MAHI Research MAHI Research DatabaseDatabase

Project DirectionsProject Directions

June 7, 2001June 7, 2001

Overview of Client RequirementsOverview of Client Requirements

Biostatisticians

IS Patients

Physicians

Management

MAHI Research Database

• Quaterly reports (STS, ACC)• Data to/from external organizations

• General patient data• Simple queries

• Fast & reliable queries• Add new data points

• Efficient data storage• Internal security• Extensibility • Maintenance

Q R A

Change Request/Record Editor

MGenerates user interface using DHTML, ASP

Processing, normalization using ATL, COM, C++

Ad-Hoc Query

ODBC

HL7

SAS

SPSS

ASCII

ACC

STS

PatientPrimary customer:

Physicians

T

HL7

ODBC

ASCII

Digital Sender

Management Database

(contains metadata)

MAHI DB Interface(HTML?)

DTS L

DB Explorer user interface

Currently manually implemented using SQL scripts

Digital form scanner/transmitter

(model HP 9100C)

Legacy database (no quarantine/data cleansing)

Interim Solution

Concept Diagram of MAHI Architecture(designed by: Kelly Kerns)

Cardiff (optical recognition

software)

Current ImplementationCurrent Implementation

Status:Status:

Interim solution in placeInterim solution in place

Angioplasty and Cardiac Angioplasty and Cardiac Cath data availableCath data available

Simple queries available Simple queries available via DB Explorervia DB Explorer

Limitations:Limitations:

Missing Surgical data Missing Surgical data (legacy database)(legacy database)

Unable to perform Unable to perform quarterly reportsquarterly reports

No single repository to No single repository to store common datastore common data

No simple analytic tools No simple analytic tools built-inbuilt-in

Why are we using a database?Why are we using a database?

To expose legacy dataTo expose legacy data

To record/store/maintain/access patient and treatment To record/store/maintain/access patient and treatment informationinformation

To allow extraction and investigative analysis of above To allow extraction and investigative analysis of above informationinformation

To meet clinical organization IS standardsTo meet clinical organization IS standards

To collect and store data from external entitiesTo collect and store data from external entities

Storage and ProcessingStorage and Processing

MAHI’s storage and processing needs are MAHI’s storage and processing needs are data-data-centriccentric (as opposed to document-centric), (as opposed to document-centric), related to related to dynamic procedures, dynamic procedures, andand patient- patient-oriented.oriented.

Storage and Retrieval technologiesStorage and Retrieval technologies

Database (relational, OO, hierarchical) and middleware Database (relational, OO, hierarchical) and middleware (built-in or 3(built-in or 3rdrd party) party)

Data warehousingData warehousing

XML serverXML server

- Native XML database to manage large numbers of XML - Native XML database to manage large numbers of XML

documentsdocuments

XML-enabled web server XML-enabled web server

- Web server that can build XML documents from data in a - Web server that can build XML documents from data in a

databasedatabase

Database features of XMLDatabase features of XML

Storage (XML documents)Storage (XML documents)

Schemas (DTDs, XML Schema)Schemas (DTDs, XML Schema)

Query language (XQuery)Query language (XQuery)

Programming interface (SAX, DOM)Programming interface (SAX, DOM)

Why XML as storage format? (contd.)Why XML as storage format? (contd.)

System needs to store data with repeating fieldsSystem needs to store data with repeating fields Example:Example:

Caregiver has several patients (some repeat patients)Caregiver has several patients (some repeat patients)Location can be used for multiple encountersLocation can be used for multiple encountersPatient may be administered multiple materials/medication (some Patient may be administered multiple materials/medication (some prescriptions are repeated)prescriptions are repeated)

XML provides mechanism to quickly parse and extract data with XML provides mechanism to quickly parse and extract data with repeating structure, or to generate new documents.repeating structure, or to generate new documents.

System needs to store data with arbitrary lengthSystem needs to store data with arbitrary length Example:Example:

Text of medical notesText of medical notes XML can store nested elements of arbitrary depth and length.XML can store nested elements of arbitrary depth and length.

Why XML as storage format? (contd.)Why XML as storage format? (contd.)

System needs to exchange information with other System needs to exchange information with other organizationsorganizations

Example:Example:External Stroke database, external Women’s Health Clinic External Stroke database, external Women’s Health Clinic database, external HL7 compliant database; currently this formatting database, external HL7 compliant database; currently this formatting has to be done manually because data formats are different. has to be done manually because data formats are different.

XML can be used to make formatting easier (similar data items XML can be used to make formatting easier (similar data items will have similar markup tags; more human readable), and will have similar markup tags; more human readable), and possibly automate some of the work by using DTDs/Schemas as possibly automate some of the work by using DTDs/Schemas as reference.reference.

Why XML as storage format? (contd.)Why XML as storage format? (contd.)

System needs to store standard queries/analytical System needs to store standard queries/analytical results for display on multiple end-user client appsresults for display on multiple end-user client apps

Example:Example:Currently, Kelly and biostatisticians have to make specialized query Currently, Kelly and biostatisticians have to make specialized query every time it is requested by a user.every time it is requested by a user.

Standard queries can be stored as SQL procedures, and query Standard queries can be stored as SQL procedures, and query results can be returned in a single XML format document (with results can be returned in a single XML format document (with its associated DTD) to be transformed into views for multiple its associated DTD) to be transformed into views for multiple end-users (e.g. via XML-enabled web server).end-users (e.g. via XML-enabled web server).

Why XML as storage format? (contd.)Why XML as storage format? (contd.)

System needs to store metadataSystem needs to store metadata Example:Example:

Medical groups access to information, originating source of data, Medical groups access to information, originating source of data, etc.etc.

Metadata can be easily incorporated into XML documents as Metadata can be easily incorporated into XML documents as attributes in the element tags.attributes in the element tags.

Example:Example: <Caregiver id=“1234” medgroup=“MHI”><Caregiver id=“1234” medgroup=“MHI”>

<name> … </name><name> … </name>

<ssn> … </ssn><ssn> … </ssn>

<type> … </type><type> … </type>

</Caregiver></Caregiver>

Limitations of XML as storage formatLimitations of XML as storage format

Efficient storage?Efficient storage?

Security?Security?

Transactions and data integrity?Transactions and data integrity?

Multi-user access?Multi-user access?

Recovery and fault-tolerance?Recovery and fault-tolerance?

Queries across multiple documents?Queries across multiple documents?

Others?Others?

An XML extension to existing architectureAn XML extension to existing architecture

Q R

Legacy

Extender

Converter

(e.g. Surgical database)

Current architecture

Neutral storage facility

Legacy storage

Q/R

H

Adaptable front-end apps for Query/Report

Report Harvester (e.g. ACC, STS)

I

Input data

Adapter

XQ XR

XML

Key tasks (initial thoughts)Key tasks (initial thoughts)

Develop storage facility for XML documentsDevelop storage facility for XML documents

Design schema/DTD for data to be converted and storedDesign schema/DTD for data to be converted and stored

Develop retrieval (via query) facility for searching, Develop retrieval (via query) facility for searching, indexing, extraction, and analysis of documentsindexing, extraction, and analysis of documents

Perform data conversion of legacy databasePerform data conversion of legacy database

Integrate into existing architecture Integrate into existing architecture

Modified Project TasksModified Project Tasks

Re-visit the tables in the Repository data storeRe-visit the tables in the Repository data store Re-engineerRe-engineer

Validate structure of Repository data modelValidate structure of Repository data model

Develop a X-Quarantine using XML (from Legacy & New Develop a X-Quarantine using XML (from Legacy & New Data)Data)

Develop a process from X-Quarantine to RepositoryDevelop a process from X-Quarantine to Repository

Develop a process from Repository to X-RepositoryDevelop a process from Repository to X-Repository

Query tool (for Bio-Statistician) from X-RepositoryQuery tool (for Bio-Statistician) from X-Repository

Other IssuesOther Issues

Ensure X-Repository information is ‘secure’ (i.e. bio-Ensure X-Repository information is ‘secure’ (i.e. bio-statisticians can ‘trust’.)statisticians can ‘trust’.)