| The main goal of each Healthcare Institution in a | | | | The star schema captures information related to |
| highly controlled & competitive environment, | | | | an inpatient event, which normally may last few |
| is to reduce operating costs while maintaining a | | | | days. In order to capture the whole lifecycle of |
| consistently acceptable level of patient treatment. | | | | the event, an accumulating snapshot fact table is |
| Reduce operating costs at all levels: | | | | used, as shown in the figure (check link below). |
| - Cost of healthcare Professionals | | | | Based on this star schema, a wide range of |
| - Cost of lab equipment & consumables | | | | analytical tasks can be carried out. Analysis related |
| - Cost of pharmaceuticals / medical material | | | | to medical treatment of a specific event |
| - Cost of a treatment per Diagnosis related | | | | (indicatively): |
| grouping (DRG) | | | | - Produce a medical history report on a patient |
| - Cost per type of medical intervention (e.g. | | | | - Produce stats on morbidity by restricting on |
| specific medical operation) On the other hand, an | | | | specific ICD codes (e.g. frequency of an ICD as a |
| acceptable level of patient treatment involves: | | | | percentage of total events, ICD related to |
| - Evidence based medicine, accurate diagnosis and | | | | demographic info like age or educational level) |
| efficient treatment | | | | - Analyse the relation of medical interventions to |
| - On time admittance in the Hospital and | | | | ICD & DRGs, by restricting on specific DRGs |
| healthcare treatment | | | | - Mortal events per ICD / DRG (this can be |
| - Treatment with respect for the Patient- analysis | | | | coded in a specific Exit_diagnosis value) Analysis |
| of options | | | | related to cost incurred by a specific event |
| - Reduction of risks during treatment (e.g. related | | | | (indicatively): |
| to the use of medicine, biomedical equipment, | | | | - Analysis on the average length of stay (ALOS) |
| blood transfusions) | | | | per DRG as well as per Patient demographics. |
| - Capture of medical history of the patient in | | | | - Analysis on the medical material & |
| order to support evidence based medicine | | | | consumables cost related to a medical intervention |
| Moreover, goals of each Healthcare Institution are: | | | | - Analysis on the medical material & |
| - Reduction of medical errors and exposure of | | | | consumables cost related to an event of specific |
| the patient to medical hazards (e.g. inappropriate | | | | DRG |
| levels of radiation) | | | | - Analysis on the pharmaceutical cost related to |
| - Support medical research with patient & | | | | an event of specific DRG |
| treatment data | | | | - Delays in payment and collection levels |
| - Participate and support a larger Healthcare | | | | Department related analysis: |
| system, with the exchange of medical information | | | | - Number of treatment events / medical |
| on a patient, as well as statistics on population | | | | interventions per Department |
| morbidity & mortality. In Private Healthcare, | | | | - comparison of same specialty Departments The |
| the excellent Patient service is critical to Customer | | | | star schema could also capture the involvement |
| retention & loyalty and business growth. In | | | | and performance of medical Professionals. In |
| order to achieve these goals, each modern | | | | addition it could capture many more facts related |
| Healthcare system aims to enhance its | | | | to the event like manhours spent by the Doctor |
| Organisational capability with the introduction of | | | | in charge, by the other professionals involved. The |
| standard business processes, standard healthcare | | | | datamart can be linked to the datamart of |
| treatment based on standardized healthcare | | | | another Hospital or Healthcare system, if the two |
| interventions. Medical information management is | | | | use conformed dimensions and facts. Standardized |
| supported by the introduction of information | | | | codifications (like ICD) aim at achieving this |
| systems aligned to the standardized processes as | | | | conformance, in order to be able to consolidate |
| well as the introduction of classifications or | | | | information at the regional, national and |
| codifications of certain information types like | | | | international level. Why develop the star schema, |
| diseases (based on ICD), medical interventions, lab | | | | instead of querying directly the Hospital |
| exams, biomedical equipment & consumables. | | | | Information System database. For two important |
| Hospital information systems (HIS) are used to | | | | reasons: |
| capture and process all information related to the | | | | - The star schema model is easily understandable |
| administrative as well as the medical aspects of a | | | | by the Business Analyst |
| patient event. A patient record is created which | | | | - The analysis on the star schema is |
| stores all the patient history, structured per | | | | computationally more efficient (the symmetric |
| event. A datamart monitoring the inpatient and | | | | structure’s simplicity allows for better |
| outpatient service could be based on data | | | | query optimization) Moreover the star schema |
| retrieved from the HIS database. In a dimensional | | | | incorporates enriched information at the |
| model it would store the dimensions involved in | | | | dimensions as well as derived facts on the fact |
| the service: Patient, Date, Healthcare Unit and | | | | table (cost, duration). This additional information is |
| Department, exit DRG (diagnosis related grouping) | | | | produced and appended in the datamart staging |
| group, Diagnosis (based on ICD), Medical | | | | area. Business intelligence infrastructures, like the |
| intervention based on selected codification, | | | | one presented above can facilitate the analysis |
| pharmaceutical treatment, medical material used, | | | | and continuous improvement in a Healthcare |
| and capture all cost related facts in the fact table. | | | | system. |