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Healthcare Data Models

Healthcare Data Models. UCLA Health Data Day | Data Science Ecosystem Track | Session 2 Albert Duntugan Senior Director, Enterprise Information Architecture. Clinical Data Mart to Discovery Data Mart. xDR. DDR. Visualization. OHIA Clinical Data Mart. Analytics-Friendly Data Sets.

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Healthcare Data Models

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  1. Healthcare Data Models UCLA Health Data Day | Data Science Ecosystem Track | Session 2 Albert Duntugan Senior Director, Enterprise Information Architecture

  2. Clinical Data Mart to Discovery Data Mart xDR DDR Visualization OHIA Clinical Data Mart Analytics-Friendly Data Sets OHIA Discovery Data Mart OHIA Finance Data Mart OHIA Conformed Dimensions AtLAs SNP arrays Source Data Clarity

  3. Modeling Data Dimensions Facts The events in a process. Dynamic Each row represents a single event associated with the process Contains attributes, such as quantitative measurement data, associated with that event • The context within which an event happens. Includes actors, environment, and related concepts. • Relatively static • Each row represents an actor or concept • Contains details about each instance of an object, such as traits and characteristics

  4. ICD-10-CM: 1,4212,11 Epic 94,742 unique ICD-9-CM: 1,558,635 Epic 18,452 unique Patient Diagnosis Code Drug: 34,901 Drug Class: 308 Drug Ingredient: 17,039 Food: 9 Allergen CPT: 42,265 HCPCS: 11,520 ICD-10-PCS: 79,753 Custom: 39,398 Provider Procedure 5,238,024 unique patients Active UCLA Physicians with a Home Department: 2,383 Provider Types: 92 44,581 Records Department Lab Component 144,538 Records Medication 3,053 unique departments Context

  5. 136M diagnosis events across 1.52M patients 47.9M medication orders across 1.11M patients Encounter Diagnosis Problem 79.9M orders across 1.51M patients Order 100.2M encounters across 2.96M patients among 53.9K providers Allergy 1.72M allergies across 1.27M patients 439.1M lab results tied to 83.6M lab orders across 1.49M patients Lab Order Result 174M lab orders across 1.73M patients Lab Order Medication Order Immunization Clinical Events 4.45M immunizations across 631.6K patients

  6. Patient Sex Female Male Other Unknown Preferred Language Arabic Basque Catalan DutchEnglish French German Hebrew Indonesian Japanese Korean Latin Moldavian Navajo Other Punjabi Quechua Russian Samoan Tagalog Ukranian Vietnamese Yiddish Zapotec … • Patient ID 9345626291 • Birth Date 1962-02-09 • Death Date NULL • Sex Female • Preferred Language English • Ethnicity Not Hispanic or Latino • First Race White or Caucasian • Patient Living Status Alive • Marital Status Married • Religion Eastern Orthodox • Smoking Status Never Smoker • Highest Level of Education *Unspecified • Multi Racial 0 Identifiers Date/Time Ethnicity Cuban Hispanic or Latino Not Hispanic or Latino Patient Refused Puerto Rican Unknown … Categorical Smoking Status Current Every Day Smoker Current Some Day Smoker Former Smoker Heavy Tobacco Smoker Never Assessed Never Smoker Unknown If Ever Smoked … Yes/No

  7. Encounter • Patient Encounter Key 9823238445 • Patient ID 2436823182 • Department ID 80071 • Visit Provider ID 16212 • Encounter Contact Date 2017-04-25 • Encounter Close Time 2017-04-25 11:41:00.000 • ED Departure Time • Inpatient Admission Date • Encounter Type Code 101 • Hospital Admission Type Code • Patient BMI 23.95 • BP Systolic 111 • BP Diastolic 70 • Patient Height 5’3” • Patient Pulse 57 • Patient Temperature 98.7 • Patient Weight 1760 Identifiers Encounter Type Code 1 – Registration 2 – Walk-in 3 – Hospital Encounter 5 – Canceled 11 – Research Encounter 51 – Surgery 52 – Anesthesia 55 – Ancillary Procedure 60 – Health Maintenance Letter 61 – Patient Email 62 – E-Visit 101 – Office Visit … Hospital Admission Type Code 1 – Emergency 2 – Urgent 3 – Elective 4 – Newborn 5 – Trauma Center 6 – Obstetrics 7 – Voluntary Elective NPH 8 – Voluntary Urgent NPH 9 – Information Not Available 10 – Voluntary Emergent NPH 11 – Involuntary Urgent NPH 12 – Involuntary Emergent NPH 13 – Obstetrics - Elective Date/Time Categorical Quantitative

  8. E-Scooters n = 320 Patient ID n = 340 Patient ID Patient ID Diagnosis ID Patient Encounter Key Order Description • OXYCODONE HCL 5 MG PO TABS • HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS • HYDROMORPHONE HCL 1 MG/ML IJ SOLN • fentaNYL (PF) 100 mcg/2 mL inj • MORPHINE SULFATE (PF) 4 MG/ML IV SOLN • FENTANYL CITRATE (PF) 50 MCG/ML 5ML Patient Encounter Key Encounter Type Code Diagnosis ID Diagnosis Code Type = ‘ICD-10-CM’ Diagnosis Name like ‘%motorized mobility%’ Order Description • MECHANICAL VENTILATION • HYPERINFLATION/AIRWAY CLEARANCE THERAPY • LACERATION REPAIR • PLACE AND MAINTAIN ALTERNATING LEG PRESSURE DEVICE • ORTHOPEDIC INJURY TREATMENT • TRACH COLLAR TRIAL • SPLINT APPLICATION • CRUTCHES • CHEST PERCUSSION DEVICE • ELEVATE EXTREMITY • DME FRONT WHEEL WALKER Encounter Type Code – Hospital Encounter – Appointment 53 – Anesthesia Event – Ancillary Procedure 101 – Office Visit 117 – Ancillary Orders 287 2 1 1 48 1 Patient Encounter Key

  9. Navigating the DDM Matrix OHIA Discovery Data Mart Context Clinical Events

  10. Ideas from OMOP Observational Medical Outcomes Partnership Common Data Model Person Provider Device Exposure Concept Measurement Visit Occurrence Note NLP Survey Conduct

  11. DDM vs. OMOP for Encounters VARIANCE SIMILAR CONCEPT, DIFFERENT VOCABULARY ALIGNED • Patient Encounter Key • Patient ID • Encounter Contact Date • Encounter Close Time • Department ID • Provider ID Hospital Billing After Visit Summary Cadence Appointment Made Date Appointment Length Appointment Visit Type Appointment Status Check-In Time Check-Out Time Inpatient Ambulatory Attending Provider Ordering Provider Discharge Provider Visit Occurrence ID Person ID Visit Start Date Visit End Datetime Care Site ID Visit Provider ID Encounter Type Code Visit Concept ID Admitted From Discharge To Source Lineage ADT Visit Vocabulary Concept IDs 9201 – Inpatient Visit 9203 – Outpatient Visit 9203 – ER Visit 32036 – Laboratory Visit 32037 – Intensive Care 581458 – Pharmacy Visit 581476 – Home Visit 581478 -- Ambulance … Encounter Type Code 1 – Registration 2 – Walk-in 3 – Hospital Encounter 11 – Research Encounter 51 – Surgery 52 – Anesthesia 55 – Ancillary Procedure 61 – Patient Email 62 – E-Visit 101 – Office Visit … Hospital Bed Hospital Admission Time Hospital Admission Type Visit Source Type Visit Source Value

  12. Concepts from Notes (results may vary!) ASSERTION POLARITY CLASSIFICATION NAMED ENTITY RECOGNITION [H36.0] Retinal disorders in diseases classified elsewhere [C0011884]  Diabetic Retinopathy diabetic retinopathy Disease Disorder Mention Absent Nonproliferative diabetic retinopathy scattered dot and blot hemorrhage right eye, single blot left eye [C0004606] Nonproliferative diabetic retinopathy MetaMap Nonproliferative diabetic retinopathy [NULL] Absent Disease or Syndrome [H35.9] Unspecified retinal disorder [C0035309] Retinal Diseases CLAMP Clinical Language Annotation, Modeling, and Processing Toolkit retinopathy Present Problem

  13. DDR Product Roadmap • Make the data easier to use • Add attributes and vocabularies from the OHIA Foundational Data Marts and other healthcare data models • Derive condition and problem terms from notes

  14. Albert Duntugan • Senior Director, Enterprise Information Architecture • UCLA Health Information Technology • aduntugan@mednet.ucla.edu

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