Enterprise Data Warehouse / Data Operating system

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Health Catalyst Editors

The Digitization of Healthcare: Why the Right Approach Matters and Five Steps to Get There

While many industries are leveraging digital transformation to accelerate their productivity and quality, healthcare ranks among the least digitized sectors. Healthcare data is largely incomplete when it comes to fully representing a patient’s health and doesn’t adequately support diagnoses and treatment, risk prediction, and long-term health care plans. But even with the obvious urgency for increased healthcare digitization, the industry must raise this trajectory with sensitivity to the impacts on clinicians and patients. The right digital strategy will not only aim for more comprehensive information on patient health, but also leverage data to empower and engage the people involved.
Health systems can follow five guidelines to digitize in a sustainable, impactful way:

Achieve and maintain clinician and patient engagement.
Adopt a modern commercial digital platform.
Digitize the assets (the patients) and the processes.
Understand the importance of data to drive AI insights.
Prioritize data volume.

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Ryan Smith

The Six Biggest Problems With Homegrown Healthcare Analytics Platforms

Most healthcare systems have been building, improving, and maintaining proprietary healthcare analytics platforms since the early 2000s and have invested heavily in the people and resources required to do so. As the demands of today’s healthcare environment continue to increase, it’s becoming more difficult for analytic teams to keep up.
This article deals with the six biggest problems to maintaining a homegrown healthcare analytic platform today:

Inability to keep pace with analytic demands.
Difficult to support and scale for the future.
Difficulty finding and keeping talent.
Use of point solutions to fill gaps.
Analytic teams must also support third-party vendors and affiliated groups.
Difficulty keeping abreast of rapidly changing regulatory requirements.

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Health Catalyst Editors

The Healthcare Data Warehouse: Lessons from the First 20 Years

Twenty years after Intermountain Healthcare launched its enterprise data warehouse in 1998, industry leaders are looking at what they did right, what they’d do differently, and what the future holds for healthcare data and analytics. While early successes (such as a hiring framework of social, domain, and technical skills; lightweight data governance; and late-binding architecture) continue to hold their value, advanced analytics and technology and innovation in diagnosis and treatment are reshaping the capabilities of and demands on the healthcare data warehouse. Present-day and future healthcare IT leaders will have to revisit approaches to data warehousing people, processes, and technology to understand how they can improve, continue to adapt, and fully leverage emerging opportunities.

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Dale Sanders

The Homegrown Versus Commercial Digital Health Platform: Scalability and Other Reasons to Go with a Commercial Solution

Public cloud offerings are making homegrown digital platforms look easier and more affordable to health system CTOs and CIOs. Initial architecture and cost, however, may be the only real benefit of a do-it-yourself approach. These homegrown systems can’t scale at the level of commercial vendor systems when it comes to long-term performance and expense, leaving organizations with a potentially costly and undereffective platform for years to come.
Over his 25 years as a health system CIO, Dale Sanders, President of Technology for Health Catalyst, has observed both the tremendous value of healthcare-specific vendor platforms, as well as the shortcomings of homegrown solutions. He shares his insights in a question-and-answer session that addresses pressing issues in today’s digital healthcare market.

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Jane Felmlee

Clinical Data Management: 3 Improvement Strategies

Most health systems suffer from data clutter and efficiency problems. As a result, analysts spend most of their time searching for data, not performing high value work.  There are three steps that can help you address your data management issues: 1) find all your dispersed analysts in the organization, 2) assess your analytics risks and challenges, 3) champion the creation of an EDW as the foundation for clinical data management.

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Jared Crapo
Linda Simovic

Cloud-Based Open-Platform Data Solutions: The Best Way to Meet Today’s Growing Health Data Demands

Smartphone applications, home monitoring equipment, genomic sequencing, and social determinants of health are adding significantly to the scope of healthcare data, creating new challenges for health systems in data management and storage. Traditional on-premises data warehouses, however, don’t have the capacity or capabilities to support this new era of bigger healthcare data.
Organizations must add more secure, scalable, elastic, and analytically agile cloud-based, open-platform data solutions that leverage analytics as a service (AaaS). Moving toward cloud hosting will help health systems avoid the five common challenges of on-premises data warehouses:

Predicting future demand is difficult.
Infrastructure scaling is lumpy and inelastic.
Security risk mitigation is a major investment.
Data architectures limit flexibility and are resource intensive.
Analytics expertise is misallocated.

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Health Catalyst

Data Warehousing in Healthcare: A Guide to Success

Looking for a way to share his extensive experience with data warehousing in healthcare, in 2002 Dale Sanders wrote what many consider to be the “EDW Bible.” It’s a document with guidance that, if followed, will drive value and utilization from a data warehouse. We’ve made that report available now.

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Drew Cardon

Database vs Data Warehouse: A Comparative Review

What are the differences between a database and a data warehouse?
A database is any collection of data organized for storage, accessibility, and retrieval.
A data warehouse is a type of database the integrates copies of transaction data from disparate source systems and provisions them for analytical use.
The important distinction is that data warehouses are designed to handle analytics required for improving quality and costs in the new healthcare environment. A transactional database, like an EHR, doesn’t lend itself to analytics.

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Dennis Schmuland, MD, FAAFP
Sree Chaguturu, MD

Episode Analytics Now Mission Critical as Outcomes Meet Incomes: Partners HealthCare Paves Volume-To-Value Path With Late-Binding Data Warehouse

In this reprint from Microsoft, Dennis Schmuland, MD, FAAFP (Chief Health Strategy Officer, Microsoft US Health & Life Sciences), sits down with Sree Chaguturu, MD (Vice President and Chief Population Health Officer, Partners HealthCare) to learn how Partners HealthCare has prepared for the tipping point of value-based care.

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Steve Barlow
Bryan Hinton

Healthcare Data Warehouse Models Explained

Want to know the best healthcare data warehouse for your organization? You’ll need to start first by modeling the data, because the data model used to build your healthcare enterprise data warehouse (EDW) will have a significant effect on both the time-to-value and the adaptability of your system going forward. Each of the models I describe below bind data at different times in the design process, some earlier, some later. As you’ll see, we believe that binding data later is better. The three approaches are 1) the enterprise data model, 2) the independent data model, and 3) the Health Catalyst Late-Binding™ approach.

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Bobbi Brown, MBA

The Best Solution for Declining Medicare Reimbursements

I am one of the brave souls who takes the time to read the report issued each spring by the Medicare Payment Advisory Commission (Medpac). The report shows the numbers of Medicare beneficiaries and claims are growing; healthcare organizations are increasingly losing money on Medicare; payment increases certainly will not keep pace with declining margins; and Medicare policies will continue to incentivize quality and push providers to assume more risk. But the report also reveals that some healthcare organizations—referred to as “relatively efficient”—are making money from Medicare with an average 2 percent margin. How do you become one of these organizations? And how do you target and counter Medicare trends that impact your business?

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Imran Qureshi

Healthcare Analytics Platform: DOS Delivers the 7 Essential Components

The Data Operating System (DOS™) is a vast data and analytics ecosystem whose laser focus is to rapidly and efficiently improve outcomes across every healthcare domain. DOS is a cornerstone in the foundation for building the future of healthcare analytics. This white paper from Imran Qureshi details the seven capabilities of DOS that combine to unlock data for healthcare improvement:

Acquire
Organize
Standardize
Analyze
Deliver
Orchestrate
Extend

These seven components will reveal how DOS is a data-first system that can extract value from healthcare data and allow leadership and analytics teams to fully develop the insights necessary for health system transformation.

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Imran Qureshi

What Is a Healthcare Data Lake and Why Do You Need One? Imagine a Supermarket

Using a supermarket analogy, this article helps healthcare leaders understand what data lakes are (open reservoirs for vast amounts of data), why they’re essential (they reduce the time and resources required to map data), and how they integrate with three common analytic architectures:

Early-Binding Data Warehouse
Late-Binding Data Warehouse
Map-Reduce Hadoop System

Data lakes are useful parts of all three platforms, but deciding which platform to integrate a data lake with depends heavily on a health system’s resources and infrastructure.
Once understood and appropriately integrated with the optimal analytics platform, data lakes save health systems time, money, and resources by adding structure to data only as use cases arise.

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Dan Lowder

The Healthcare Data Warehouse: Evolved for Today’s Analytics Demands

What do health systems risk when they hold onto an older enterprise data warehouse (EDW) perspective? By thinking about the EDW as a tool for only historic data that’s not highly reliable and can’t support important decisions, organizations miss out on near real-time (NRT) reporting and valuable decision-making resources.
Far from an outdated tool, today’s EDW is capable of meeting rising demands for timely, quality data. Health systems can ensure their EDW reaches its full potential by prioritizing it among their technology and properly supporting it—with the best equipment and human resources. The well maintained EDW is not stuck in the past, but rather, an invaluable tool to move healthcare analytics forward.

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Peter Johnson

A 5-Step Guide for Successful Healthcare Data Warehouse Operations

Starting and sustaining an enterprise data warehouse (EDW) for a sizeable healthcare organization might seem as challenging as, say, forming a new country. While it is an arduous undertaking, there are plenty who have gone before. In this article, one EDW operations manager shares five steps for success:

Start with a Leadership Commitment to Outcomes Improvement
Build the Right Team
Establish Effective Partnerships with IT
Develop Interest and Gain Buy-In
Pivot Toward Maintaining Success

Successfully implementing and sustaining EDW operations is about establishing and managing priorities and understanding the enterprise-wide implications.

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Mark McCourt

Three Must-Haves for Generating Innovation in Healthcare IT

What most often restricts IT innovation at a healthcare organization? It’s not limitations of the tools for innovation (the data infrastructure) or the workforce, but the organizational culture of the health system. A culture that’s too focused on past failed initiatives and their consequences won’t identify opportunities that lead to new ideas. They likely have the right parts for a great idea, but aren’t enabling those parts for innovation.
Organizations can build and environment that fosters innovation in healthcare IT by operating with three principles:

Give teams the freedom to fail.
Remember the adjacent possible.
Leverage organizational networks.

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Bryan Hinton
Sean Stohl

Hadoop in Healthcare: Getting More from Analytics

Healthcare data is positioned for momentous growth as it approaches the parameters of big data. While more data can translate into more informed medical decisions, our ability to leverage this mounting knowledge is only as strong as our data strategy. Hadoop offers the capacity and versatility to meet growing data demands and turn information into actionable insight.
Specific use cases where Hadoop adds value data strategy include:

Archiving
Streaming
Machine learning

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Ann Tinker, MSN, RN

The Top Seven Quick Wins You Get with a Healthcare Data Warehouse

In an industry known for its complex challenges that can take years to overcome, health systems can leverage healthcare data warehouses to generate seven quick wins—reporting and analytics efficiencies that empower healthcare organizations to thrive in a value-based world:

Provides significantly faster access to data.
Improves data-driven decision making.
Enables a data-driven culture.
Provides world class report automation.
Significantly improves data quality and accuracy.
Provides significantly faster product implementation.
Improves data categorization and organization.

Health systems that leverage healthcare data warehouses position themselves to do more than just survive the transition to value-based care; they empower themselves to achieve and sustain long-term outcomes improvement by enabling data-driven decision making based on high quality data.

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Jared Crapo

Evaluating an EHR-Centric vs Data Warehouse-Centric Analytics Strategy: Seven Points to Ponder

Too much is at stake in value-based healthcare and the technology needed to provide it. When it comes to investing in the best healthcare analytics tools for delivering data-driven care management and outcomes improvement, executives should compare these seven points to determine whether an electronic health record or an enterprise data warehouse should be the foundation of their analytics platform:

Incorporating data from a wide range of sources
Ease of reporting
The data mart concept
Relevance of each to value-based care
Relevance of each to managing population health
Surfacing results of sophisticated analysis for physicians at the right time
Ability to combine best practices, data, and technology tools into a system of improvement

This executive report starts by examining the origin of EHRs and EDWs, then dives into the value derived from both in terms of their contributions to the major issues impacting healthcare delivery today.

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Eric Just

Questions You Should Ask When Selecting a Healthcare Analytics Platform

As vice president of technology for a healthcare IT company, I’m often asked what should be considered when selecting a solution for healthcare analytics. Healthcare organizations have many choices when selecting a healthcare data warehouse and analytics platforms. I advise them to consider the following fundamental criteria: 1) time-to-value (measured in months, not years), 2) experience as a predictor of future success, and 3) extensibility to meet your needs.

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Matt Unwin

Early- vs. Late-Binding Speed: Which Is the Faster Data Warehouse?

Which is a faster data-warehousing model, early-binding or late-binding? Skipping the suspense, the late-binding approach is the speedier option. Binding has to do with how data is modeled within the EDW. Early-binding requires business rules to be set up early in the analysis process. This means early-binding isn’t very flexible or adaptable to changes. On the other hand, the late-binding approach is all about speed and flexibility. Business rule decisions can happen at the last moment, right when the analysis takes place.

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Jared Crapo

Data Lake vs. Data Warehouse: Which is Right for Healthcare?

The data lake style of a data warehouse architecture is a flexible alternative to a traditional data warehouse. It allows for unstructured data. When a warehousing approach requires that the data be in a structured format, there are constraints on the analyses that can be performed because not all of the data can be structured early. The data lake concept is very similar to our Late-Binding approach in that data lakes are our source marts. We increase the efficiency and effectiveness of these through: 1. Metadata, 2. Source Mart Designer, and 3. Subject Area Mart Designer.

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Mike Doyle

Early- or Late-binding Approaches to Healthcare Data Warehousing: Which Is Better for You?

Most industries use enterprise data warehouses (EDWs) to create meaningful analytics on their operations and processes. Healthcare has long struggled with implementing and maintaining EDWs. One reason for this is that a lot of the data healthcare uses is unstructured, meaning there are few to no restrictions on it. And this unstructured data can exist in several systems within the organization. Additionally, health systems must pull data from many sources, such as EMRs, financial systems, and patient satisfaction data. The early-binding approach to data warehousing makes the binding decisions early in the process and, thus, lacks the agility healthcare needs to respond to ever-changing business rules and requirements. This approach can also take a long time to implement. Late-binding data warehousing has a much faster time-to-value and allows users to create analytics based on what-if scenarios. Plus, it can change to reflect the always-moving world of healthcare analytics needs.

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David Burton, MD

Data Management and Healthcare: Why Databases and EMRs Don’t Make the Cut on Their Own

Healthcare organizations preparing for the value-based payment model shift have found their internal resources pushed to the limit. Often, in an attempt to address regulatory timetables, systems will use point solutions rather than move toward a long-term strategy of developing robust clinical analytics. If an organization is using their EHR for analytics, they will soon discover that these built-in analytics packages cannot help them identify opportunities for cost effectiveness and clinical best practices. Sophisticated data management and healthcare analytics solutions, however, can provide leaders with the integrated clinical, financial, and patient satisfaction data they need to transform their systems into data-driven enterprises.

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Steve Barlow

6 Reasons Why Healthcare Data Warehouses Fail

It’s no secret that the failure rate of data warehouses across all industries is high – Gartner once estimated as many as 50 percent of data warehouse projects would have only limited acceptance or fail entirely. So what makes the difference between a healthcare data warehouse project that fails and one that succeeds? As a former co-founder of HDWA, Steve details six common reasons: 1) a solid business imperative is missing, 2) executive sponsorship and engagement is weak or non-existent., 3) frontline healthcare information users are not involved from start to finish, 4) boil-the-ocean syndrome takes over, 5) the ideal trumps reality, and 6) worrying about getting governance “perfect” immobilizes the project.

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