TOPIC 2: CLINICAL DATA WAREHOUSES

Learning Objectives
At the end of this topic, the students will be able to:
✓ Discuss the basic concepts of clinical data warehouse
✓ Explain the differences between clinical data repository and data warehouse

The confusion between clinical data repositories mentioned above and data
warehouse is quite frequent. Well, the two concepts are similar, but they are not identical.
In this this section we will be discussing later. Clinical data warehouse or data warehouse
is repositories of information from clinical, and sometimes research, records from a single
organization, such as a care provider or a payer designed for query and analysis rather
than for transaction processing This serves as storage for retrospective analysis and
reporting of aggregate views of the clinical, operational, and financial performance of the
enterprise. It contains a subset of the clinical data as well as the operational and financial
data of the enterprise and is focused primarily on administrative, managerial, and
executive decision-making.
Unlike, CDR, data warehouse has a high level of integration to allow very flexible
queries of its content. It has the ability to de-identify queried data, or to allow query for
frequencies of records and enables data access by having data at one place from several
sources, linked together, and easily searchable. A data warehouse is designed by
integrating data from multiple heterogeneous sources, shown in the figure below, which
support analytical reporting, structured and/or ad hoc queries, and decision-making. Data
management includes data maintenance, data integration, and data consolidation. It
includes an extraction, transportation, transformation, and loading (ETL) solution, an
online analytical processing (OLAP) engine, client analysis tools, and other applications
that manage the process of gathering data and delivering it to business users.

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 Data Warehouse Basic Architecture
Source: https://docs.oracle.com/cd/B10500_01/server.920/a96520/concept.htm

The table below compares clinical data repositories from data warehouse.

CLINICAL DATA REPOSITORIES DATA WAREHOUSES

Detail-oriented-focused on the individual
patient
Users can read and write to the database
Real-time updates from operational
systems
Aggregated data summarized to decision-
making level(s); example: executive
information system or key performance
indicator report card
Nonvolatile-read only access to data
Updated periodically (static) by operational
systems

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 Normalized data; no redundant data
Integrates clinical data
Stores data in its most current updated
form
Data is fed from clinical systems
Source: © FCG 1998
Denormalized data is often included;
redundancy of data
Integrates operational, clinical, and financial
data
Time variant-stores data and time, dates;
allows trending
Data is fed from clinical, financial, and
administrative systems

Data Warehouse architecture is generally based on a Relational Database System

Management Server which functions as the central repository for information data. This
central repository of information is surrounded by several key components designed to
make the entire environment usable, manageable, and available by both the operating
systems that bring data into the warehouse and the end-users query and analysis tools.
Therefore, the application of clinical data warehouse can be efficient in producing
valuable information on patient care aspects to promote budgeting, planning, testing,
process development, public monitoring, benchmarking, and trend analysis, as well as in
facilitating the decisions required to avoid the disease's occurrence or emergence
associated with preserving population health.

Question#4. Answer the questions below based on your current understanding

on data warehouse.

What are the important elements of clinical data warehouses?

What are the similarities between clinical data repositories and clinical data warehouse?

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SUMMARY

▪ A clinical data repository (CDR) collects, assembles and stores data from different
clinical sources over time. It permits health care professionals to examine trends
in utilization and outcomes and also perform sophisticated quality assurance and
medical management queries independent from the systems that collect the data.
▪ Integration structure may be different for laboratory, radiology and pharmacy
department.
▪ There are six different types of CDR which include study, HER, registry,
warehouse, collection and federation.
▪ In contrast to CDR, clinical data warehouse is subset of the clinical data that is
focused primarily on administrative, managerial, and executive decision-making.

REFERENCES

1. Calano, R. B. and Del Rio, F. R. (2017). HEALTH INFORMATICS (An Illustrative

Approach). First Edition). APD EDUCATIONAL PUBLISHING HOUSE, Malabon.
2. Ebuen, B. U. et. al. (2019). HEALTH INFORMATION SYSTEM for MEDICAL
LABORATORY SCIENCE. C & E Publishing, Inc. Quezon City.
3. Wade T. D. (2014). Traits and types of health data repositories. Health information
science and systems, 2, 4. https://doi.org/10.1186/2047-2501-2-4. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340801/
4. Min L, Liu J, Lu X, Duan H, Qiao Q. An Implementation of Clinical Data Repository
with openEHR Approach: From Data Modeling to Architecture. Stud Health
Technol Inform. 2016;227:100–105. Retrieved from
https://pubmed.ncbi.nlm.nih.gov/27440296/
5. Campbell, T. (2014). Clinical Data Repository Versus a Data Warehouse — Which
Do You Need? Enterprise Data Warehouse / Data Operating system. Health
Catalyst. Retrieved from https://www.healthcatalyst.com/insights/clinical-data-
repository-data-warehouse
6. Min, Lingtong & Liu, Juanjian & Lu, Xudong & Duan, Huilong & Qiao, Qingzhi.
(2016). An Implementation of Clinical Data Repository with openEHR Approach:
From Data Modeling to Architecture. Studies in health technology and informatics.
227. 100-5. Retrieved from
https://www.researchgate.net/publication/323104629_An_Implementation_of_Cli
nical_Data_Repository_with_openEHR_Approach_From_Data_Modeling_to_Arc
hitecture/citation/download
7. Altman M. (2007). The clinical data repository: a challenge to medical student
education. Journal of the American Medical Informatics Association : JAMIA,
14(6), 697–699. https://doi.org/10.1197/jamia.M2483 . Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2213489/

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 LEARNING FEEDBACK

NAME: DATE:
COURSE/YEAR/SECTION: SCORE:
SCHEDULE:

Activity 5
CLINICAL DATA REPOSITORIES

Instruction: Answer the following questions briefly but concisely.

Question#5. List three most common available information in a CDR and give some
example for each?

Question#6. What is the importance of the graphical representation feature of a CDR in

helping the physician carry out their task more effectively?

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Question#7. Discuss the different repository types in the CDR. Cite some examples.

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Question#8. Name at least five (5) common information in the CDR and explain the
importance of the information in the smooth flow of procedures inside the hospital.

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 REFLECTION

Reflect on the concepts and ideas that have just been introduced, make connections to prior
knowledge or experience, and seek clarification.
Questions include:
▪ I changed my attitude about

▪ I am more aware of

▪ I was surprised about

▪ I felt

▪ I relate it to

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