A Clinical Data Warehouse Architecture based on the Electronic Healthcare Record Infrastructure

Fabrizio Pecoraro, Daniela Luzi, Fabrizio L. Ricci

Abstract

The development of clinical data warehouses is becoming increasingly important in the healthcare domain to support organizations in the improvement of decision-making, business processes as well as the communication between clinicians, patients and the administration. However, data and process integration is a big challenge considering the heterogeneous and distributed nature of healthcare information systems. This paper proposes a data warehouse architecture based on the Italian Electronic Health Record (EHR) technological infrastructure. It describes the main advantages in the application of EHR systems for secondary purposes and reports the data warehouse design framework outlining its architecture as well as a dimensional model based on a dashboard defined to manage the intervention of patients with diabetes. The adoption of EHR systems enhances interoperability given that these systems share standardized clinical data among multiple parties involved in different healthcare settings.

References

  1. Botsis T., Hartvigsen G., Chen F., Weng C., 2010. Secondary use of EHR: data quality issues and informatics opportunities. In AMIA Summits Translational Science Proceedings pp. 1-5.
  2. Ciampi M., De Pietro G., Esposito C., Sicuranza M., Donzelli P., 2012. On Federating Health Information Systems. In International Conference on Green and Ubiquitous Technology (GUT), pp. 139-143.
  3. Committee on Data Standards for Patient Safety, 2003. Key Capabilities of an Electronic Health Record System. Institute of Medicine Report 5.
  4. Contenti M., Mercurio G., Ricci F.L., Serbanati L.D., 2008. LuMiR: A Region-wide Virtual Healthcare Record. In Proceeding of the 9th International HL7 Interoperability Conference. Crete, Greece. pp. 80-3.
  5. De Mul, M., Alons, P., Van der Velde, P., Konings, I., Bakker, J., Hazelzet, J., 2012. Development of a clinical data warehouse from an intensive care clinical information system. Computer methods and programs in biomedicine 105 (1) pp. 22-30.
  6. Diomidous M., Zimeras S., Mantas J., 2009. Spatial Electronic Health Record for the epidemiological clinical data. Travel Health Informatics and Telehealth 1, pp. 66-72.
  7. Dolin R. H., Alschuler L., Boyer S., Beebe C., Behlen F. M., Biron P. V., Shvo A. S., 2006. HL7 clinical document architecture, release 2. Journal of the American Medical Informatics Association 13 (1) pp. 30-9.
  8. EN 13940-1:2007 Health informatics - System of concepts to support continuity of care - Part 1: Basic concepts. CEN 2007. British Standards Institution.
  9. Gillespie G., 2000. There's gold in them thar' databases. Health Data Management 8 (11) pp. 40-52.
  10. Hussain S., Ouagne D., Sadou E., Dart T., Jaulent M. C., De Vloed B., Daniel C., 2012. EHR4CR: A semantic web based interoperability approach for reusing electronic healthcare records in protocol feasibility studies. In Proceedings of the 5th International Workshop on Semantic Web Applications and Tools for Life Sciences. Paris, France.
  11. Inmon W., 1999. Building the Operational Data Store. John Wiley & Sons. New York. 2nd edition.
  12. Jensen P. B., Jensen L. J., Brunak S., 2012. Mining electronic health records: towards better research applications and clinical care. Nature Reviews Genetics 13 (6) pp. 395-405.
  13. Kamal J., Pasuparthi K., Rogers P., Buskirk J., Mekhjian H., 2005. Using an information warehouse to screen patients for clinical trials: a prototype. In Proceeding of American Medical Informatics Association Symposium. Washington DC, USA. pp. 1004.
  14. Koh H. C., Tan G., 2011. Data mining applications in healthcare. Journal of Healthcare Information Management 19 (2) p. 65.
  15. Kush R. D., Helton E., Rockhold F. W., Hardison C. D., 2008. Electronic health records, medical research, and the Tower of Babel. New England Journal of Medicine 358 pp. 1738-40.
  16. Lurio J., Morrison F. P., Pichardo M., Berg R., Buck M. D., Wu W., Calman N., 2010. Using electronic health record alerts to provide public health situational awareness to clinicians. Journal of the American Medical Informatics Association 17 (2) pp. 217-9.
  17. Maggini M., 2009. IGEA-A chronic disease management project for people with diabetes. Annali Istituto Superiore di sanità 45 pp. 349-352.
  18. Mettler T., Rohner P., 2009. Supplier Relationship Management: A Case Study in the Context of Health Care. Journal of Theoretical and Applied Electronic Commerce Research 4 pp. 58-71.
  19. Oemig F., and Blobel B., 2005. Does HL7 Go towards an architecture standard? Studies in Health Technology and Informatics 116 pp. 761-6.
  20. Roque F. S., Jensen P. B., Schmock H., Dalgaard M., Andreatta M., Hansen T., Søeby K., Bredkjaer S., Juul A., Werge T., Jensen L. J., Brunak S., 2011. Using Electronic Patient Records to Discover Disease Correlations and Stratify Patient Cohorts. PLoS Computational Biology 7 (8), pp. 1-10.
  21. Roth M. T., Schwarz P., 1997. Don't scrap it, wrap it! a wrapper architecture for legacy data sources. In Proceeding of the Conference on Very Large Data Bases (VLDB). Athens, Greece. pp. 266-275.
  22. Safran C., Bloomrosen M., Hammond W. E., Labkoff S., Markel-Fox S., Tang P. C., Detmer D. E., 2007. Toward a national framework for the secondary use of health data: an American Medical Informatics Association white paper. Journal of the American Medical Informatics Association 14 (1) pp. 1-9.
  23. Sahama T. R., Croll P. R., 2007. A data warehouse architecture for clinical data warehousing. In Proceedings of the fifth Australasian symposium on ACSW frontiers 68. Ballarat, Victoria, Australia. pp. 227-32.
  24. Schadow G., Mead C. N., Walker D. M., 2006. The HL7 reference information model under scrutiny. Studies Health Technology Informatics 124 pp. 151-6.
  25. Stow P. J., Hart G. K., Higlett T., George C., Herkes R., McWilliam D., Bellomo R., 2006. Development and implementation of a high-quality clinical database: the Australian and New Zealand Intensive Care Society Adult Patient Database. Journal of Critical Care 21 (2) pp. 133-41.
  26. Taylor P., 2008. When consent gets in the way. Nature 456 pp. 32-3.
  27. Wang X., Hripcsak G., Markatou M., Friedman C., 2009. Active Computerized Pharmacovigilance using Natural Language Processing, Statistics, and Electronic Health Records: a Feasibility Study. Journal of the American Medical Informatics Association 16 (3) pp. 328-37.
  28. Wickramasinghe N., Schaffer J.L., 2006. Creating knowledge-driven healthcare processes with the intelligence continuum. International Journal of Electronic Healthcare 2 (2) pp. 164-74.
  29. Zhou X., Chen S., Liu B., Zhang R., Wang Y., Li P., Guo Y., Zhang H., Gao Z., Yan X., 2010. Development of traditional Chinese medicine clinical data warehouse for medical knowledge discovery and decision support. Artificial Intelligence in Medicine 48 (2) pp. 139-52.
Download


Paper Citation


in Harvard Style

Pecoraro F., Luzi D. and L. Ricci F. (2014). A Clinical Data Warehouse Architecture based on the Electronic Healthcare Record Infrastructure . In Proceedings of the International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2014) ISBN 978-989-758-010-9, pages 287-294. DOI: 10.5220/0004764502870294


in Bibtex Style

@conference{healthinf14,
author={Fabrizio Pecoraro and Daniela Luzi and Fabrizio L. Ricci},
title={A Clinical Data Warehouse Architecture based on the Electronic Healthcare Record Infrastructure},
booktitle={Proceedings of the International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2014)},
year={2014},
pages={287-294},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0004764502870294},
isbn={978-989-758-010-9},
}


in EndNote Style

TY - CONF
JO - Proceedings of the International Conference on Health Informatics - Volume 1: HEALTHINF, (BIOSTEC 2014)
TI - A Clinical Data Warehouse Architecture based on the Electronic Healthcare Record Infrastructure
SN - 978-989-758-010-9
AU - Pecoraro F.
AU - Luzi D.
AU - L. Ricci F.
PY - 2014
SP - 287
EP - 294
DO - 10.5220/0004764502870294