Emil Gatus

Student Number
Name of School
LESSON XIII
Lesson 1
1.1 Definition of Vision,
Mission, Goals and
Objectives
CLINICAL DATA REPOSITORIES
1.2 Comparison of Vision
and Mission
1.3 Purpose and Inclusion
of Vision and Mission
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Lesson 7
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 CLINICAL DATA REPOSITORIES

Nowadays, most institutions have existing clinical data repositories (CDR) in electronic or
written format, to represent an aggregated database of clinical information. The repositories
Emil Gatus
Student
usually Number
house a multitude of laboratory results, diagnostic reports, and various clinical
Name of School
documentation. These data are readily searchable and exportable, often because the
Lesson 1
1.1information is gathered from standard clinical care procedures (Robertson and Williams, 2016).
Definition of Vision,
Mission, Goals and
Objectives
1.2 Comparison of Vision
and Mission
The repositories integrate physician-entered data with data from different existing
1.3 Purpose and Inclusion
information systems including laboratory, radiology, admission, and pharmacy. They are places
of Vision and Mission
where
Lesson 2 both clinical data and other data of interest, such as external data sources and financial
Lesson 3
data,
Lesson 4 are assimilated (Carter, 2001).
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Lesson 15
 A clinical data repository can successfully depict the same sample across different points
in time, from varying sources both within and outside the health institution. Common kinds of
available information in the CDR are listed below:
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✔Number
Student Patient Demographics ✔ Immunizations
Name of School
✔ Patient’s Primary Care Provider ✔ Diagnoses
Lesson 1
✔ of Vision,
1.1 Definition Medication List ✔ Procedures
Mission, Goals and
Objectives ✔ Allergies ✔ Laboratory Results
1.2 Comparison of Vision
and Mission✔ Hospital Inpatient Visits ✔ Social History
1.3 Purpose and Inclusion
✔Mission
of Vision and Emergency Department Encounters ✔ Vitals
Lesson 2
Lesson 3 ✔ Outpatient Practice Visits
Lesson 4
Lesson 5
Lesson 6
Lesson 7 Maintaining them poses a lot of advantages since the longitudinal view of a patient’s
Lesson 8
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medical record can assist in improving patient experience, and having information about prior
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test11results and procedures leads to more informed patient care decisions and helps avoid
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redundant treatment.
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 CDR INTEGRATION WITH HIS

Bergeron (2013) describes a clinical data repository as a systematically structured and

gathered “storehouse” of patient-specific data, which is usually mirrored from a clinical
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application,
Student Numberor supplemented with data from other clinical systems. Since it is maintained as a
Name of School
separate database particularly created in aiding decision analysis, the main application avoids
Lesson 1
computational loading, and response time to a query is improved. Moreover, because almost all
1.1 Definition of Vision,
Mission,
simple,Goalscustomized
and or complex patient records are mirrored in it, queries are possible without
Objectives
1.2sacrificing
Comparison of Vision
the performance of the source applications. Furthermore, since the data typically
and Mission
1.3originated
Purpose and Inclusion
from one source with little to no manipulation, near real-time retrieval of clinical data
of Vision and Mission
is possible.
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Lesson 4
Lesson 5 There are different levels of integration in the said repository. These levels depend on
Lesson 6
locations,
Lesson 7 indices, catalogues, semantic translations or equivalences, syntactic structures, and
Lesson 8
links
Lesson 9 to external information. They influence functionality by setting constraints on how easily
Lesson 10
someone
Lesson 11 can make queries for any of the contents. The integration structure from the CDR to
Lesson 12
the13Laboratory Information System, for example, may be different for radiology or pharmacy.
Lesson
Lesson 14
These
Lesson 15 differences might mean that a user may only access certain types of information, and

use particular types of queries from a given information system depending on the restrictions
 The aforementioned restrictions vary in terms of the user’s access. While some CDRs are
fairly open, others are restricted either to employees of an institution or to members of some
research network. Access control to the CDR functions as a safeguard to uphold data security
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and Gatus
integrity.
Student Number
Name of School
Wade (2014) emphasizes that the longitudinal nature of the CDR requires a way of linking
Lesson 1
1.1various
Definition ofobservations
Vision, of the same identified subject. Most repositories usually contain
Mission, Goals and
personally-identified data; however, due to privacy issues, they only release de-identified data
Objectives
1.2 Comparison of Vision
andwhich
Mission can lead to the omission of some data in a dataset. The lack of identifiers could also
1.3 Purpose and Inclusion
prevent
of Vision the linking of data for some patients.
and Mission
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 Table 13.1:Types of clinical data repositories
REPOSITORY TYPE DEFINITION

Study A database that collects observations for a specific clinical research study.
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Electronic Health
A database of observations made as a result of direct health care.
Student
Record Number
Name of School Observations collected and organized for the purpose of studying or guiding particular
Lesson 1
Registry outcomes on a defined population. Associated studies are either multiple or long-term
1.1 Definition of Vision,
Mission, Goals and and evolving over time.
Objectives
1.2 Comparison of Vision A repository that adds levels of integration and quality to the primary (research or
and Mission
Warehouse
1.3 Purpose and Inclusion clinical) data of a single institution, to support flexible queries for multiple uses. Is
of Vision and Mission broader in application than a registry.
Lesson 2
Lesson 3 A library of heterogeneous data sets from more organizations than a warehouse or
Lesson 4
Collection more sources than a registry. Organized to help users find a particular data set, but
Lesson 5
Lesson 6 not to query for data combined across data sets.
Lesson 7
Lesson 8
Lesson 9 A repository distributed across multiple locations, where each location retains control
Lesson 10
Federation over access to its own data, and is responsible for making the data comparable with
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Lesson 12 the data of other locations.
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Lesson 15
 These repositories are beneficial in consolidating patient information, a disadvantage is
that most CDRs are only integrated with clinical data. Laboratory results, diagnoses, and
demographics might be available in one platform, but overall patient satisfaction, the amount of
Emila Gatus
time patient had to wait before being treated, and other information not directly related to his
Student Number
care might
Name be unavailable.
of School
Lesson 1
1.1 Definition of Vision,
Mission, Goals and
Objectives
1.2 Comparison of Vision
and Mission
1.3 Purpose and Inclusion
of Vision and Mission
Lesson 2
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 MULTIPLE VIEWS FOR PATIENT MEDICAL RECORD

Information for patients is typically scattered across multiple subsystems. A clinical

data repository standardizes data from disparate sources into a cohesive format. It
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Student Number
comprises numerous tables which offer a partial view of patient information (Gensinger,
Name of School
2014). Its structure allows data to be extracted along dimensions such as time (by year,
Lesson 1
month,of Vision,
1.1 Definition week, or day), location, or diagnosis. These data can often be accessed in smaller
Mission, Goals and
units within the same dimension.
Objectives
1.2 Comparison of Vision
and Mission
1.3 Purpose and Inclusion
For instance, a user can view the number of patients with a certain type of
of Vision and Mission
diagnosis,
laboratory
Lesson 2 result, or prescription within a year, then a month in that year, and further into a
Lesson 3
day
Lesson 4 in that month. One can also access how many times a particular procedure has been
Lesson 5
performed
Lesson 6 at all locations within a health system, and then see the aggregate amount per
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region
Lesson 8 or per facility. It helps organizations to transform large amounts of information from
Lesson 9
distinct
Lesson 10 transactional files into a unitary decision-support database (Wager, Lee, & Glaser,
Lesson 11
2013).
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 Ball and Douglas (2013) elaborate that a well-deployed clinical repository has
multiple advantages. First advantage is the CDR function to provide longitudinal views
of patient information. It is often organized primarily around patients and secondly
Emil Gatus
around visits or encounters, a method that easily accommodates views that span
Student Number
multiple
Name visits. This allows clinicians to trend and chart results independent of the visits
of School
Lessonand
1 test panel organization. For example, a clinician could study the trend of a patient’s
1.1 Definition of Vision,
blood
Mission, Goals sodium
and levels over the past six months independent of other factors.
Objectives
1.2 Comparison of Vision
and Mission Another advantage is its capability to provide access to information when needed.
1.3 Purpose and Inclusion
Since
of Vision it receives information from a multitude of feeder systems, it can create a
and Mission
Lesson 2
“one-stop shopping” environment. This is done by allowing the clinical staff to access a
Lesson 3
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variety of patient-focused information through a consistent and easy-to-use graphical
Lesson 5
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interface (GUI). The GUI access can be deployed through hand-held devices, bedside
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computing devices, computers in physician’s offices, or computing devices in nursing
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stations. In any case, this wide variety of information access moves far closer to
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deployment of information at the point of care.
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 Finally, CDR provides a cross-continuum view of information, since it allows
information to be gathered and viewed from sources other than an acute setting. This
type of ambulatory-focused information combines with the acute information to give
Emil Gatusa new level of insight into the wellness of their patients.
clinicians
Student Number
Name of School
Lesson 1
1.1 Definition of Vision,
Mission, Goals and
Objectives
1.2 Comparison of Vision
and Mission
1.3 Purpose and Inclusion
of Vision and Mission
Lesson 2
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 DATA VISUALIZATION OF LABORATORY RESULTS AND VITALS

Data collected through an electronic health record system may be retrieved at the request
ofEmil
an authorized
Gatus user, whether a physician, medical technologist, nurse, or radiologist. The
Student Number
electronic health record may present patient care information as text, tables, graphs, sounds,
Name of School
images, full-motion video, or signals on an electronic screen, phone, pager, or paper (Bronzino &
Lesson 1
1.1Peterson, 2014).
Definition of Vision,
Mission, Goals and
Objectives
1.2 Comparison of Vision
and Mission
Unfortunately, analyzing trends and patterns from large data sets can be a challenging
1.3 Purpose and Inclusion
process. This is where data visualization,
of Vision and Mission
the art of representing data in a pictorial or graphical
format,
Lesson 2 becomes useful. It helps in simplifying a wide array of information, and it allows
Lesson 3
decision-makers
Lesson 4 to derive analytical results from the information presented visually. Through
Lesson 5
this,6 correlations, patterns, and trends which might be undetected from text-based clinical data
Lesson
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can8 be revealed and recognized with more ease.
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 For example, the physician can easily review the results of multiple chest x-rays obtained
over the course of months or years when deciding if a nodule has grown. This information
would
Emilnot have been accessible when basing on textual clinical data alone. Moreover, patients
Gatus
Student
sufferingNumber
from specific diseases that require careful charting or monitoring of laboratory values,
Name of School
including anticoagulation or blood sugar values, can understand what is expected in their care
Lesson 1
because
1.1 ofVision,
Definition of better means of data presentation (Figure 13.1). 
Mission, Goals and
Objectives
1.2 Comparison of Vision
 
and Mission
1.3 Purpose and Inclusion
of Vision and Mission
 
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Figure 13.1:Sample Blood Sugar Level Chart
 Visualization of clinical data is increasingly becoming an important tool in
decision-making. The graphical representation feature of most clinical data repositories
enables scenario analysis, which helps users use different kinds of filters in order to change the
EmilofGatus
level information that may be seen. Common filters include age and gender, in order to
Student Number
assess
Name of outcomes
School of certain interventions based on isolating certain factors. This kind of
analysis
Lesson 1 is a good opportunity in empowering the frontline staff by giving them straightforward
1.1 Definition of Vision,
dataGoals
Mission, which
and will efficiently and effectively facilitate the performance of their tasks (Rains &
Objectives
1.2McCuistion, 2018).
Comparison of Vision
and Mission
1.3 Purpose and Inclusion
of Vision and Mission
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 KEY POINTS TO REMEMBER:
✔
EmilClinical
Gatus data repositories (CDR) integrate physician-entered data with data from different
Studentexisting
Number information systems including laboratory, radiology, admission, and pharmacy.
Name of School
✔1 A CDR is a systematically structured and gathered “storehouse” of patient-specific data,
Lesson
1.1 Definition of Vision,
which
Mission, Goals and is usually mirrored from a clinical application, or supplemented with data from
Objectives
other
1.2 Comparison clinical systems.
of Vision
and Mission
1.3 Purpose and Inclusion
✔ and
of Vision Repository
Mission types include study, electronic health record, registry, warehouse, collection
Lesson 2 and federation.
Lesson 3
Lesson 4
✔5
Lesson CDRs offer a cross-continuum view of information since they allow information to be
Lesson 6
Lesson 7 gathered and viewed from sources other than an acute setting.
Lesson 8
Lesson 9
✔10
Lesson Data visualization helps in simplifying a wide array of information, and it allows
Lesson 11
Lesson 12 decision-makers to derive analytical results from information presented visually.
Lesson 13
Lesson 14
Lesson 15
 Emil Gatus
Student Number
Name of School
Lesson 1
1.1 Definition of Vision,
Please take the
Mission, Goals and
Objectives Learning Outcomes Assessment
1.2 Comparison of Vision
and Mission
1.3 Purpose and Inclusion
of Vision and Mission
Lesson 2
Lesson 3
Lesson 4
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