Enterprise Wide Meta Data...
Transcript of Enterprise Wide Meta Data...
Version: 30.10.2012 Dokument/Ersteller: Version: E. Flamme
A individual Story how to handle Big DataKlinikum Wels-Grieskirchen / Austria
01.11.2012Healthcare World Oslo
E. FlammeStrategic CIO
Enterprise Wide Meta Data Archive
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Where ist Wels located ?
Population County Districts Wels / Grieskirchen = 300.000Population Upper Austria Federal State = 1.400.000Population Austria = 8.000.000
Center of Austria
LinzWels
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Facts about Klinikum Fraternity Kreuzschwestern and Klinikum Wels Grieskirchen
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Fraternity „Kreuzschwestern“ / Partner Enterprises
Healthcare Public and PrivateHealthcare Education / Prevention
Nursing Homes / KindergartenTechnical Hospital Services
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Hospital GrieskirchenLocation Grieskirchen
• Since January 2008: One hospital on four sites• 1000 bed Hospital in Wels merged with 260 bed
Hospital in Grieskirchen and 60 bed Psychiatric Hospital in Wels
• 1.349 beds with over 80.000 inpatients per year• 37 departments, 26 different specialities
• 37 outpatient departments with approx. 290.000 outpatient visits /yr
• 30.000 operations and 2.600 births per year• Number of staff is 3.800 (including 500 doctors
and 1200 nurses)• Budget: approx. 288 million Euro
The largest Convent Hospital in Austria5th largest Hospital in Austria
Facts about Klinikum Wels – GrieskirchenA Cooperation of Fraternities Kreuzschwestern / Fran ziskanerinnen
Private Clinic PKALocation Wels
Psychiatric ClinicLocation Wels
Main Clinic Wels-GrieskirchenLocation Wels
Main ClinicWels-GrieskirchenLocation Grieskirchen
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• Since 2003 Developing Partnership with Siemens• SOARIAN Clinical Beta Side• SOARIAN Physician Letter / Emergency Department Moduls
• Evaluating, Improving and Developing Healthcare Sol utions together with X-tention and other Partners (HDS, CISCO)• eMEDIC (Medication Documentation and Reconciliation Tool)• MDES (CISCO Tiani IHE compatible eHealth Solution• eMIND – Healthcare Meta Data Archive as HCR with HDS
• Pilot Site for Public Healthcare Solutions• eMedication Austria / epSOS• Integration in the Upper Austrian eHealth Infrastructure (Pre National Pilot)
Klinikum Wels – Grieskirchen / XT Partnership – Sucse ss in Healthcare IT
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• Three data centers • One high availability data center (200qm) / Second with 180qm) – 80qm
separated and dedicated for X-tention and X-tention customers. • Backup Location (inside) and 60 miles away.
• 2.500 Clients• >100 Mobile Devices (iPAD on to clinical Tablets)
• > 500 servers (60% virtualized)• VMWare Products (Vsphere, LabManager, ….)
• Network Environment• CISCO SAN / LAN / WLAN
• HDS Enterprise Storage Environment• Hitachi Enterprise Solutions (Storage and Solutions)• NEXSAN S-ATA / SAS Beast (Dual Vendor Strategy Low Cost)• Falconstore VTL / Deduplication
Klinikum Wels Grieskirchen Infrastructure
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Healthcare Challenges for the next decades
Data out of Admin or HIS Systems
Data out of Modalities and other Healthcare-
provider
Additional Information Personal Training
Life ScienceWellness
Detailed (Genetic) and Epidemical and
Forensically correlations
Information about health related quality
of life
Treatment
Maintenance ofgoodHealthiness
Healing
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Challenges for Healthcare IT in Austria in the next years
Government's Expectations:• Cutting Costs• Centralization of IT Services and Providers • Collaboration between the different Health Care Providers
User / Clinician / Healthcare Professionals Expecta tions:• Data Exchange and Collaboration Support for Clinical • Integration of new User Interfaces and new Devices
including new integrations Strategies (BYOD / CLOUD ) )• Integration of new Software Platforms / User Interfaces
similar to „Apps“ / similar to Social Networks• Decision Support and integrated Knowledge
Management• Medical Platforms similar to social Networks as
(personal) PHR assentivs or part of a CRM Strategy
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The World of Heathcare Data is growing up ………………
from „birth“ to „death“
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From a large Number of Data
only a few documents are important
in a specific Situation
Our Challenge: Presenting Information
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Essential: “Data Suppliers” meets “Content Consumers”
• Main Data Suppliers in Healthcare are GP, Hospitals, Nursing Homes and HomeCare
• Main Consumers of Healthcare Information's are Healthcare Providers, Insurances, Science and Research
• Every Healthcare Employees and every Healthcare Consumer needs Application and Devices which offers him information:
• At the right time• At the right place• In the right context• At the right role
• An NEW: The Patient himself will be OWNER and CONSU MER of relevant Healthcare Data (PHR)
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Starting thinking about a (clinical) Meta Data Repository
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• Status Quo : Starting with PACS and a non DICOM Archive we needed additional archive solutions for SAP Digital Receipt Management, eHealth Repository, Email, Share Portal Server …..
• CEO Order: Look for a vendor who supports most of the our requirements !
• Considerations: Which vendor delivers most of our requirements and can help migrate from our previous archives?
We decided not to do so !
Looking for Solutions
What happens in five years ? Will we do this again, again and again ?
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1. Challenge: Avoiding Data Overload
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• Accessing and Presenting data in different context cases for patient treatment, science and education
• Considering Commercial interests (prevention rather than cure / medical trial evaluations / managerial decisions)
• Prepared to Support decision support systems with data
Meta Data Repository - A base for semantic networks solution soffering information for all Users in the right time, the rig ht placeand in the right context (Clinical / Administration / Busine ss)
2. Challenge: Stop Data Grave Yard
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An Archive or Repository should not become a graveyard for da ta, information andknowledge
• Consolidation of the different archives, archive technologies, archivvendors
• Content archiving in one plattform forcommon access
• Avoiding permanent Data Migration producing or losing Data andInformation
3. Challenge: Delivering Data
• Compliance with meetings legal retention periods for data
• IHE compliance for health portals and health data exchange
• Data “Independence” – avoid migrations, yet easy to access
• Readiness for a “digital memory” of a hospital and a regional healthcare record
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From “unstructered Data” to “structured Information
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Our Vision
Adm. / ERP
System(HR, FI, CO, DW,
MM)
eHealth
GP Portal
Home Care Portal
Upper Austria
n eHealt
h Conne
ct
Clinicals / SchedulingClinical Information Systems
EHR / CPOE / PoC / ED
PACSLaboratory 3rd Party Departmental’ / Subsystems
Self-develop-
mentproducts
MedicationCoding
Displaying Information / Content in new Context
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What we understand under “Content” Services ?
• The knowledge to convert information into Standards and structured Information (like CDA).
• The knowledge to extract (Custom) Meta Data from structured Information.
• The knowledge to offer Custom Meta Data to Applications like “Snomed” or “.Dr. Watson” to display information in individualized views based on roles, events and different point of care.
• The knowledge to offer “Patient Safety Systems ” like Medication reconciliation Applications additional information.
• The possibilities to combine every object information under a knew Question.
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If you are Master of the Data (like a regional IHE repositories) you have under restriction of law and data privacy a lot of possibilities to develop Services around Content
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A clinical meta data repository needs high-availabl ity, flexible storage and content-based Platforms that a re…..
“Open” for Standards
• HL7• CDA• DICOM• PDF (PDF-A)• HTML• XML• XLS
“Open” for Access
• Enterprise Search Engine
• API-free Ingest from Multiple Sources
“Open” for Data
• Object Oriented
• System Meta Data
• Custom Meta Data
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Our Concept
“Meta Data Robot” analyzes and prepares data
Source systems exports data via standard interfaces
Hitachi Content Platform
Automaticextraction
and adding meta data information
Storing as Object (HL7 message /
PDF-A, DICOM, CDA)
API delivers result back to the Apps.
Target system inbound
Using API for Query
Source systems or Semantic Network Applications
• Meta Data Structure• Analyzing all enterprise document types (clinical/
office documents)• Analyzing the content of all documents• Analyzing the possible different levels for
information (equal content / different content)
Preparing Meta Data
Applications• Chose application which provides
extracting Meta Data � otherwhile usethe HCP Standard Features
Classification• Defining document categories• Defining rules and regulations• Choosing standards for automatic
classification of documents types and automatic content filtering
Consider your enterprise Architecture
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Example: Defining CDA Level 2 Document
Custom Meta Daten:Department / SpecialityInformation
Custom Meta DataSections
Custom Meta Daten:Diagnosis / Coding
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Example: RIS / PACS – DICOM / DICOM Header
Custom Meta Daten:DICOM Header + RIS Result Text
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Clinicals / SchedulingClinical Information Systems
EHR / CPOE / PoC / ED
Clinical User
Other Source Systems
Output Input
Access and Display via HIS System / Special Viewer Software
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One Repository for All (Meta) Data
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eMind
Master Index Specialised Indices
PACS
Kernel
Documents
IHE
HCP Lucene IHE-RegistryAIM
MetadataPACS-MD
DICOM-Header-Data
eMind-Metadata
IHE-Metadata
Documents
PACS-ApplicationIHE-
ApplicationKIS ISH
AIM
HDDS
StandardConnectors
Spe
cial
ised
Con
nect
ors
Whatever
WardApplication
Whatever˅
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HIS EHR Portal
Syndedra View
Microbiology
Radiology
User View
Pathology
…………..
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One Archiv, One Viewer for diff. Sources, diff. Appl.
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Search resultvia Meta Data on CDA Level 2
GP Portal ViewIHE Application
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Different Applications – Common View – One Archive
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Example: Phrase Search: „Duodenalschleimhautbiopsien“Expected Result: Pathology Results / Documents
CDA Level 2 Pathology DocumentDoc
umen
ts w
ith th
is P
hras
e
Search
Example for eMIND
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eMIND / HCR Document / Project Status
15 diff. Source Systems
500 diff. Documenttypes1.2 Mill Documents / Objectsexpected End of 2012….Physician Letter, LIS, Assesments, ECG ….
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Summary
Content Search / Forensic Search- Search over all (Custom) Meta Data (not on Object / Document)- Search for Phrases / Expressions- Including Objects (Pictures) which includes Expression and Phrases as
Custom Meta Data
Clinical Search- Real Time Search (depends from Transfer Time)- Search over PID (all Documents)
- Including Merges- Custom Meta Data Changes
- (including SAP Patient Reciepts � PID)
Administrative Search- SAP ERP / HR Documents- (later: Email)- (later: SharePoint)- (later: FileServer)
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Summary
Storing- Every (TextBased) Information is stored as CDA Level 2 Document- Every Information is stored as Orignal Information (HL7, TXT, …..)- Every (TextBased Information is stored as PDF-A- Meta Data can be changed / updated (without impact to orginal object)
Display- Every Stored Information can be displayed by
- XML Viewer (CDA-L2)- DICOM / NonDICOM Picture Viewer- PDF Viewer
Restoring- Every Information which is needed for Restoring is saved inside the Custom
Meta Data- No DataBase is needed – Only XML Tools for Reading Custom Meta Data
(TXT)
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Long Term Project (5 – 10 – 15 years)
• Building an enterprise-wide meta data repository needs a lot of preparation inside the enterprise organizations (Document Management, Standardization).
• Consider short-term requirements: A meta data repository can not substitute archive application solutions and most of the existing clinical and administration software is simply not ready for meta data yet.
• IHE is a key feature for improving patient treatment with the standardization based on IHE Profiles, CDA – clinical document architecture etc. With standardization you can extract META DATA Information.
• Greater flexibility and cost effectiveness: Having stored data in a generic way you are independent from migration timelines and costs. Change applications as and when needed for user acceptance and improving your processes.
• Implementing a Qualitiy Process for Data (similar to “Data Analyst”)
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Contact
Strategic CIOE. FlammeKlinikum Wels – Grieskirchen A-4600 Wels, Grieskirchner Straße 42
Tel: + 43 / (0) 7242 / 415 – 9 - 3220, Fax: DW – 3774 / Mobil: + 43 / (0) 699 / 14163220
E-Mail: [email protected]: www.klinikum-wegr.at