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