Thursday, December 4, 2008

Northwestern Enterprise Data Warehouse Milestone

In past blogs, I've alluded to the development of our Enterprise Data Warehouse at Northwestern. The "enterprise" is currently inclusive of data content from Northwestern Memorial Hospital (NMH), the Northwestern University Biomedical Informatics Center, and the Northwestern Medical Faculty Foundation (NMFF). In the future, the enterprise will hopefully include Children's Memorial Hospital, the Rehabilitation Institute of Chicago, and our affiliated private physicians.

The EDW project is complicated by the fact that all of these organizations are separate business entities, even though we serve the common mission of Northwestern University's Feinberg School of Medicine. We all report to separate governance bodies, CEOs or the Dean. The EDW project forced us to define new models for collaborating on several levels including joint financing models, human resources management, data security, project oversight and governance, identity management, etc. Data warehouse projects are inherently very political and culturally risky, no matter what the industry or organizational structure involved. I am constantly amazed and pleased at how incredibly smooth this project has progressed. It is a phenomenally positive reflection on the culture of senior leadership, myself excluded from the compliment. Since so many new models and processes were required for the project, we've had to be comfortable with route finding and learning as we progressed. This required each organization to trust one another, significantly, as each took turns leading the climb at one time or another.

The clinical research value and momentum around the EDW is growing. At last count, 36 different research projects have been served with 62 data sets, using a secure, researcher-specific work area on the EDW web portal. The majority of these requests were fulfilled in the last 12 weeks.

Today, the EDW Team released a data set which was emblematic of the "enterprise" potential and capability of the EDW. The data set combined diagnosis data from the NMH case mix system (Primes) and the NMFF EpicCare system; and free-text data from NMH and NMFF lab reports. Another noteworthy milestone in this case-- The lab reports' text data was scrubbed of patient identifiers by an open source software algorithm developed by MIT and modified by our EDW Team for use in our system.

A description of the data set is below; 18,463 patients were in the cohort. The request was prep-to-research from one of our physicians who is investigating mild versus severe cases of the flu. Our newest member of the EDW Team, Nathan Sisterson, was the analyst who programmed the query and the text processing.

"The cohort is defined as: All patients whose text reports in Epic labs match are of a type whose lab name contains “influenza”, starts with “virus” or starts with “respiratory virus”. From this subset, the cohort is narrowed to only patients whose matching lab results contained the phrases “positive for parainfluenza”, “positive for influenza”, “influenza virus isolated”, “positive influenza”, “influenza virus detected”, or “* SD” (which is always accompanied by a number indicating a positive lab result). Patients whose ICD9 codes match 488, V04.81 or 487.x in Epic or Primes are also included."

Too early to celebrate a summit, but this is very exciting stuff at this stage of the EDW project.

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