obstetrics and Labor & Delivery

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* Representative list of key data items14

Cogito DW Dimensions*

Admission Profile Department Lab Component

Appointment Diagnosis Lab Result

Billing Area Diagnosis Hierarchy Medication

Billing Account Discharge Profile Patient Attributes

Billing Service DRG Patient

Billing Status Duration Procedure

Billing Procedure Employee Provider Attributes

Cost Center Encounter Provider

Coverage Encounter Profile Reaction Profile

Date Guarantor Visit Attributes

Time of Date Immunization Visit Profile

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*Partial, representative list15

Cogito DW Data Dictionary

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Cogito Timeline

• Version 8

– Additional Epic Data

• ED

• Surgery

• Coded Procedures

– Non-Epic Data

• CMS Medicate Shared Savings Plan Claims

• Press Ganey

– Additional Universes – Received Claims, Patient Satisfaction

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Summary

• Creating an Enterprise DW and Analytics Team

– Coordinate UCSF data architecture, metadata definitions and serve as a resource for available data sources

• Cogito Data Warehouse is being implemented

– Research Data Browser 1st use case

– Understandable set of data structures

– Extensible data model

– Facilitates sharing of data with other Epic sites

– Epic continues to refine and enhance

• More information

– Doug Berman - Academic Research Systems

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Questions?

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David.Dobbs@ucsfmedctr.org404-514-6921