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

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.

[1]  Charles Safran,et al.  Toward a national framework for the secondary use of health data: an American Medical Informatics Association White Paper. , 2007, Journal of the American Medical Informatics Association : JAMIA.

[2]  Bernd Blobel,et al.  Does HL7 Go towards an Architecture Standard? , 2005, MIE.

[3]  Patrick L. Taylor.  Personal Genomes: When consent gets in the way , 2008, Nature.

[4]  Anaïs Schaeffer.  There's gold in them thar' hills! , 2011 .

[5]  Rinaldo Bellomo,et al.  Development and implementation of a high-quality clinical database: the Australian and New Zealand Intensive Care Society Adult Patient Database. , 2006, Journal of critical care.

[6]  Farzad Mostashari,et al.  Using electronic health record alerts to provide public health situational awareness to clinicians , 2010, J. Am. Medical Informatics Assoc..

[7]  Xiaoyan Wang,et al.  Active computerized pharmacovigilance using natural language processing, statistics, and electronic health records: a feasibility study. , 2009, Journal of the American Medical Informatics Association : JAMIA.

[8]  Charles N. Mead,et al.  The HL7 Reference Information Model Under Scrutiny , 2006, MIE.

[9]  Baoyan Liu,et al.  Development of traditional Chinese medicine clinical data warehouse for medical knowledge discovery and decision support , 2010, Artif. Intell. Medicine.

[10]  Nilmini Wickramasinghe,et al.  Creating knowledge-driven healthcare processes with the Intelligence Continuum , 2006, Int. J. Electron. Heal..

[11]  Tony R. Sahama,et al.  A Data Warehouse Architecture for Clinical Data Warehousing , 2007, ACSW.

[12]  P. Donzelli,et al.  On federating Health Information Systems , 2012, 2012 International Conference on Green and Ubiquitous Technology.

[13]  W. H. Inmon,et al.  Building the Operational Data Store , 1995 .

[14]  G Gillespie,et al.  There's gold in them thar' databases. , 2000, Health data management.

[15]  M. Maggini.  IGEA--a chronic disease management project for people with diabetes. , 2009, Annali dell'Istituto superiore di sanita.

[16]  S. Brunak,et al.  Mining electronic health records: towards better research applications and clinical care , 2012, Nature Reviews Genetics.

[17]  H. Koh,et al.  Data mining applications in healthcare. , 2005, Journal of healthcare information management : JHIM.

[18]  Mary Roth,et al.  Don't Scrap It, Wrap It! A Wrapper Architecture for Legacy Data Sources , 1997, VLDB.

[19]  Tobias Mettler,et al.  Supplier Relationship Management: A Case Study in the Context of Health Care , 2009, J. Theor. Appl. Electron. Commer. Res..

[20]  Marleen de Mul,et al.  Development of a clinical data warehouse from an intensive care clinical information system , 2012, Comput. Methods Programs Biomed..

[21]  R. Kush,et al.  Electronic health records, medical research, and the Tower of Babel. , 2008, The New England journal of medicine.

[22]  Christel Daniel-Le Bozec,et al.  EHR4CR: A Semantic Web Based Interoperability Approach for Reusing Electronic Healthcare Records in Protocol Feasibility Studies , 2012, SWAT4LS.

[23]  Søren Brunak,et al.  Using Electronic Patient Records to Discover Disease Correlations and Stratify Patient Cohorts , 2011, PLoS Comput. Biol..

[24]  G. Hartvigsen,et al.  Secondary Use of EHR: Data Quality Issues and Informatics Opportunities , 2010, Summit on translational bioinformatics.

[25]  Hagop S. Mekhjian,et al.  Using an Information Warehouse to screen patients for Clinical trials: A prototype , 2005, AMIA.