Adam Wilcox, PhD Adam Wilcox, PhD Columbia University
Intermountain Healthcare Columbia University Medical Center/ NewYork Presbyterian Hospital Evolving EHR Data Needs for Research, Business Intelligence and Quality Improvement
We will support our core aspiration to deliver "extraordinary care in all its dimensions" with our vision, which is to provide: The best clinical practice delivered in a consistent and integrated way. Lowest appropriate cost to the population we serve. A service experience, supported by systems and processes, that focuses on patients, enrollees, families, and one another. A genuine caring and concern in our interactions with patients, families, and one another. 5
Clinical i l Program Staff Medical director Operations director Data manager Outcomes analyst Data architect (EDW team) Reporting App Developer (EDW team)
Business/Clinical Leader Determines vision priorities nical Pro ogram Cli Data Outcomes Analyst/Statistician Analyst/Statistician Data Manager Data Architect Reporting App Developer Develops the analytical processes Performs advanced statistical analysis Serves as liaison between EDW I.T. and and business Clinical Program Leads requirements analysis effort Improves p data Data quality y Facilitates data Data capture of of the the operational systems Designs, develops, and maintains data infrastructure Provides software project management Assists with ETL Develops reports and reporting applications ED DW
Tactical App (Enrollment) HELP (EMR) EDW Financial Data 8
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Authoring Data mining SQL Power Analysts Interactive analysis Users Business Users Managers Emailed report Dashboard Scorecard Casual Users Executives
1994: Created, sponsored by Columbia University Department of Medical Informatics and Office of Clinical Trials Populated with data from existing clinical data repository Supporting clinical research 1998: Columbia + Cornell = NewYork Presbyterian Hospital Warehouse funded by NYPH Goal to incorporate and provide data across whole system 2004: Formal analysis of CDW user needs by Clinical Quality and Information Technology Committee (CQIT) Creation of Data Warehousing Subgroup Need to bring together disparate clinical data sources Need to manage user requests for data
Data in vendor-based transactional systems Could not query across transactional systems Users needed help in defining their needs Mature initiatives required more robust data solutions
AD HOC Complex Analytical Queries A A B B C CES INTEGRAT TION SERVI DM DM DM Reports OLAP RECURRING Clinical Care Reporting & Business Analysis & Research C REPLICATED Databases DM Online Analytical Processing (OLAP) Research SOURCE SOURCE DATAMARTS Systems Databases VIRTUAL CLINICAL DATA WAREHOUSE
Comprehensive understanding of the WH/I population Facilitate research with this population Demonstrate infrastructure capabilities i
Across care institutions Hospital, ambulatory care, home care, long-term care Longitudinal Outside the care setting Demographics and social information Vital statistics Patient assessments
Ad-Hoc Queries Questions Research Define A B C INTEGRAT TION SERVI ICES DM DM Recurring Management Automated Reports Queries OLAP Analytics Operational Reports Measure Analyze REPLICATED DM Dashboards Point of Care Reporting Improve Databases DATAMARTS Applications Decision Support Control VIRTUAL DATA WAREHOUSE DATA WAREHOUSE TOOLS
AHRQ grant R01 HS019853-01, Washington Heights/Inwood Informatics Infrastructure for Community-Centered Comparative Effectiveness Research (WICER)