Introduction to Healthcare Database Design and Management

What is a Database?
An organized collection of logically related data and information, Books, Medical records
Database Management Systems (DBMS)
Software system used to create, maintain, and secure databases
Four Common Functions Any database will support the following operations:
Create, Read, Update, Delete
“CRUD”
Create, Read, Update, Delete
Data
Stored measurements and representations of objects and events
Structured data
Simple, well defined data structures such as characters, numbers, dates
Unstructured data
Complex, loosely defined data structures such as audio, video, images, entire documents
What are examples of structured data in healthcare?
Structured: patient name, address, lab test results
What are examples of unstructured data in healthcare?
Unstructured: ultrasound images, dictation recordings, patient/doctor interactions videos
Information
is data that has been processed to give the user of the data more knowledge, Data with context that makes it useful (gives it meaning)
Metadata
is often referred to as data about data, Gives context to data, Provides characteristics and properties of the data, Equal importance as the data itself
Why collect data and information?
One of the most important resources in any entity today
Aids an organization in understanding itself and its environment in which it operates
Enables an organization to transform or incrementally improve its operations
What is the cost of incorrect data and information in healthcare?
From File to Relational-File Disadvantages
Program-Data Dependence
Duplication of Data
Limited Data Sharing
Lengthy Development Times
Excessive Program Maintenance
From File to Relational-All addressed by the relational model, plus
Enforcement of standards
Improved data quality
Improved access (standardization)
Improved decision support
Costs and Risks
Specialized personnel
Installation and management
Conversion of legacy systems
Backup and recovery
Organizational conflict
Scope of Databases-Different levels for different needs
Personal
Workgroup
Department/Division
Enterprise
Web-enabled
Scope of Databases-Each have their own unique challenges
Personal -> synchronization
Enterprise -> performance
“A clinical data repository (CDR)
is a real-time database that consolidates data from a variety of clinical sources to present a unified view of a single patient. It is optimized to allow clinicians to retrieve data for a single patient rather than to identify a population of patients with common characteristics or to facilitate the management of a specific clinical department. Typical data types which are often found within a CDR include: clinical laboratory test results, patient demographics, pharmacy information, radiology reports and images, pathology reports, hospital admission/discharge/transfer dates, ICD-9 codes, discharge summaries, and progress notes.”