Enterprise Data Warehouse

toddSpring 2013

Data Repository Improves Health Care Quality

By Ben Boulden

Ann Riggs, M.D., vaccinates a patient for pneumonia. The UAMS data warehouse was used to determine whether all patients older than 65 had received such vaccinations.

Ann Riggs, M.D., vaccinates a patient for pneumonia. The UAMS data warehouse was used to determine whether all patients older than 65 had received such vaccinations.

Nearly 1 million patient records are at the fingertips of UAMS researchers and clinicians to use for everything from tracking patient medication response to cutting costs in the clinic.

The data repository known as the UAMS Enterprise Data Warehouse makes available de-identified inpatient, outpatient, lab and registration records while abiding by the federal patient privacy law known as HIPAA, the Health Insurance Portability and Accountability Act.

A strong data warehouse is essential to ongoing health system redesign that is improving the efficiency and quality of health care delivery, said William Hogan, M.D., chief of the Division of Biomedical Informatics in the College of Medicine.

Hogan oversees the enterprise, which is a collaborative effort between UAMS’ Division of Biomedical Informatics, Translational Research Institute and Information Technology Services. It is housed and staffed under Information Technology.

Online since fall 2011, the warehouse began with 500,000 patient records. A year later it had grown to nearly 1 million, including the recent addition of records from UAMS’ regional family medical centers in Jonesboro, Springdale, El Dorado, Fort Smith, Pine Bluff and Texarkana.

College of Medicine Dean Debra H. Fiser, M.D., is an enthusiastic proponent of the enterprise and its capability to advance understanding of many chronic conditions that disproportionately affect Arkansans, such as obesity, hypertension and diabetes.

“We really want to make the most of this resource, so we’re doing everything we can to support its development and to help our researchers understand its capabilities and how to access data,” Fiser said.

Robert Price, Ph.D., director of research and practice improvement for UAMS Regional Programs, is looking forward to the ways in which the data warehouse will be able to advance health care at UAMS’ regional medical centers.

“The new system gives us the information better, more reliably, more often and puts it in one place so we can begin to improve the efficiency of our management as well as the quality of our patient care,” he said. “We can look at these data any point in time. It’s going to upgrade the quality of everything we do.”

Previously, Price and his staff had to pull information from two systems and re-enter it. It was like that for every regional center. Now, that information is consolidated, easier to use and updated more regularly through the data warehouse.

Because the regional family medical centers are primary care providers, their research is directed at patient care rather than basic science. They will be able to more closely monitor the performance of the health care providers at the centers.

“We’re doing whatever we can to improve chronic care and that mission is going to stay the same,” Price said. “We’re developing research activities directed at that.”

Irfan Chaudhry, data warehouse project manager, said it is also helping with core measures,

financial planning and staffing. For example, the »

UAMS Winthrop P. Rockefeller Cancer Institute is using it to better identify patient outcomes over time. It’s also using the database to make sure existing patients aren’t rebranded as new patients should they get referred to another Cancer Institute physician.

The system allows tracking of patients and the number of tests ordered for them per physician. It can identify whether the institute is being reimbursed for certain services. It can save money by identifying whether a patient is being given a drug that’s not yet approved by an insurer.

The enterprise was used to identify whether all patients older than 65 were being vaccinated for pneumonia, as required, Chaudhry said.

With major database acquisitions now behind it, Hogan is looking at incorporating smaller but significant departmental databases like the ones for radiology and pathology. The university’s tumor registry was recently added.

He said pent-up demand drove an early spike in use at the outset, followed by slower but steady growth. As researchers become more familiar with the possibilities, it’s likely to take off again. In less than a year, researchers had made more than 1,000 queries of the database, including many quality reports, and created 21 data sets.

The Translational Research Institute is offering incentives to use the enterprise. A project that provides pilot grant funding of up to $35,000 for research projects that use the data warehouse is directed by Mike Owens, Ph.D., a professor in the College of Medicine Department of Pharmacology and Toxicology, and Sudhir Shah, M.D., a professor and director of the Division of Nephrology in the College of Medicine’s Department of Internal Medicine.

“The data warehouse is enabling meaningful new research that will make a difference for Arkansans,” Fiser said.