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DATA WArehousing moDel
for meDicAl cenTer

       Presented by :
     Aleem Alsanbani
     Saleem Almaqashi
     Mohammed akhtar
            Ali
Data Warehouse
 Data Warehouse
   – A copy of transaction data specifically structured for
     querying and reporting
 Data Mart
   – A logical subset of the complete data warehouse
 OLAP (On-Line Analytic Processing)
   – The activity of querying and presenting text and number
     data, usually with underlying multidimensional ‘cubes’ of
     data
 Dimensional Modeling
   – A specific discipline for modeling data that is an
     alternative to entity-relationship (E/R) modeling; usually
     employed in data warehouses and OLAP systems.
Data Warehouse Goals
 Speed up reporting
 Reduce reporting load on transactional systems
 Make institutional data more user-friendly and
  accessible
 Integrate data from different source systems
 Enable ‘point-in-time’ analysis and trending over
  time
 To help identify and resolve data integrity issues,
  either in the warehouse itself or in the source
  systems that collect the data
Warehouse Challenges
 High-level support
 Identification of reporting needs by subject area
  and organizational role
 Bridging the gap between reporting needs and
  technical specifications
 Partnerships with central and campus
  administrative areas
 Customer support and training
Data Warehouse Web Sites
 Patient Support Web Site
 Main Reporting Web Site
 General Operating Budget Web Sites
 Web Sites Using Warehouse Extracts
   – Health care Web Site
   – Patients register online
   – Patients cancel appointment online
   – Doctors can register online .. Etc
 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.
 Many healthcare organizations see data
  warehousing as a way to facilitate operational
  efficiency and informed administrative decision
  making.
Medical Center

                                 Application
                                 Development      Web
               Systems
                                                  Services
               Architecture
                                                              eMail/
   Systems                                                    Messaging
   Integration
                                 Medical Center

                                                                 Data
Database
Admin                             Education
                                  Education
                                  Patient Care                   Warehousing



    Server
    Admin                                                     Desktop
                                                              Support
           Telephone

                       Network                    Help Desk
                                    Data Center                         7
Medical Entities Dictionary:
A Central Terminology Repository
MED Structure

                                 Medical
                                  Entity

          Substance                   Laboratory            Event
                                      Specimen

     Chemical     Anatomic             Plasma              Diagnostic
                  Substance           Specimen             Procedure




                                                  Ha
                                   pl ce
                                 m tan




                                                    s
                      Plasma         ed             Laboratory      Laboratory



                                             Sp
                               Sa bs

                                                       Test         Procedure
                                Su




                                               eci
Carbo-       Bioactive
                                                   me
hydrate     Substance                        n
                                                        Plasma          CHEM-7
                                                        Glucose Part of
      Glucose                        sured               Test
                       Sub stance Mea
DW model for medical center
Medical center
 Data warehousing and architecture
 Medical Management System
  –   Patient details and registration
  –   Consultations
  –   Resource allocation
  –   Pharmaceuticals management
  –   Billing and payments
  –   User interface conforming to usability guidelines
  –   Database with audio/visual and past consultations
  –   Future extensions (web, remote a/v consulting, etc)
  –   Management reports, security levels, accounting, etc.
Description
 Scope
   – Patient registration
   – Appointments scheduling
   – Billing and payments (cash, CC, insurance)
   – Security of the whole system
   – Web interface (proposed for future)
Description
 Assumptions
   – Patient must provide insurance details when
     registering.
   – Advance deposit require when patient don’t have
     Insurance.
   – Appointments can be cancelled 24 hours in
     advance without penalty
   – Patient medical history can be viewed by
     concerned doctors at the hospital with approval
     of the patient .
Background about medical center
 Office staff can perform various functions like appointment scheduling,
  billing, entering prescriptions, lab results, patient charts, etc. through
  the Web or manually .
 Doctors can look up their schedules enter schedule changes, review
  patient charts, look at lab results and enter prescriptions.
 Patients can look up appointments, cancel them, request new
  appointments, look up statements, enter credit card payments, look up
  their medications, receive notifications of their lab results and change
  their addresses. New patients may look up physicians by their specialty,
  request appointments, register themselves on line. Direct Electronic
  Billing avoids paper.
 Patients can review statements & make payments over the internet.
  Pharmacists can receive notifications regarding prescriptions, request
  re-fills or re-work on a prescription.
Users

The Hospital Management System is mainly designed by keeping in mind
all the possible users, which are:


                     • Doctors
                     • Staffs
                     • Patients

Everyone has their unique ID and passwords to access their
patients and patient’s to see their reports and medication.
Doctors
Doctor has to login with unique login id and password for particular practice
i.e. s/he can not login to more than one practice at a time. (Since there will
be different database for different practices) After successful login s/he will
be redirected to schedule for that day to see his/her appointments, (default
page). S/he doctor can make new appointment, mark event, recall and give
prescriptions.
The Doctor’s section contains the following features:



                           • Patient
                           • Appointments
                           • Prescriptions
                           • Billing
                           • Reports
                           • Patient charts
                           • Lab results
                                                                          User’s
Staffs
Staff has to login with unique login id and password for particular practice
after successful login s/he will be redirected to staff’s authorities . S/he can
perform all functions in the practice management as dictated by the
permissions set up by the Practice administrator.
Among the staff there will be one practice administrator who will set
permissions for doctors, staff & patient
The staff’s section contains the following features:


                           • Patient
                           • Appointments
                           • Prescriptions
                           • Billing
                           • Reports
                           • Patient charts
                           • Lab results

                                                                            User’s
Patient
Patient has to login with unique login id and password for particular practice
i.e. s/he can not login to more than one practice at a time. (Since there will
be different database for different practices) After successful login s/he will
be redirected schedule for that day to see his/her appointments where
Patient can view his appointment, cancel appointment or view prescriptions
and request new appointment via email or phone call. Patient can sign
up/register for particular practice by entering his information, which will be
validated by staff & will respond accordingly. Any alert posted through e-mail
if not responded within a stipulated time then the patient is contacted on
his/her contact no/Fax.
The patient’s section contains the following features:


                                     • Appointments
                                     • Prescriptions
                                     • Reports
                                     • Lab results

                                                                           User’s
Data Warehousing Architecture

  Monitoring &
                                             OLAP
  Administration
                                             servers
                   Metadata
                   Repository                          Analysis

             Extract
                                                       Query/
External     Transform                                 Reporting
Sources      Load                            Serv
Operatio
             Refresh
                                             e         Data
nal dbs                                                Mining



                                Data Marts
Medical Management Systems
     This software targets to provide complete
    solution for Hospital and related services.
    The software Includes following:
•   Admin
•   Chemist
•   Laboratory
•   OPD
•   Create/Edit User
•   Backup
•   Add/ Edit Doctor


                                    continued
Hospital Management systems
Add/Edit Supplier
Add/Edit Medicine
Purchase Order
Inventory Transaction
Sales
Add/Edit Text
Patient Text Report
Text Bills

                         continued
Hospital Management Systems
Patient registration.
Consultancy Record
OPD Bill
Add/Edit Finding
Add/Edit Advise
Conflicting Medicine composition
Hospital Management Systems
 Report
   Chemist
     Stock Report
     Medicine List
     Sales Report
   Laboratory
     Test Report
     Account Report
   OPD
     Patient List
     Search list
     Accounts Report
Requirement

Operating System
    Windows NT 4.0 and above
    Windows 9x
Database
    My SQL
    SQL SERVER
    MS Access
Security
 Security. A steering committee of clinicians guided the initial
  development of the CDR and established policies for its
  utilization and access. Only authorized users may log onto
  the CDR. To protect confidentiality, all patient and physician
  identifying information has been partitioned into a “secure”
   database. Translation from or to disguised identifiers to or from
   actual identifiers is possible but requires a written request and
   appropriate approval (for example, from a supervisor or the human
   investigations committee). All data transmitted from the database
   server to the user’s browser are encrypted using the secure
   Netscape Web server, and all accesses to the database are logged.
   In addition,
Conclusion
 The most challenging security threat in Data Warehouse and
  OLAP systems is:
    Data stored in data warehouse may be disclosed through
      seemingly innocent OLAP queries
 2 main inference threat that should be considered:
    1-d inference
    m-d inference
 We presented 3 methods to prevent / remove inference:
    Cardinality-based method
    Parity-based method
    Lattice-based inference control
 All above methods are applicable to the three-tier inference
  control architecture, that especially suits OLAP systems.
References
 1. Kachur, R. J. The Data Warehouse Management Handbook.
  Upper Saddle River, N.J.: Prentice Hall, 2000.
 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,

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Medical center using Data warehousing

  • 1. DATA WArehousing moDel for meDicAl cenTer Presented by : Aleem Alsanbani Saleem Almaqashi Mohammed akhtar Ali
  • 2. Data Warehouse  Data Warehouse – A copy of transaction data specifically structured for querying and reporting  Data Mart – A logical subset of the complete data warehouse  OLAP (On-Line Analytic Processing) – The activity of querying and presenting text and number data, usually with underlying multidimensional ‘cubes’ of data  Dimensional Modeling – A specific discipline for modeling data that is an alternative to entity-relationship (E/R) modeling; usually employed in data warehouses and OLAP systems.
  • 3. Data Warehouse Goals  Speed up reporting  Reduce reporting load on transactional systems  Make institutional data more user-friendly and accessible  Integrate data from different source systems  Enable ‘point-in-time’ analysis and trending over time  To help identify and resolve data integrity issues, either in the warehouse itself or in the source systems that collect the data
  • 4. Warehouse Challenges  High-level support  Identification of reporting needs by subject area and organizational role  Bridging the gap between reporting needs and technical specifications  Partnerships with central and campus administrative areas  Customer support and training
  • 5. Data Warehouse Web Sites  Patient Support Web Site  Main Reporting Web Site  General Operating Budget Web Sites  Web Sites Using Warehouse Extracts – Health care Web Site – Patients register online – Patients cancel appointment online – Doctors can register online .. Etc
  • 6.  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.  Many healthcare organizations see data warehousing as a way to facilitate operational efficiency and informed administrative decision making.
  • 7. Medical Center Application Development Web Systems Services Architecture eMail/ Systems Messaging Integration Medical Center Data Database Admin Education Education Patient Care Warehousing Server Admin Desktop Support Telephone Network Help Desk Data Center 7
  • 8. Medical Entities Dictionary: A Central Terminology Repository
  • 9. MED Structure Medical Entity Substance Laboratory Event Specimen Chemical Anatomic Plasma Diagnostic Substance Specimen Procedure Ha pl ce m tan s Plasma ed Laboratory Laboratory Sp Sa bs Test Procedure Su eci Carbo- Bioactive me hydrate Substance n Plasma CHEM-7 Glucose Part of Glucose sured Test Sub stance Mea
  • 10. DW model for medical center
  • 11.
  • 12.
  • 13.
  • 14.
  • 15. Medical center  Data warehousing and architecture  Medical Management System – Patient details and registration – Consultations – Resource allocation – Pharmaceuticals management – Billing and payments – User interface conforming to usability guidelines – Database with audio/visual and past consultations – Future extensions (web, remote a/v consulting, etc) – Management reports, security levels, accounting, etc.
  • 16. Description  Scope – Patient registration – Appointments scheduling – Billing and payments (cash, CC, insurance) – Security of the whole system – Web interface (proposed for future)
  • 17. Description  Assumptions – Patient must provide insurance details when registering. – Advance deposit require when patient don’t have Insurance. – Appointments can be cancelled 24 hours in advance without penalty – Patient medical history can be viewed by concerned doctors at the hospital with approval of the patient .
  • 18. Background about medical center  Office staff can perform various functions like appointment scheduling, billing, entering prescriptions, lab results, patient charts, etc. through the Web or manually .  Doctors can look up their schedules enter schedule changes, review patient charts, look at lab results and enter prescriptions.  Patients can look up appointments, cancel them, request new appointments, look up statements, enter credit card payments, look up their medications, receive notifications of their lab results and change their addresses. New patients may look up physicians by their specialty, request appointments, register themselves on line. Direct Electronic Billing avoids paper.  Patients can review statements & make payments over the internet. Pharmacists can receive notifications regarding prescriptions, request re-fills or re-work on a prescription.
  • 19. Users The Hospital Management System is mainly designed by keeping in mind all the possible users, which are: • Doctors • Staffs • Patients Everyone has their unique ID and passwords to access their patients and patient’s to see their reports and medication.
  • 20. Doctors Doctor has to login with unique login id and password for particular practice i.e. s/he can not login to more than one practice at a time. (Since there will be different database for different practices) After successful login s/he will be redirected to schedule for that day to see his/her appointments, (default page). S/he doctor can make new appointment, mark event, recall and give prescriptions. The Doctor’s section contains the following features: • Patient • Appointments • Prescriptions • Billing • Reports • Patient charts • Lab results User’s
  • 21. Staffs Staff has to login with unique login id and password for particular practice after successful login s/he will be redirected to staff’s authorities . S/he can perform all functions in the practice management as dictated by the permissions set up by the Practice administrator. Among the staff there will be one practice administrator who will set permissions for doctors, staff & patient The staff’s section contains the following features: • Patient • Appointments • Prescriptions • Billing • Reports • Patient charts • Lab results User’s
  • 22. Patient Patient has to login with unique login id and password for particular practice i.e. s/he can not login to more than one practice at a time. (Since there will be different database for different practices) After successful login s/he will be redirected schedule for that day to see his/her appointments where Patient can view his appointment, cancel appointment or view prescriptions and request new appointment via email or phone call. Patient can sign up/register for particular practice by entering his information, which will be validated by staff & will respond accordingly. Any alert posted through e-mail if not responded within a stipulated time then the patient is contacted on his/her contact no/Fax. The patient’s section contains the following features: • Appointments • Prescriptions • Reports • Lab results User’s
  • 23. Data Warehousing Architecture Monitoring & OLAP Administration servers Metadata Repository Analysis Extract Query/ External Transform Reporting Sources Load Serv Operatio Refresh e Data nal dbs Mining Data Marts
  • 24. Medical Management Systems This software targets to provide complete solution for Hospital and related services. The software Includes following: • Admin • Chemist • Laboratory • OPD • Create/Edit User • Backup • Add/ Edit Doctor continued
  • 25. Hospital Management systems Add/Edit Supplier Add/Edit Medicine Purchase Order Inventory Transaction Sales Add/Edit Text Patient Text Report Text Bills continued
  • 26. Hospital Management Systems Patient registration. Consultancy Record OPD Bill Add/Edit Finding Add/Edit Advise Conflicting Medicine composition
  • 27. Hospital Management Systems  Report Chemist Stock Report Medicine List Sales Report Laboratory Test Report Account Report OPD Patient List Search list Accounts Report
  • 28. Requirement Operating System  Windows NT 4.0 and above  Windows 9x Database  My SQL  SQL SERVER  MS Access
  • 29. Security  Security. A steering committee of clinicians guided the initial development of the CDR and established policies for its utilization and access. Only authorized users may log onto the CDR. To protect confidentiality, all patient and physician identifying information has been partitioned into a “secure” database. Translation from or to disguised identifiers to or from actual identifiers is possible but requires a written request and appropriate approval (for example, from a supervisor or the human investigations committee). All data transmitted from the database server to the user’s browser are encrypted using the secure Netscape Web server, and all accesses to the database are logged. In addition,
  • 30. Conclusion  The most challenging security threat in Data Warehouse and OLAP systems is:  Data stored in data warehouse may be disclosed through seemingly innocent OLAP queries  2 main inference threat that should be considered:  1-d inference  m-d inference  We presented 3 methods to prevent / remove inference:  Cardinality-based method  Parity-based method  Lattice-based inference control  All above methods are applicable to the three-tier inference control architecture, that especially suits OLAP systems.
  • 31. References  1. Kachur, R. J. The Data Warehouse Management Handbook. Upper Saddle River, N.J.: Prentice Hall, 2000.  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,