EFFECTIVENESS OF A BUSINESS INTELLIGENCE SOLUTION

TO MANAGE THE ANTIRETROVIRAL THERAPY

PROGRAMME

Eduan Kotzé and Theo McDonald

Department of Computer Science and Informatics, University of the Free State, Bloemfontein, South Africa

Keywords: HIV/AIDS, Antiretroviral therapy, Data warehousing, Business intelligence, OLAP.

Abstract: The Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) has caused

the death of millions of people worldwide. To combat the effect of HIV/AIDS, the South African

government started with the provisioning of Antiretroviral Therapy (ART) in the public health sector.

Monitoring and evaluating the effectiveness of this ART programme is of the utmost importance. A

business intelligence approach was followed that first of all integrated several independent operational

sources into one data warehouse and then delivered strategic management information with easy to use

business intelligence tools that was developed and deployed for the users. The business intelligence solution

was then evaluated by the users of the system and the results indicated that the users deemed the solution to

be an effective way to obtain strategic information on the rollout of the ARV treatment programme.

1 INTRODUCTION

In response to the HIV/AIDS epidemic the South

African Government created the HIV/AIDS and

Sexually Transmitted Disease (STD) Strategic Plan.

In November 2003, after considerable sustained

pressure from advocacy groups, the government

adopted the Operational Plan for Comprehensive

HIV and AIDS Treatment and Care, which included

the provisioning of Antiretroviral Therapy (ART) in

the public health sector (National Department of

Health, 2003).

Monitoring and evaluating the effectiveness of

this ART programme is of the utmost importance. In

this endeavour strategic information plays a major

role. The Free State Department of Health (FSDOH)

decided that strategic information must be provided

through a business intelligence solution. How this

business intelligence solution was developed and

evaluated to determine its effectiveness forms the

basis of this paper.

2 RESEARCH METHODOLOGY

The research methodology used by this study was

action research. Butler, et al. (2006) noted that in

action research projects, researchers collaborate with

practitioners to solve practical problems while

expanding scientific knowledge. Baskerville (1999)

characterizes information system action research as

an increased understanding of an immediate social

situation, with emphasis on the complex and

multivariate nature of this social setting in the

information systems (IS) domain. It simultaneously

assists in practical problem solving and expands

scientific knowledge.

The action research description (Susman &

Evered, 1978) details a five phases, cyclical process.

The approach first requires the establishment of a

client-system infrastructure or research environment.

Then, five identifiable phases are iterated: 1)

diagnosing, (2) action planning, (3) action taking,

(4) evaluating and (5) specifying learning.

Baskerville (1999) provides an explanation of these

components. The client-system infrastructure is the

specification and agreement that constitutes the

research environment and provides the conditions

under which action and change may be specified.

The client will be the FSDOH and the researcher

will be the author of this paper. The research

environment will be the Free State Province and will

include staff working for the FSDOH at different

levels of management.

543

Kotzé E. and McDonald T..

EFFECTIVENESS OF A BUSINESS INTELLIGENCE SOLUTION TO MANAGE THE ANTIRETROVIRAL THERAPY PROGRAMME.

DOI: 10.5220/0003150905430546

In Proceedings of the International Conference on Health Informatics (HEALTHINF-2011), pages 543-546

ISBN: 978-989-8425-34-8

 2011 SCITEPRESS (Science and Technology Publications, Lda.)

3 BACKGROUND

Strategic information is an essential requirement in

the fight against HIV/AIDS. The lack of strategic

information is, however, apparent if a closer look is

taken at the Free State antiretroviral (ARV) patient

information system. The patient information system

was a traditional online clinical system, dealing with

operational issues of accumulating data on a patient.

Very little functionality was provided to deal with

the complexities of managing the clinical outcomes

of the ART programme. To add to the problem,

other independent online transaction processing

(OLTP) systems, all closely related to HIV/AIDS,

had to be interrogated to gain an understanding of

the impact the rollout of ARV drugs had. Examples

of these systems were standalone human resource

systems, information systems accumulating data on

tuberculosis, patient admissions, notifiable diseases

and blood tests.

As a first step to obtain strategic information on

the rollout of the ARV treatment programme, the

Hospital Information System and all the other

disparate information systems were integrated in one

data warehouse. This had the advantage that all the

disparate systems could be interrogated using the

same tool. Next a BI analytical tool was used to

provide strategic information for the FSDOH ART

management team. The research question, therefore,

was to determine if this BI solution was effective.

4 BUSINESS INTELLIGENCE (BI)

APPROACH

The current study is the first, as far as can be

determined, that attempted a data warehouse that

integrated several standalone systems which are all

closely related to ART.

The main focus was Antiretroviral Treatment and

therefore the data warehouse had to contain an

antiretroviral clinical data mart. Data marts for other

systems closely related to ART (i.e. Blood Tests,

TB, Notifiable Diseases and Hospitalization) also

had to be included in the data warehouse. To

complicate matters, the FSDOH had a separate

challenge in optimizing key internal business

processes such as human resource management and

revenue collection. Data marts for these processes

were also required and had to be developed.

Strategic information was required by the respective

managers to improve the business performance for

each of these business processes. Figure 1 illustrates

diagrammatically the data warehouse, resulting from

several interdependent data marts (Gray and Watson,

1998:104-105).

Figure 1: Data warehouse framework.

The idea behind business intelligence (BI) is to

turn data into information and then into knowledge

(Golfarelli, Rizzi and Cella, 2004). Analytical tools

do this by accessing and analyzing information

contained in the data warehouse. These tools include

reporting, querying, on-line analysis and

exploration, visualization, decision modeling and

planning, and data mining tools.

The FSDOH BI solution can be divided into two

parts: ad-hoc query and OLAP cube analysis. Ad-

hoc query functionality was made available using

Cognos Query Studio and Cognos Report Studio.

OLAP functionality was made available using the

Web-based front-end interface of Cognos PowerPlay

Enterprise Server.

By deploying Cognos BI functionality, security

and privacy was also addressed by using Cognos

Framework Manager. Cognos Framework Manager

captures the BI metadata (including the dimensional

model and database model) as well as which user is

allowed to access which portion of the BI metadata.

Cognos role-based authentication was used for any

user logging into Cognos Portal. The cubes and drill-

down reports were only made available to users that

successfully logged into Cognos Portal and the

user’s credentials were matched in the background

by Cognos Access Manager to determine what the

user was allowed to browse and drilldown into.

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544

5 BI EVALUATION

Wixom and Watson (2001) investigated several

implementation success factors affecting data

warehouse success. Shin (2003) expanded on the

work done by Wixom and Watson (2001) and

examined the success factors in data warehousing by

using system quality, information quality, service

quality and user satisfaction as variables.

A questionnaire was used as the instrument to

evaluate the BI implementation. Some of the

questions of Shin (2003) were re-used in the

questionnaire and new ones were added that were

applicable to the FSDOH data warehouse evaluation.

The questionnaire utilized a 5 point Likert scale

and consisted of three sections. Section 1 covered all

the basic demographics of the respondents. Section 2

looked at how the respondents used the existing data

warehouse while section 3 covered the perceptions

of respondents on the information from the data

warehouse.

Data was collected from data warehouse users in

the FSDOH which included ART, human resources,

revenue collection and hospital managers. All users

received a questionnaire if they were either using the

data warehouse themselves or request information

from the knowledge workers who extract

information for them from the data warehouse on a

regular basis. The selected group was well

represented over the five layers of employment at

the FSDOH namely: production workers,

supervisors, assistant managers, middle managers

and top managers.

A total of 87 questionnaires were sent to this

selected group of whom 51 responded. This

translated into a response rate of 58.6%. Three (3) of

the 51 respondents’ questionnaires were incomplete

and discarded from the study. The final number of

completed questionnaires to be used for analysis was

48.

6 RESULTS

Most users (56.2%) accessed the system either

monthly or quarterly. Six users used the system on a

daily basis. Eight main organizational tasks were

included in the survey. The first four (decision-

making support, status monitoring, planning, and

forecasting) were considered more unstructured than

the others (administration, accounting, resource

allocation/budgeting and personnel management).

Personnel management (62.5%) stood out as the

most frequent task while forecasting (45.9%) was

the least performed task.

Direct and indirect usage was also investigated.

Most users (67.2%) indicated that they make use of

either an assistant or knowledge workers at head

office to obtain the information from the data

warehouse for them. It is worth mentioning that the

knowledge workers at head office were provided

with certified training that was offered by Cognos

South Africa. These courses empowered them to

assist users with analysis requests.

The remaining users (32.8%) retrieve the data by

themselves and perform their own analysis. Most of

these users attended an in-house business

intelligence course, which introduced them to basics

of Cognos reporting and Cognos cube analysis.

For the unstructured tasks, most of the survey

respondents would use the data warehouse

sometimes or never while for the structured tasks the

usage would be from very frequently to sometimes.

According to the study done by Shin (2003), more

users were using the data warehouse for unstructured

duties rather than for routine or administrative

responsibilities. For this study the weight tends to be

for structured tasks instead of unstructured tasks.

This was an unexpected finding. A possible

explanation for this finding could be that the BI

maturity of the survey respondents was much lower

than the respondents used in the study by Shin

(2003). This possibility is supported with the finding

that 67.2% of respondents indicated they make use

of either an assistant or knowledge worker to obtain

information from the data warehouse instead of by

them self.

Respondents were on the whole very positive

about data quality, levels of detail and accuracy.

Most respondents (89.6%) agreed that the data in the

data warehouse is current enough to meet work

needs. That was matched by 75% who disagreed that

the data warehouse was out of date for a similar

question that was negatively phrased.

A total of 79.2% of the respondents indicated

that the data warehouse maintains data at an

appropriate level of detail to perform their tasks.

This was matched by 68.1% who disagreed that the

data warehouse does not have enough detail to make

them more productive.

Most respondents (70.3%) indicated that the data

in the data warehouse is accurate and reliable and

this was matched by (81.9%) who were either unsure

or disagreed that the data is inconsistent.

Next the data warehouse was evaluated in terms

of functionality, flexibility, processing speed and

ease of use. Respondents were on the whole very

EFFECTIVENESS OF A BUSINESS INTELLIGENCE SOLUTION TO MANAGE THE ANTIRETROVIRAL

THERAPY PROGRAMME

545

positive about these aspects. A large number

(78.9%) of respondents indicated that they were

satisfied with the overall functionality of the data

warehouse. This was matched by 80.4% of

respondents who indicated that they were either

unsure or did not agree that the data warehouse had

no functional value to them.

Again a large number (68.8%) of respondents

indicated they were satisfied with the overall

flexibility of the data warehouse and that was

matched by 68.7% who disagreed that they cannot

perform their own analysis. A total of 68.7% of the

respondents indicated that the data warehouse

processing speed is good, but the negative question

had a relative high number (41.7%) who indicated

they were unsure. This could be due to the fact that

network speed and bandwidth restrictions placed an

uncertainty in the users’ minds. A large number

(79.2%) of respondents indicated that the data

warehouse is convenient and easy to use, but

interestingly 78.7% also indicated that more training

is needed to find, understand and use the data

warehouse.

Finally, 93.8% of the respondents indicated that

overall the data warehouse is a valuable asset for the

FSDOH and it is recognized as being a critically

important tool to improve the productivity of

knowledge workers by providing strategic

information.

7 CONCLUSIONS

Strategic information is an essential requirement in

the fight against HIV/AIDS. In the Free State a

business intelligence approach was followed in order

to provide strategic information for the management

of the ART programme in the province. This was

achieved by integrating several disparate systems

into one appropriately designed data warehouse,

specifically focused on ART.

By using OLAP technology it was possible for

the FSDOH ART management team to extract

strategic information by means of easy to use

analytical tools. Finally, the business intelligence

solution was evaluated by the users of the system.

The results indicated that the users were on the

whole very positive about the data quality,

responsiveness, functionality, flexibility and ease of

use. Overall the system was deemed a huge success.

Taking all the results into consideration, it can

therefore be concluded that BI solution was

effective.

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