Transcript ORNEC Project - University of Ottawa

Evolving E-Health
Business Processes
Around Accessible
Data Warehouses
Background information for
demonstrations
January 24, 2007
Agenda
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Overview of ORNEC
Overview of project and team
Discussion of major activities and accomplishments
– Simulation of Ottawa Hospital Data Warehouse and
environment
– Business Intelligence prototype – Infection control data mart
– Business Process Modeling – Discharge process
– Requirements engineering – Quality indicator survey
– Others
Challenges – Obtaining access to real data/real users
Evolving E-Health Business Processes Around Accessible Data Warehouses
Description of ORNEC
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Ontario Research Network for Electronic Commerce
– Partnership between 4 universities and 40 corporations
– Funded in part by the Ontario government
Interdisciplinary research involving:
– Information and communications technologies
– Business and administration
– Law and ethics
Goals
– Creation of scientific knowledge, business models, and best practices
– Training of highly qualified academic and business leaders
– Transfer of knowledge and innovation
Research Themes
– E-Government, E-Commerce Transactions, E-Learning and Collaborative
Environments, E-Governance, E-Health, and others
http://www.ornec.ca/
Evolving E-Health Business Processes Around Accessible Data Warehouses
Project Description
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Evolving E-Health Business Processes Around Accessible Data
Warehouses
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2-year project (Jan. 2006 – Dec. 2007)
Funding: ~ $525,000, with half this amount in in-kind contributions
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Goals
– Process improvement to take advantage of e-technologies and DW
– Having good methodologies to describe, analyze, evolve, manage,
support, and automate DW-oriented, e-health processes
– Promoting the access to DWs and managing changes
– All goals consider privacy, confidentiality, quality, and consent, as
well as heavy legacy (and often manual) processes and regulatory
environments
Evolving E-Health Business Processes Around Accessible Data Warehouses
Project Investigators
• Daniel Amyot (Principal Investigator), Assistant Professor
School of Information Technology and Engineering (SITE), uOttawa
• Doug Angus, Professor
School of Management, and
Director, Ph.D. program in Population Health, uOttawa
• Alan Forster, Associate Professor
Department of Medicine, uOttawa, and
Scientist, Clinical Epidemiology, Ottawa Health Research Institute
• Michael Weiss, Assistant Professor
School of Computer Science, Carleton University
• Liam Peyton, Assistant Professor
School of Information Technology and Engineering (SITE), uOttawa
Evolving E-Health Business Processes Around Accessible Data Warehouses
Project Partners
• Provides Cognos 8 (most tools)
– with setup, training, and consulting
• Contacts: Rupert Bonham-Carter, Gerry Leavy
• Provides (discounted) Adaptive Server
Enterprise and IQ
– with setup and training
• Contacts: Dan Murphy, Ahmadou Monfopa
• Provides DOORS and FocalPoint
– with training and support
• Contacts: Frank J. Araby, Chris Sibbald
Evolving E-Health Business Processes Around Accessible Data Warehouses
Students, Staff and Collaborators
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Students involved in this project
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uOttawa staff and collaborators
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Saeed Behnam, PhD Computer Science
Pengfei Chen, MSc Computer Science
Sepideh Ghanavati, MSc Systems Science
Jason Kealey, MSc Computer Science
Sarah Musavi, Masters in Health Administration
Gunter Mussbacher, PhD Computer Science
Alireza Pourshahid, MSc E-business Technologies
Jean-François Roy, MSc Computer Science
Pierre Seguin, MSc. Computer Science
Bo Zhan, MSc Computer Science
Jacques Sincennes, System analyst
Greg Richards, Cognos Professor of Performance Management
TOH collaborators
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Cameron Keyes, Director (Acting), Decision Support
Richard Ciavaglia, Decision Support
Laurie Strano, Decision Support
Sylvain Paquette, Consultant
Josée Blackburn, Research Assistant, OHRI
Evolving E-Health Business Processes Around Accessible Data Warehouses
Research Focus
• Develop new methods to model, analyze, and evolve business
goals (why) and business processes (what/who/when/where)
based on the use of goals, scenarios, and aspects, and adapted
to DW-oriented e-Health services.
• This will in particular lead to suitable ways of exploiting the DW
for trends and goal-driven decision support, and allow us to
determine how the right data can be made available by the right
individuals in the chain of care at the right level of detail, and
how this data can best be accessed.
Evolving E-Health Business Processes Around Accessible Data Warehouses
Project Tasks
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Study goal-driven and quality-driven decision making in an e-health
context
– How to map goals to business processes to data requirements in a
DW, and goals to reports or analytics
– Goal example: “improve patient safety at a teaching hospital”
Study the suitability and relevance of recent developments in
requirements engineering, decision support, and business intelligence
Study how best to combine goal-, scenario-, and aspect-oriented
modeling for process modeling and requirements engineering
Study and model relevant processes
– For example: providing data to the DW, managing changes in the
DW requirements, secure access for various stakeholders, etc.
Replication of TOH work environment for lab study
Prototyping support for some of the processes using the lab facilities
Evolving E-Health Business Processes Around Accessible Data Warehouses
Description of DW Project @ TOH
• Multiphase project
• Collaboration between OHRI scientists, TOH Information
Systems
• Phase 1 – Building the DW for researchers
– Funded through a CFI grant
– Nearing completion
• Phase 2 – Using DW for administrative purposes
– Investigation now underway
– Identify key users
– Access through a BI toolkit
Evolving E-Health Business Processes Around Accessible Data Warehouses
Combining Healthcare and IT
Examples of Clinical / Healthcare Issues
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Nosocomial infections
Drug costs
Bed utilization
Improving the safety of the discharge process
Information Technology Issues
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Data needs, integration, quality, access, and reporting
Information Technology Opportunities
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Data Warehouse (for integration and access)
Business Intelligence tools (for reporting)
Requirements Engineering (for needs and surrounding processes)
Evolving E-Health Business Processes Around Accessible Data Warehouses
Agenda
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Overview of ORNEC
Overview of project and team
Discussion of major activities and accomplishments
– Simulation of Ottawa Hospital Data Warehouse and
environment
– Business Intelligence prototype – Infection control data mart
– Business Process Modeling – Discharge process
– Requirements engineering – Quality indicator survey
– Others
Evolving E-Health Business Processes Around Accessible Data Warehouses
Data Warehouse “Simulation”
• Intelligent Data Warehouse Lab (U. Ottawa)
– CFI grant with IBM provides:
• Powerful servers and software
• 10 Terabyte Storage Area Network (SAN)
– ORNEC project with Ottawa Hospital provides
• Cognos 8 BI, Metrics Studio, Sybase IQ + ASE
• Telelogic DOORS and FocalPoint, jUCMNav
• Same database schema as The Ottawa Hospital
– Test data generator
– Apply for an anonymous data extract
Evolving E-Health Business Processes Around Accessible Data Warehouses
Demonstration / Learning Vehicle
• Students, Researchers (and Ottawa Hospital) have access to
– Configuring and designing the environment
– Hands-on training and mentoring (from Cognos)
– Courses
– Creation of sample applications and processes
• Antibiotics Tracking
• Discharge process
Evolving E-Health Business Processes Around Accessible Data Warehouses
Integrating Data Warehouse
Data Marts
Operational
Feedback
Operational
Systems
Data
Warehouse
End-User Access
Data Extraction &
Transformation
Data Extraction &
Transformation
Evolving E-Health Business Processes Around Accessible Data Warehouses
Agenda
•
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Overview of ORNEC
Overview of project and team
Discussion of major activities and accomplishments
– Simulation of Ottawa Hospital Data Warehouse and
environment
– Business Intelligence prototype –
Infection control data mart
– Business Process Modeling – Discharge process
– Requirements engineering – Quality indicator survey
– Others
Challenges – Obtaining access to real data/real users
Next steps
Evolving E-Health Business Processes Around Accessible Data Warehouses
Data Mart Extract – For Infection Control
Evolving E-Health Business Processes Around Accessible Data Warehouses
Performance Management Portal
Key Metrics
News Feed
Important Links
Antibiotics Tracking
Campus
Dashboard
Evolving E-Health Business Processes Around Accessible Data Warehouses
Drill into
General Campus
Evolving E-Health Business Processes Around Accessible Data Warehouses
Drill into Surgery
Drill into Most
Prescriptions
Evolving E-Health Business Processes Around Accessible Data Warehouses
Drill into
metric…
Balanced
Scorecard
Metric History
Evolving E-Health Business Processes Around Accessible Data Warehouses
Dimensional Model
Report Authoring
Evolving E-Health Business Processes Around Accessible Data Warehouses
Performance Management
Infrastructure
• Data Mart “cubes” or “extracts”
– Multi-dimensional snapshot with drill up and drill down
– Pre-packaged security roles
– Ethics and privacy review
• Performance Management Portal
– Dashboards, flexible end-user tools for reporting, exploration, and
metrics
• Operational Integration
– Data collection, data quality
– Timely effect reports support decision making and track targets,
Service-Level Agreements (SLAs)
– Business process improvements, transformations
Evolving E-Health Business Processes Around Accessible Data Warehouses
Assessment Framework Tied to Operational
Systems, Performance MGT & Data
Warehouse Strategy
Stakeholders
Use Case Maps
Goals
Reports
PIQ
Tasks
Performance
Mgt Systems
& Processes
Business Systems
& Processes
Data
Warehouse
PIQ measures the
effectiveness of Reports to
measure effectiveness of
Organization in meetings its
goals.
Evolving E-Health Business Processes Around Accessible Data Warehouses
Assessment Framework Tied to Operational
Systems, Performance MGT & Data
Warehouse Strategy
• Identify stakeholders, goals, tasks and use case maps to
capture requirements and specify operational systems
• Identify reports needed to measure attainment of goals, inform
tasks
• Measure importance of reports (related to goals)
• Measure quality of reports (related to tasks, goals)
• Measure penetration of reports (related to stakeholders, goals)
• Measure effort, cost, timeliness, scalability, reliability etc. of data
collection, report creation, and distribution (effectiveness and
efficient)
• Performance MGT/Data Warehouse strategy and
implementation defined and driven by Reports & PIQ
Evolving E-Health Business Processes Around Accessible Data Warehouses
Agenda
•
•
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Overview of ORNEC
Overview of project and team
Discussion of major activities and accomplishments
– Simulation of Ottawa Hospital Data Warehouse and
environment
– Business Intelligence prototype – Infection control data mart
– Business Process Modeling – Discharge process
– Requirements engineering – Quality indicator survey
– Others
Evolving E-Health Business Processes Around Accessible Data Warehouses
Overview of Approach
Business Intelligence
Which reports to
generate?
Process
Health Care
Services
Goals
What data to
collect?
Data Warehouse
Evolving E-Health Business Processes Around Accessible Data Warehouses
Goal: Patient Safety
Governance Process
Discharge Process
Medical Management
Evolving E-Health Business Processes Around Accessible Data Warehouses
Approach: BPM
Redesign
Collect
Evolving E-Health Business Processes Around Accessible Data Warehouses
Monitor
Process Design and Evolution
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Identify goals and indicators (GRL)
Model the process (UCM)
Monitor process execution (DW)
Generate data mart (DM) and reports (BI)
Redesign process (redesign patterns)
Evolving E-Health Business Processes Around Accessible Data Warehouses
jUCMNav:
Goal model
editor/analyzer
(GRL)
Evolving E-Health Business Processes Around Accessible Data Warehouses
jUCMNav:
Process model
editor/analyzer
(UCM)
Evolving E-Health Business Processes Around Accessible Data Warehouses
Goals and Indicators
Evolving E-Health Business Processes Around Accessible Data Warehouses
Monitoring and Redesign
Evolving E-Health Business Processes Around Accessible Data Warehouses
Start
Discharge
Process
End
Actors
Subprocess
Evolving E-Health Business Processes Around Accessible Data Warehouses
Discharge to Other Process
Evolving E-Health Business Processes Around Accessible Data Warehouses
Dictate Process
Indicators
• Delay between dictation and transcription time
• Delay between discharge and dictation time
• Percentage of patients that are delayed over
three months (one month, one week)
• Percentage of incomplete dictations
Evolving E-Health Business Processes Around Accessible Data Warehouses
Report: Time Lag in Campuses
Evolving E-Health Business Processes Around Accessible Data Warehouses
Drilling Down General Campus…
Evolving E-Health Business Processes Around Accessible Data Warehouses
Report: Time Lag in Services
Evolving E-Health Business Processes Around Accessible Data Warehouses
Drilling Down General Medicine
Evolving E-Health Business Processes Around Accessible Data Warehouses
Drilling Down Guimarães Rosa, João
Evolving E-Health Business Processes Around Accessible Data Warehouses
Predefined Reports
Evolving E-Health Business Processes Around Accessible Data Warehouses
Evolving E-Health Business Processes Around Accessible Data Warehouses
Evolving E-Health Business Processes Around Accessible Data Warehouses
Agenda
•
•
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Overview of ORNEC
Overview of project and team
Discussion of major activities and accomplishments
– Simulation of Ottawa Hospital Data Warehouse and
environment
– Business Intelligence prototype – Infection control data mart
– Business Process Modeling – Discharge process
– Requirements engineering – Quality indicator survey
– Others
Evolving E-Health Business Processes Around Accessible Data Warehouses
Quality Indicator Survey
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Identified 78 quality of care indicators.
– These indicators consist of a patient population and a treatment. Examples:
• Patients with atrial fibrillation should be prescribe warfarin unless there
is an important contraindication
• Patients hospitalized due to an asthma exacerbation should be treated
with beta-agonists
14 participants from TOH
– Asked to determine which indicators were the most important
A quality of care indicator is important if:
a) the patient population is large (i.e. diagnosis/condition is highly prevalent)
b) the treatment is highly effective and easily available to most patients
c) there are few patients in whom the treatment is contraindicated; and,
d) in your role as an attending physician on CTU, you frequently treat this
population.
Survey performed with the help of a new Web-based tool we developed
– Answer collection and prioritization
Analysis of actual data vs. goal satisfaction using clustering
Reports (on-line and PDF) generated via Cognos BI tools
Evolving E-Health Business Processes Around Accessible Data Warehouses
Online Survey Tool
Allows for secure
questionnaires to
be filled and
answers (indicators,
requirements, etc.)
to be prioritized
Evolving E-Health Business Processes Around Accessible Data Warehouses
Some Survey Results
1. Quality indicators reflecting treatment decisions were rated higher than
those reflecting investigation decisions
– Example: For myocardial infarction, internal medicine physicians
felt it was more important to prescribe ASA than to order lipid
profiling
2. Good agreement on the main indicators for Civic/General campuses
– Top 5 very similar
3. Not all diseases surveyed have important indicators
– For instance, pneumonia is very common yet its current indicators
scored second last
We also received feedback to improve the survey tool itself.
Evolving E-Health Business Processes Around Accessible Data Warehouses
Survey: Next Steps
1. Go back to the doctors to discuss and validate the results
2. Design appropriate data marts for the top priorities
3. Create portals for these indicators
4. Get access to the real data and deploy the portals/reports
Evolving E-Health Business Processes Around Accessible Data Warehouses
Overview of Other Activities: Using DWs
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Literature survey on uses and challenges of DW in the health sector
– Report available (S. Musavi)
Joined the Health Data Warehouse Association (HDWA)
– Excellent networking opportunity
– Attended their annual conference in June (J. Blackburn)
External peer survey
– Experience from peer organizations in HDWA and Canada
– Approved by the TOH Research Ethics Board.
Comparative study
– Approaches for implementation of DW in publicly-funded healthcare
organizations (S. Musavi)
– Canadian Blood Services and The Ottawa Hospital
– Look at effectiveness of current reports (G. Richards)
Coming soon: pharmacy technician to clean data in DW
– Drug frequencies, routes, names…
Evolving E-Health Business Processes Around Accessible Data Warehouses
Overview of Other Activities: Compliance
• Modelled governance process to access patient data via the DW
– Goals/processes documented with jUCMNav (S. Ghanavati)
• Linked to Personal Health Information Protection Act (PHIPA)
– Establish compliance and check compliance as the law and
the business process evolve over time.
– Integration of model with Telelogic DOORS
Privacy Laws
Hospital
3-
C
om
pl
ia
nc
e
Li
nk
Policies and Procedure
Documents
Law and Legislations
Documents
GRL- High LevelSoftgoals, and Goals
GRL- Detail-Softgoals,
Goals, Tasks and
Actors
1- High Level
Traceability Link
2- Detail Traceability Link
sp o
4- Re
nsibil
ity Lin
GRL- High LevelSoftgoals, and Goals
GRL- Detail-Softgoals,
Goals, Tasks and Actors
k
Use Case Maps
Evolving E-Health Business Processes
Around Accessible Data Warehouses
Overview of Other Activities: Tools
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Tool support for business goal/process models
– Improved jUCMNav tool substantially: editing, analysis, export (J. Kealey)
– Improved the User Requirements Notation itself to explore aspect-oriented
modelling (G. Mussbacher)
• Might ease the description and analysis of evolving goals / processes
Business Intelligence tools
– Training of students and partners on Cognos BI tools
– Created tool to generate fake but representative data to simulate existing
DW (B. Zhan)
– Performance evaluation of Cognos BI tools
• Heavy usage of DW, growing/evolving DW, etc.
– New descriptor tool, based on SAS (A. Forster)
• Could be used as a preprocessor for BI tools (e.g. Cognos)
– New graduate course on the use of databases for measuring healthcare
quality
• To be offered for the first time in January 2007 (A. Forster)
Evolving E-Health Business Processes Around Accessible Data Warehouses
Agenda
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Overview of ORNEC
Overview of project and team
Discussion of major activities and accomplishments
– Simulation of Ottawa Hospital Data Warehouse and
environment
– Business Intelligence prototype – Infection control data mart
– Business Process Modeling – Discharge process
– Requirements engineering – Quality indicator survey
– Others
Evolving E-Health Business Processes Around Accessible Data Warehouses
For Further Information
• Daniel Amyot
Assistant Professor
SITE, University of Ottawa
(613) 562-6800 ext. 6947
[email protected]
• Web site:
http://cserg0.site.uottawa.ca/twiki/bin/view/EHealth/WebHome
Evolving E-Health Business Processes Around Accessible Data Warehouses