Creating a data warehouse to support monitoring of NSQHS blood management standard from EMR data

Abstract

Background

Blood management is an important aspect of healthcare and vital for the well-being of patients. For effective blood management, it is essential to determine the quality and documentation of the processes for blood transfusions in the Electronic Medical Records (EMR) system. The EMR system stores information on most activities performed in a digital hospital. As such, it is difficult to get an overview of all data. The National Safety and Quality Health Service (NSQHS) Standards define metrics that assess the care quality of health entities such as hospitals. To produce these metrics, data needs to be analysed historically. However, data in the EMR is not designed to easily perform analytical queries of the kind which are needed to feed into clinical decision support tools. Thus, another system needs to be implemented to store and calculate the metrics for the blood management national standard.

Methods

In this paper, we propose a clinical data warehouse that stores the transformed data from EMR to be able to identify that the hospital is compliant with the Australian NSQHS Standards for blood management. Firstly, the data needed was explored and evaluated. Next, a schema for the clinical data warehouse was designed for the efficient storage of EMR data. Once the schema was defined, data was extracted from the EMR to be preprocessed to fit the schema design. Finally, the data warehouse allows the data to be consumed by decision support tools.

Results

We worked with Eastern Health, a major Australian health service, to implement the data warehouse that allowed us to easily query and supply data to be ingested by clinical decision support systems. Additionally, this implementation provides flexibility to recompute the metrics whenever data is updated. Finally, a dashboard was implemented to display important metrics defined by the National Safety and Quality Health Service (NSQHS) Standards on blood management.

Conclusions

This study prioritises streamlined data modeling and processing, in contrast to conventional dashboard-centric approaches. It ensures data readiness for decision-making tools, offering insights to clinicians and validating hospital compliance with national standards in blood management through efficient design.