Concept: Converted Clinical Data Warehouse

Galen’s process for performing health information system conversions is continually improved.  We want conversions to be as safe, flexible, predictable and seamless for our clients as possible.  This is why we develop workbooks, and it’s why we’ve invested countless hours incorporating premium functionality into our Galen ETL conversion platform.  Just this past Friday morning, four of the technical consultants from Burlington, VT secluded ourselves to a corner of our hundred year old converted manufacturing building’s basement to develop the functionality necessary to extract documents of varying  formats out of a system that stores documents as zipped archives in a binary column within its database.  This wasn’t something we’d encountered before, but the next time we run into this configuration, we’ll be ready.   Galen ETL quite literally represents the collective knowledge of all of our conversion analysts’ past experiences combined with our software developers’ innovative technical solutions.  Yet, Galen ETL can do even more for our clients.

The Galen ETL platform facilitates both discrete and non-discrete data conversions.  Galen ETL’s chart summary plugin has made non-discrete conversions of clinical data more popular by providing an easy way to summarize a patient’s chart in a single PDF document. One significant advantage to this approach is that it alleviates the need to complete large and intricate mapping workbooks designed to translate codes, types, and other dictionary-like data from the verbiage in the source system to values compatible with the target system.  It also alleviates the need to store dirty, conflicting, or duplicate data discretely in the target EHR system. However, the end result are documents which cannot be searched or analyzed easily. Therefore, while chart summaries are a great option, there are consequences.

It is because of these consequences and compromises that we are researching and developing a middle ground; a best of both worlds solution. Think of it as a discrete conversion, but not into your EHR, and with no required mapping workbooks.  We are developing a clinical data warehouse.

I mentioned earlier that Galen ETL represents our collective conversion knowledge.  Because of this, Galen ETL already has a robust data model for staging (temporarily storing and manipulating) clinical data from just about every EHR Galen conversion analysts have previously encountered.  Galen ETL’s comprehensive data model served as the ideal source system from which to design a data warehouse.  And that’s what we did – built a centralized repository for clinical data.  As we’d already developed means to extract and stage clinical data to facilitate our conversion process, we were already well on our way to developing a warehouse solution for storing clinical data.  Galen ETL still performs the heavy lifting when it comes to getting data from source EHR’s and transforming it.  But rather than load the data into a target EHR, or create chart summaries from the data, we store the data discretely in a separate database. However, we still needed to make the data readily accessible.

The ability and ease of viewing data stored in the warehouse is crucial.  But how do we make viewing the data in our warehouse as seamless for providers as using their EHR?  This question necessitated the development of a warehouse clinical data viewer that resides inside EHR systems, such as Allscripts TouchWorks. By doing so, not only is authentication seamless, but we can utilize contextual information like the currently viewed patient, and other relevant details such as the specialty of the provider, in order to provide valuable information to the provider from the moment our warehouse data viewer is accessed.  Our vision is for the warehouse viewer to be situated adjacent to the Chart Viewer in your EHR.  The provider knows that the data either exists in the EHR, or has been converted/archived form another clinic and exists in the warehouse. Another requirement was that the viewer not feel like an external application, but instead like a logical extension of the EHR.  From the start, Galen Warehouse was designed to complement rather than disrupt existing workflows.

Still, this is R&D. Whether or not Galen Warehouse will evolve past the functioning prototype stage is yet to be seen. Nonetheless, it is a testament to Galen’s ever evolving definition of what a conversion is. We will continue to question what converting a health information system’s data means and what options should be presented to organizations.  Conversion workbooks and large volumes dirty data are deterrents to pursuing discrete conversions.  Yet, non-discrete document conversions with chart summaries means storing important clinical information in a relatively less accessible format.  We think that a data warehouse built specifically to house converted clinical data, paired with an EHR-integrated viewer, can represent the best of both worlds. It provides a fast and approachable means of accessing all of the vital patient information from converted systems, while maintaining the discrete nature of your EHR’s data.  Even if our conversion warehouse never comes to fruition, its development represents Galen’s continuing effort to improve our conversion processes so that each conversion we perform is faster, safer and easier for you, our valued clients, than the previous.

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