Data Warehouse Case Study
Case Study: A Data Warehouse for an Academic Medical Center
Jonathan S. Einbinder, MD, MPH; Kenneth W. Scully, MS; Robert D. Pates, PhD; Jane R. Schubart, MBA, MS; Robert E. Reynolds, MD, DrPH
ABSTRACT The clinical data repository (CDR) is a frequently updated relational data warehouse that provides users with direct access to detailed, flexible, and rapid retrospective views of clinical, administrative, and financial patient data for the University of Virginia Health System. This article presents a case study of the CDR, detailing its five-year history and focusing on the unique role of data warehousing in an academic medical center. Specifically, the CDR must support multiple missions, including research and education, in addition to administration and management. Users include not only analysts and administrators but clinicians, researchers, and students. KEYWORDS • Data warehousing • Database • Academic medical center • Clinical research • Case study • Evaluation Large organizations build data warehouses to “analyze what has occurred within the business across time” in order to obtain “a competitive edge in the marketplace.”1 Many healthcare organizations see data warehousing as a way to facilitate operational efficiency and informed administrative decision making. In the 2000 HIMSS Leadership Survey of more than eleven hundred healthcare professionals, 58 percent of respondents indicated that their organizations were currently creating data warehouses or planned to do so within the next two years.2 However, the missions of academic medical centers extend beyond administrative analysis and decision making. The mission statement for the University of Virginia Health System, for example, refers to
JOURNAL OF HEALTHCARE INFORMATION MANAGEMENT®, vol. 15, no. 2, Summer 2001 © Healthcare Information Management Systems Society and Jossey-Bass, A Publishing Unit of John Wiley & Sons, Inc.
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Einbinder, Scully, Pates, Schubart, Reynolds
“advancement of
Jonathan S. Einbinder, MD, MPH; Kenneth W. Scully, MS; Robert D. Pates, PhD; Jane R. Schubart, MBA, MS; Robert E. Reynolds, MD, DrPH
ABSTRACT The clinical data repository (CDR) is a frequently updated relational data warehouse that provides users with direct access to detailed, flexible, and rapid retrospective views of clinical, administrative, and financial patient data for the University of Virginia Health System. This article presents a case study of the CDR, detailing its five-year history and focusing on the unique role of data warehousing in an academic medical center. Specifically, the CDR must support multiple missions, including research and education, in addition to administration and management. Users include not only analysts and administrators but clinicians, researchers, and students. KEYWORDS • Data warehousing • Database • Academic medical center • Clinical research • Case study • Evaluation Large organizations build data warehouses to “analyze what has occurred within the business across time” in order to obtain “a competitive edge in the marketplace.”1 Many healthcare organizations see data warehousing as a way to facilitate operational efficiency and informed administrative decision making. In the 2000 HIMSS Leadership Survey of more than eleven hundred healthcare professionals, 58 percent of respondents indicated that their organizations were currently creating data warehouses or planned to do so within the next two years.2 However, the missions of academic medical centers extend beyond administrative analysis and decision making. The mission statement for the University of Virginia Health System, for example, refers to
JOURNAL OF HEALTHCARE INFORMATION MANAGEMENT®, vol. 15, no. 2, Summer 2001 © Healthcare Information Management Systems Society and Jossey-Bass, A Publishing Unit of John Wiley & Sons, Inc.
165
166
Einbinder, Scully, Pates, Schubart, Reynolds
“advancement of
References: 1. Kachur, R. J. The Data Warehouse Management Handbook. Upper Saddle River, N.J.: Prentice Hall, 2000. 2. “The Eleventh Annual HIMSS Leadership Survey,” sponsored by IBM. [http://www.himss.org/ survey/2000/survey2000.html]. 2000. 3. Scully, K. W., and others. “Development of an Enterprisewide Clinical Data Repository: Merging Multiple Legacy Databases.” Paper presented at the annual symposium of the American Medical Informatics Association, 1997. 4. Reynolds, R. E., and Knaus, W. A. “Clinical Data Repository Enhancements.” Internal memorandum, University of Virginia, Jan. 30, 1998. 5. Slack, W. V. “Assessing the Clinician’s Use of Computers.” MD Computing, 1993, 10(8), 357–360. 6. Schubart, J. R., and Einbinder, J. S. “Evaluation of a Data Warehouse in an Academic Health Sciences Center.” International Journal of Medical Informatics (forthcoming). 7. Rogers, E. Diffusion of Innovations. (3rd ed.) New York: Free Press, 1983. 8. Schubart, J. R., and Einbinder, J. S. “Evaluation of a Data Warehouse: Understanding User Needs.” Paper presented at the annual symposium of the American Medical Informatics Association, 2000. 9. Halamka, J. D., and others. “Managing Care in an Integrated Delivery System via an Intranet.” Paper presented at the annual symposium of the American Medical Informatics Association, 1998. About the Authors Jonathan S. Einbinder, MD, MPH, is assistant professor of clinical informatics in the Department of Health Evaluation Sciences at the University of Virginia, director of data administration at the University of Virginia Health System, and project director for the CDR. Kenneth W. Scully, MS, is technical director and database administrator for the CDR. Robert D. Pates, PhD, is a developer for the CDR. Jane R. Schubart, MBA, MS, is a lecturer in clinical informatics in the Department of Health Evaluation Sciences at the University of Virginia. Robert E. Reynolds, MD, DrPH, is vice president and interim chief information officer for the University of Virginia and professor of informatics in the Department of Health Evaluation Sciences.