Faculty of Information Technology, Monash University, Melbourne, Australia.
Eastern Health, Melbourne, Australia.
BMC Med Inform Decis Mak. 2024 Nov 22;24(1):353. doi: 10.1186/s12911-024-02732-8.
Blood management is an important aspect of healthcare and vital for the well-being of patients. For effective blood management, it is essential to determine the quality and documentation of the processes for blood transfusions in the Electronic Medical Records (EMR) system. The EMR system stores information on most activities performed in a digital hospital. As such, it is difficult to get an overview of all data. The National Safety and Quality Health Service (NSQHS) Standards define metrics that assess the care quality of health entities such as hospitals. To produce these metrics, data needs to be analysed historically. However, data in the EMR is not designed to easily perform analytical queries of the kind which are needed to feed into clinical decision support tools. Thus, another system needs to be implemented to store and calculate the metrics for the blood management national standard.
In this paper, we propose a clinical data warehouse that stores the transformed data from EMR to be able to identify that the hospital is compliant with the Australian NSQHS Standards for blood management. Firstly, the data needed was explored and evaluated. Next, a schema for the clinical data warehouse was designed for the efficient storage of EMR data. Once the schema was defined, data was extracted from the EMR to be preprocessed to fit the schema design. Finally, the data warehouse allows the data to be consumed by decision support tools.
We worked with Eastern Health, a major Australian health service, to implement the data warehouse that allowed us to easily query and supply data to be ingested by clinical decision support systems. Additionally, this implementation provides flexibility to recompute the metrics whenever data is updated. Finally, a dashboard was implemented to display important metrics defined by the National Safety and Quality Health Service (NSQHS) Standards on blood management.
This study prioritises streamlined data modeling and processing, in contrast to conventional dashboard-centric approaches. It ensures data readiness for decision-making tools, offering insights to clinicians and validating hospital compliance with national standards in blood management through efficient design.
血液管理是医疗保健的一个重要方面，对患者的健康至关重要。为了实现有效的血液管理，必须确定电子病历（EMR）系统中输血过程的质量和文件记录。EMR 系统存储了数字医院中执行的大多数活动的信息。因此，很难全面了解所有数据。国家安全和质量卫生服务（NSQHS）标准定义了评估医院等卫生实体护理质量的指标。为了生成这些指标，需要对历史数据进行分析。然而，EMR 中的数据设计并不是为了方便地执行需要输入临床决策支持工具的那种分析查询。因此，需要实施另一个系统来存储和计算血液管理国家标准的指标。
在本文中，我们提出了一个临床数据仓库，该仓库存储从 EMR 转换后的数据，以便能够确定医院是否符合澳大利亚 NSQHS 血液管理标准。首先，探索和评估了所需的数据。接下来，设计了临床数据仓库的架构，以便高效存储 EMR 数据。定义架构后，从 EMR 中提取数据进行预处理，以适应架构设计。最后，数据仓库允许决策支持工具使用数据。
我们与澳大利亚主要的卫生服务机构东健康合作，实施了数据仓库，使我们能够轻松查询和提供数据，供临床决策支持系统使用。此外，这种实施方式提供了灵活性，可以在数据更新时重新计算指标。最后，实现了一个仪表板，以显示国家安全和质量卫生服务（NSQHS）标准中定义的重要血液管理指标。
本研究侧重于简化数据建模和处理，与传统的以仪表板为中心的方法相反。它通过高效的设计确保了数据为决策工具做好准备，为临床医生提供了见解，并通过高效的设计验证了医院在血液管理方面的国家标准的合规性。
