Impact of a data warehouse model for improved decision-making process in healthcare

The health system is one sector dealing with a deluge of complex data. Many healthcare organisations struggle to utilise these volumes of health data effectively and efficiently. Also, there are many healthcare organisations, which still have stand-alone systems, not integrated for management of information and decision-making. This shows, there is a need for an effective system to capture, collate and distribute this health data. Therefore, implementing the data warehouse concept in healthcare is potentially one of the solutions to integrate health data. Data warehousing has been used to support business intelligence and decision-making in many other sectors such as the engineering, defence and retail sectors. The research problem that is going to be addressed is, "how can data warehousing assist the decision-making process in healthcare". To address this problem the researcher has narrowed an investigation focusing on a cardiac surgery unit. This research used the cardiac surgery unit at the Prince Charles Hospital (TPCH) as the case study. The cardiac surgery unit at TPCH uses a stand-alone database of patient clinical data, which supports clinical audit, service management and research functions. However, much of the time, the interaction between the cardiac surgery unit information system with other units is minimal. There is a limited and basic two-way interaction with other clinical and administrative databases at TPCH which support decision-making processes. The aims of this research are to investigate what decision-making issues are faced by the healthcare professionals with the current information systems and how decision-making might be improved within this healthcare setting by implementing an aligned data warehouse model or models. As a part of the research the researcher will propose and develop a suitable data warehouse prototype based on the cardiac surgery unit needs and integrating the Intensive Care Unit database, Clinical Costing unit database (Transition II) and Quality and Safety unit database [electronic discharge summary (e-DS)]. The goal is to improve the current decision-making processes. The main objectives of this research are to improve access to integrated clinical and financial data, providing potentially better information for decision-making for both improved from the questionnaire and by referring to the literature, the results indicate a centralised data warehouse model for the cardiac surgery unit at this stage. A centralised data warehouse model addresses current needs and can also be upgraded to an enterprise wide warehouse model or federated data warehouse model as discussed in the many consulted publications. The data warehouse prototype was able to be developed using SAS enterprise data integration studio 4.2 and the data was analysed using SAS enterprise edition 4.3. In the final stage, the data warehouse prototype was evaluated by collecting feedback from the end users. This was achieved by using output created from the data warehouse prototype as examples of the data desired and possible in a data warehouse environment. According to the feedback collected from the end users, implementation of a data warehouse was seen to be a useful tool to inform management options, provide a more complete representation of factors related to a decision scenario and potentially reduce information product development time. However, there are many constraints exist in this research. For example the technical issues such as data incompatibilities, integration of the cardiac surgery database and e-DS database servers and also, Queensland Health information restrictions (Queensland Health information related policies, patient data confidentiality and ethics requirements), limited availability of support from IT technical staff and time restrictions. These factors have influenced the process for the warehouse model development, necessitating an incremental approach. This highlights the presence of many practical barriers to data warehousing and integration at the clinical service level. Limitations included the use of a small convenience sample of survey respondents, and a single site case report study design. As mentioned previously, the proposed data warehouse is a prototype and was developed using only four database repositories. Despite this constraint, the research demonstrates that by implementing a data warehouse at the service level, decision-making is supported and data quality issues related to access and availability can be reduced, providing many benefits. Output reports produced from the data warehouse prototype demonstrated usefulness for the improvement of decision-making in the management of clinical services, and quality and safety monitoring for better clinical care. However, in the future, the centralised model selected can be upgraded to an enterprise wide architecture by integrating with additional hospital units’ databases.

Clinical data warehousing : a business analytics approach for managing health data

Heterogeneous health data is a critical issue when managing health information for quality decision making processes. In this paper we examine the efficient aggregation of lifestyle information through a data warehousing architecture lens. We present a proof of concept for a clinical data warehouse architecture that enables evidence based decision making processes by integrating and organising disparate data silos in support of healthcare services improvement paradigms.

Data warehouse para el Centro de Documentación Regional "Juan Bautista Vázquez"

El proceso de toma de decisiones en las bibliotecas universitarias es de suma importancia, sin embargo, se encuentra complicaciones como la gran cantidad de fuentes de datos y los grandes volúmenes de datos a analizar. Las bibliotecas universitarias están acostumbradas a producir y recopilar una gran cantidad de información sobre sus datos y servicios. Las fuentes de datos comunes son el resultado de sistemas internos, portales y catálogos en línea, evaluaciones de calidad y encuestas. Desafortunadamente estas fuentes de datos sólo se utilizan parcialmente para la toma de decisiones debido a la amplia variedad de formatos y estándares, así como la falta de métodos eficientes y herramientas de integración. Este proyecto de tesis presenta el análisis, diseño e implementación del Data Warehouse, que es un sistema integrado de toma de decisiones para el Centro de Documentación Juan Bautista Vázquez. En primer lugar se presenta los requerimientos y el análisis de los datos en base a una metodología, esta metodología incorpora elementos claves incluyendo el análisis de procesos, la calidad estimada, la información relevante y la interacción con el usuario que influyen en una decisión bibliotecaria. A continuación, se propone la arquitectura y el diseño del Data Warehouse y su respectiva implementación la misma que soporta la integración, procesamiento y el almacenamiento de datos. Finalmente los datos almacenados se analizan a través de herramientas de procesamiento analítico y la aplicación de técnicas de Bibliomining ayudando a los administradores del centro de documentación a tomar decisiones óptimas sobre sus recursos y servicios.

Modelling spatial decisión support systems focused on the development of a data warehouse: applying software engineering

Nowadays, organizations have plenty of data stored in DB databases, which contain invaluable information. Decision Support Systems DSS provide the support needed to manage this information and planning médium and long-term ?the modus operandi? of these organizations. Despite the growing importance of these systems, most proposals do not include its total evelopment, mostly limiting itself on the development of isolated parts, which often have serious integration problems. Hence, methodologies that include models and processes that consider every factor are necessary. This paper will try to fill this void as it proposes an approach for developing spatial DSS driven by the development of their associated Data Warehouse DW, without forgetting its other components. To the end of framing the proposal different Engineering Software focus (The Software Engineering Process and Model Driven Architecture) are used, and coupling with the DB development methodology, (and both of them adapted to DW peculiarities). Finally, an example illustrates the proposal.

Clinical data integration approach using SAS clinical data integration server (CDI) tools

The decisions people make about medical treatments have a great impact on their lives. Health care practitioners, providers and patients often make decisions about medical treatments without complete understanding of the circumstances. The main reason for this is that medical data are available in fragmented, disparate and heterogeneous data silos. Without a centralised data warehouse structure to integrate these data silos, it is highly unlikely and impractical for the users to get all the information required on time to make a correct decision. In this research paper, a clinical data integration approach using SAS Clinical Data Integration Server tools is presented.

Dataset validation within big data security architecture

In recent years, increasing focus has been made on making good business decisions utilizing the product of data analysis. With the advent of the Big Data phenomenon, this is even more apparent than ever before. But the question is how can organizations trust decisions made on the basis of results obtained from analysis of untrusted data? Assurances and trust that data and datasets that inform these decisions have not been tainted by outside agency. This study will propose enabling the authentication of datasets specifically by the extension of the RESTful architectural scheme to include authentication parameters while operating within a larger holistic security framework architecture or model compliant to legislation.

Data driven and practice-based evidence : design and development of efficient and effective clinical decision support system

Decision-making is such an integral aspect in health care routine that the ability to make the right decisions at crucial moments can lead to patient health improvements. Evidence-based practice, the paradigm used to make those informed decisions, relies on the use of current best evidence from systematic research such as randomized controlled trials. Limitations of the outcomes from randomized controlled trials (RCT), such as “quantity” and “quality” of evidence generated, has lowered healthcare professionals’ confidence in using EBP. An alternate paradigm of Practice-Based Evidence has evolved with the key being evidence drawn from practice settings. Through the use of health information technology, electronic health records (EHR) capture relevant clinical practice “evidence”. A data-driven approach is proposed to capitalize on the benefits of EHR. The issues of data privacy, security and integrity are diminished by an information accountability concept. Data warehouse architecture completes the data-driven approach by integrating health data from multi-source systems, unique within the healthcare environment.

Urban informatics beyond data: Media architecture, placemaking, and citizen action

Since 2006, we have been conducting urban informatics research that we define as “the study, design, and practice of urban experiences across different urban contexts that are created by new opportunities of real-time, ubiquitous technology and the augmentation that mediates the physical and digital layers of people networks and urban infrastructures” [1]. Various new research initiatives under the label “urban informatics” have been started since then by universities (e.g., NYU’s Center for Urban Science and Progress) and industry (e.g., Arup, McKinsey) worldwide. Yet, many of these new initiatives are limited to what Townsend calls, “data-driven approaches to urban improvement” [2]. One of the key challenges is that any quantity of aggregated data does not easily translate directly into quality insights to better understand cities. In this talk, I will raise questions about the purpose of urban informatics research beyond data, and show examples of media architecture, participatory city making, and citizen activism. I argue for (1) broadening the disciplinary foundations that urban science approaches draw on; (2) maintaining a hybrid perspective that considers both the bird’s eye view as well as the citizen’s view, and; (3) employing design research to not be limited to just understanding, but to bring about actionable knowledge that will drive change for good.

Constructing a traditional Chinese medicine data warehouse application

The explosive growth in the development of Traditional Chinese Medicine (TCM) has resulted in the continued increase in clinical and research data. The lack of standardised terminology, flaws in data quality planning and management of TCM informatics are preventing clinical decision-making, drug discovery and education. This paper argues that the introduction of data warehousing technologies to enhance the effectiveness and durability in TCM is paramount. To showcase the role of data warehousing in the improvement of TCM, this paper presents a practical model for data warehousing with detailed explanation, which is based on the structured electronic records, for TCM clinical researches and medical knowledge discovery.

Projeto físico de Data Warehouse no Oracle: um estudo de caso.

Este trabalho visa compartilhar a experiência no projeto físico de um DW desenvolvido pela Embrapa Informática Agropecuária utilizando o SGBD Oracle. São apresentadas algumas características do Oracle que favorecem a manutenção e o desempenho de consultas a um DW em geral, utilizando como exemplo o DW específico.

Big data warehouse framework for smart revenue management

Revenue Management’s most cited definitions is probably “to sell the right accommodation to the right customer, at the right time and the right price, with optimal satisfaction for customers and hoteliers”. Smart Revenue Management (SRM) is a project, which aims the development of smart automatic techniques for an efficient optimization of occupancy and rates of hotel accommodations, commonly referred to, as revenue management. One of the objectives of this project is to demonstrate that the collection of Big Data, followed by an appropriate assembly of functionalities, will make possible to generate a Data Warehouse necessary to produce high quality business intelligence and analytics. This will be achieved through the collection of data extracted from a variety of sources, including from the web. This paper proposes a three stage framework to develop the Big Data Warehouse for the SRM. Namely, the compilation of all available information, in the present case, it was focus only the extraction of information from the web by a web crawler – raw data. The storing of that raw data in a primary NoSQL database, and from that data the conception of a set of functionalities, rules, principles and semantics to select, combine and store in a secondary relational database the meaningful information for the Revenue Management (Big Data Warehouse). The last stage will be the principal focus of the paper. In this context, clues will also be giving how to compile information for Business Intelligence. All these functionalities contribute to a holistic framework that, in the future, will make it possible to anticipate customers and competitor’s behavior, fundamental elements to fulfill the Revenue Management