Evolution of Data Access Capabilities at Penn Medicine
Financial DW
EPIC
- Common Ambulatory Applications
DAC
- Centralized Data Access Team
EPIC - Fully Integrated EMR
PDS
- Aggregate Patient Data into EDW
PennOmics
- Research Data Warehouse
PennSeek
- Search and Discovery of Clinical Notes
Executive Analytics Governance
Executive Analytics Prioritization
EPIC Caboodle
- Integrated EMR DW
EPIC Cosmos
– Research Network
Integrate Phenotype and Genotype Data
Penn Data Lake
Common Dashboards for Ambulatory KPI’s
Specialized Datamarts and Dashboards
CCH and Practices
Enterprise Registries and Alerts
Integrate External Claims Data
Pathways of Care
Consolidate EMR
Expand Population Health &
Value Based Care
Consolidate and Expand
Data Access Resources
Princeton Medical Center
Data Access Capabilities
TriNetX
- Research Network Facilitating Clinical Trial Recruitment
Consolidated Data Access Requests Across Organization
Analytics Self-Service Storefront
Timeline of Data Access Capabilities at Penn Medicine
Data Analytics/Access Center (DAC)
shared enterprise resource
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Data analysis and visualization (reports, dashboards), registries
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19 Information analysts/report developers (3 leads), Scrum masters
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Data Analytics/Access Center (DAC)
https://www.med.upenn.edu/dac
DAC Strategic Initiatives FY2018
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Epic Caboodle
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Analytics Operational Store
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Consolidate data visualization solutions
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Reevaluate data mining and discovery tools
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New research platform
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Collaborative relationships (IBI, PennChart team, CV service line, CPUP
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PennChart Analytics team
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Educational outreach
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Staff training: Epic, domain knowledge, data science, cloud, new technologies
visits
scheduling
patient
flow
provider
Info
orders
Rx
demographics
procedures
coded
diagnoses
problem list
history
notes
MAR
POC
services
pathology
reports
endoscopy
reports
ECG
reports
labs
cath
reports
electrophys
reports
PeriOP
hosp. acq.
infections
echo
reports
anesthesia
patient
surveys
geolocation
CTMS
SSA
DMF
allergies
tumor stage
and grade
oncology
infusion
genomic
data
hospital &
prof. billing
external
claims
vaccinations
flowsheets
Data Available Through Epic Clarity and/or PDS
blood
bank
RadOnc
labor &
delivery
radiology
reports
transplant
general
ledger
other
financial
Data Access & Analytics Governance
Data Access Request Types
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Provision mode: reports, self-service applications
(PennOmics)
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All approved elements of PHI
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Provision mode: data files, self-service applications
(PennSeek, PennOmics)
Clinical Care, Operations & QI Support
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(interactive) visualization of quality and performance
metrics
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Universe – semantic layer that interprets raw data through
business rules, created for general purpose analysis or to
drive focused analysis applications
WebI – reporting tool used to display data from Universes
Internal Penn Registries in PennChart
www.med.upenn.edu/dac/registries
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Research Request Process
DAC Data Request Form
Covered Entity
- only Penn Medicine staff allowed to see PHI without legal
contract
- third parties may see de-identified data, and are required to
sign Data Use Agreement (DUA)
PennOmics
https://pennomics.med.upenn.edu
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Cohort Explorer /
Translational
Research Center
(TRC)
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Oracle Healthcare
DW Foundation
(HDWF)
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Healthcare Data
Model (HDM)
•
Omics database
(ODB)
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Cohort Data Mart
(CDM)
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Oracle Healthcare
Analytics Data
Integration (OHADI)
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Oracle Data
Integrator (ODI)
PennOmics - Data Flow
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PennSeek
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Based on Oracle Endeca
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Intuitive e-shopping-like user interface
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Reduces data sourcing burden
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Reduces data abstraction turnaround by up to 80%
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Inspires unanticipated questions
PennSeek - User Interface
PennSeek - Guided Navigation
PennSeek - Search Terms Highlighted in Context
TriNetX
https://live.trinetx.com
•
Global research network: 11 countries, 100M patients, ~70
HCOs (e.g. Penn, TJ, Drexel, Temple, Penn State)
•
Over 50% of CTSA program hub sites use TNX
•
Optimizes / lowers cost / speeds up clinical research design
and patient recruitment
•
Value to participants:
•
Attract sponsored studies from pharma and CROs, by finding and
recruiting patients that match protocol criteria
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Free-of-charge (TNX provides servers)
•
Design protocols with inclusion and exclusion criteria
TriNetX
https://live.trinetx.com
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DAC contacts
•
Custom Reporting
–
Info:
http://www.med.upenn.edu/dac/about-reporting.html
–
Requests:
http://www.med.upenn.edu/dac/data-request.html
–
Support:
yuliya.borovskiy@pennmedicine.upenn.edu
–
Open Office: Tuesdays 1-4pm (schedule at least week before)
•
PennOmics
–
Info:
www.med.upenn.edu/dac/cohort-explorer.html
–
Training:
https://performancemanager4.successfactors.com/sf/learning?company=71508P&_s.crb=Pr1juTwaOuTClazXhmXHVWiU85I%253d
–
Owner:
nebojsa.mirkovic@
pennmedicine
.upenn.edu
–
Support:
patrick.sullivan@
pennmedicine
.upenn.edu
•
PennSeek
–
Info:
www.med.upenn.edu/dac/pennseek.html
–
Owner:
nithya.seshadri@
pennmedicine
.upenn.edu
–
Support:
pennseek@uphs.upenn.edu
Penn Medicine has expanded its data access capabilities over the years through various initiatives like EPIC Cosmos Research Network, Penn Data Lake, DAC, and more. The Data Analytics/Access Center (DAC) plays a crucial role in managing enterprise resources, data architecture, development, reporting, and research analytics. Strategic initiatives focus on technology enhancements, collaboration, staff training, and educational outreach to optimize data utilization and maximize insights for improved healthcare delivery.
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Timeline of Data Access Capabilities at Penn Medicine Expand Population Health & Value Based Care EPIC Cosmos Research Network Penn Data Lake EPIC Caboodle - Integrated EMR DW Data Access Capabilities Analytics Self-Service Storefront Princeton Medical Center Pathways of Care Consolidate EMR Executive Analytics Prioritization Enterprise Registries and Alerts EPIC - Fully Integrated EMR Common Dashboards for Ambulatory KPI s Consolidated Data Access Requests Across Organization Integrate External Claims Data Consolidate and Expand Data Access Resources CCH and Practices TriNetX - Research Network Facilitating Clinical Trial Recruitment Integrate Phenotype and Genotype Data PennOmics - Research Data Warehouse Executive Analytics Governance PennSeek - Search and Discovery of Clinical Notes DAC - Centralized Data Access Team Specialized Datamarts and Dashboards PDS - Aggregate Patient Data into EDW EPIC - Common Ambulatory Applications Financial DW 2005 2009 2020 2015 2012 2014 2018 2019 2011 2013 2017 2010 2016 1
Data Analytics/Access Center (DAC) shared enterprise resource Patrick Farrell, Senior Director Nebo Mirkovic, Associate Director 1 Enterprise Data Architect; 1 Solutions Architect Data Architecture & Development Team Data warehousing (SQL, HANA , Hadoop), models, marts, feeds Brent Moore, Senior Manager 4 Data Architects, 14 Data Engineers Reporting & Research Analytics Team Data analysis and visualization (reports, dashboards), registries Liat Shimoni, Senior Manager 19 Information analysts/report developers (3 leads), Scrum masters Product Development & OptimizationTeam Long-term solutions, application implementation and ownership Amy Trenton, Business Manager; Jesse Zlatsin, Manager 4 Product owners, 2 Dev-Ops analysts, 2 Dev-ops engineers 2
Data Analytics/Access Center (DAC) https://www.med.upenn.edu/dac 3
DAC Strategic Initiatives FY2018 Technology Focus Epic Caboodle Analytics Operational Store Consolidate data visualization solutions Reevaluate data mining and discovery tools New research platform People Focus Collaborative relationships (IBI, PennChart team, CV service line, CPUP Operations, Professional billing office, etc.) PennChart Analytics team Educational outreach Staff training: Epic, domain knowledge, data science, cloud, new technologies 4
Data Available Through Epic Clarity and/or PDS provider Info orders allergies visits scheduling procedures demographics Rx coded MAR problem list history notes flowsheets vaccinations diagnoses blood bank POC radiology reports pathology reports endoscopy reports ECG reports labs services echo reports cath electrophys reports patient flow hosp. acq. infections RadOnc CTMS reports labor & delivery patient surveys SSA DMF transplant anesthesia PeriOP geolocation oncology infusion genomic data hospital & prof. billing general ledger external claims other tumor stage and grade financial 5
Data Access & Analytics Governance Strategic Direction Review with Executive Leadership (Bi-Monthly) Prioritization of Data Access with Executive Leadership (Monthly) Stewardship of Domain Data and Metric Definitions Hospital operations, ambulatory, finance, QI, research Data Dashboard & Reporting Governance Stewardship and education related to data visualization Architecture Stewardship of technologies enabling data access and analytics 6
Data Access Request Types Clinical Care, Operations, Quality Improvement All necessary information Provision mode: reports, dashboards, data files Preparatory Research Aggregates, counts Provision mode: reports, self-service applications (PennOmics) IRB Approved Protocols All approved elements of PHI Provision mode: data files, self-service applications (PennSeek, PennOmics) 7
Clinical Care, Operations & QI Support Dashboards (interactive) visualization of quality and performance metrics PennChart Internal Registries cohorts of Penn patients and metrics related to them SAP Universes & Web-Intelligence Universe semantic layer that interprets raw data through business rules, created for general purpose analysis or to drive focused analysis applications WebI reporting tool used to display data from Universes 8
Internal Penn Registries in PennChart www.med.upenn.edu/dac/registries ACTIVE Collaborative Care Behavioral Health Cancer (P Gabriel) ESS/Trauma Interstitial Lung Disease (M Porteous) Irritable Bowel Disease (C Klock) Major Lower Joint Replacement(J Piscitello E Hume) Medicare Advantage (JT Howell) Opioid Therapy (M Ashburn) Princeton Horizon (T Fisch) Sickle Cell (D Christopher) Stroke (L Leibowitz) Superutilizers (JT Howell, S Honeywell) UPHS IBC Warranty (G Kruse, C Vanzandbergen) UPHS Inpatient Readmission ACO (JT Howell) ACS NSQIP (S Diem) Adult HIV (A Norris) Anesthesia Record Asthma (A Apter) Case Management Chronic Care Management (JT Howell) Congestive Heart Failure (L Goldberg) COPD (M Sims) Coronary Artery Disease Diabetes (M Schutta) Emergency Encounters (C Edwards) Hypertension (R Townsend) Osteoporosis Wellness Registry-All (JT Howell) Build In Progress: CPC+, MBSAQIP Build Planned: Roster Management, ICU, ICU-Sepsis (sub), Penn Metabolic Medicine, Heart Safe Motherhood, ACS NSQIP, ACS TransQIP, Active Patients 9
Research Request Process Obtain IRB Approval (if applicable) Complete request form (initial requirements) Report Request Compliance Review Interactive finalization of specifications Finalize Requirements Initial report development and delivery Refinement as needed Development/ Delivery 10
Covered Entity - only Penn Medicine staff allowed to see PHI without legal contract - third parties may see de-identified data, and are required to sign Data Use Agreement (DUA) 12
PennOmics https://pennomics.med.upenn.edu Components: Cohort Explorer / Translational Research Center (TRC) Oracle Healthcare DW Foundation (HDWF) Healthcare Data Model (HDM) Omics database (ODB) Cohort Data Mart (CDM) Oracle Healthcare Analytics Data Integration (OHADI) Oracle Data Integrator (ODI) 13
PennOmics - Data Flow Clinical Data Cohort Explorer Tumor Registry EHR CTMS PennOmics Oracle Healthcare Data Warehouse Genomic Data Center for Personalized Diagnostics API Access Internal Research Labs Reference Datasets 14
PennOmics - Data Classes Data class Data Since Patients 2005 Encounters 2008 Medications 2008 Diagnosis 2008 Procedures 2008 Labs, microbiology 2008 MAR 2008 Vitals 2011 Tumor Stage & Grade 2010 Studies 2001 Clinical Genomics (CPD, PMBB) 2013 Research Genomics (CNDR) Various 15
PennSeek Based on Oracle Endeca Intuitive e-shopping-like user interface Reduces data sourcing burden Reduces data abstraction turnaround by up to 80% Inspires unanticipated questions 16
TriNetX https://live.trinetx.com Global research network: 11 countries, 100M patients, ~70 HCOs (e.g. Penn, TJ, Drexel, Temple, Penn State) Over 50% of CTSA program hub sites use TNX Optimizes / lowers cost / speeds up clinical research design and patient recruitment Value to participants: Attract sponsored studies from pharma and CROs, by finding and recruiting patients that match protocol criteria Free-of-charge (TNX provides servers) Design protocols with inclusion and exclusion criteria 20
TriNetX https://live.trinetx.com Penn Data: Demographics, Encounters, Px, Dx, Rx, Labs, Cardiology tests (LVEF, QTc, NYHA), some Vitals, PFT, Tumor Registry data TNX schema can incorporate genomic data Data mapped onto standard vocabularies (HL7, LOINC, NDF- RT, RxNorm, CPT, ICD, ICD-O) Data Security: data stays behind Penn firewall, data de- identified, pharma see only counts (rounded), cannot search by ZIP, HCO sees only own patient-level data 21
Clinical Data Access for PSOM Researchers Access Point Access Type Data Available Time for access prerequisites HIPAA training? CITI training? UPHS account required IRB approval required PennOmics Web dashboard, self-service de-identified clinical data no clinical notes some genomic data (upon request) < 1 week Yes No No No PennSeek Web dashboard, self-service. identifiable clinical data, including free-text notes 7-8 weeks Yes Yes Yes Yes Custom Data Requests Work with UPHS data analyst who retrieves data and provides in desired format. identifiable clinical data >10k tables in EPIC Clarity PDS: subset of EPIC, historical and current non- EPIC 1-2 weeks for simple requests, highly variable for complex requests No No No Yes, unless requesting aggregate or deidentified data Schemas and dictionaries: www.med.upenn.edu/dac/ penn-data-store- warehouse.html 22
DAC contacts Custom Reporting Info: http://www.med.upenn.edu/dac/about-reporting.html Requests: http://www.med.upenn.edu/dac/data-request.html Support: yuliya.borovskiy@pennmedicine.upenn.edu Open Office: Tuesdays 1-4pm (schedule at least week before) PennOmics Info: www.med.upenn.edu/dac/cohort-explorer.html Training: https://performancemanager4.successfactors.com/sf/learning?company=71508P&_s.crb=Pr1juTwaOuTClazXhmXHVWiU85I%253d Owner: nebojsa.mirkovic@pennmedicine.upenn.edu Support: patrick.sullivan@pennmedicine.upenn.edu PennSeek Info: www.med.upenn.edu/dac/pennseek.html Owner: nithya.seshadri@pennmedicine.upenn.edu Support: pennseek@uphs.upenn.edu 23
