MNIA Introduction to Health Informatics

1. MNIA Introduction to Health Informatics The Basics of Data Norma Alberg Epidemiologist Databases March 17, 2008

2. Definitions Record Structure “Wild Cards” (ie. local chart numbers) Relational Databases Unique identifiers (MHSC, PHIN) Maintenance Data Entry Standardized coding structures (mutually exclusive) Databases in Health Care Databases March 17, 2008

3. “Ah, those Databases! Databases March 17, 2008

4. A Database, Is essentially a tool for storing information for later sorting and retrieval of specific records, based on inclusion criteria determined by the end-user. The main element of its structure is a FIELD of information. What is a Database? Databases March 17, 2008

5. Nursing Informatics, “Integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information, and knowledge to support clients, nurses, and other providers in their decision-making in all roles and settings." (Staggers & Bagley-Thompson, 2002). Source www.CNIA.ca Why do we need a Database? Databases March 17, 2008

6. A Template for a single record is established to determine the required fields of information. This defines the file structure. Field name Type of information Size (length) Code structure Linkages (code lists, numeric, text…) Data entry criteria (acceptable ranges and types) What is File Structure? Databases March 17, 2008

7. Record template

8. Relational DatabasesExample - Manitoba Health Databases March 17, 2008

9. Relational DatabasesExample – Hospital Admissions Databases March 17, 2008

10. Relational DatabasesWhat can they do? • Cohort Studies (Study on Aging) • Health Care Delivery Trends (LOS) • Patient Transfer Patterns (rural-urban) • Utilization Patterns (Ca, occup, chronic) • Illness Severity and outcome • Risk Factor Identification • And so on and so on…… Databases March 17, 2008

11. Minimum data requirements (MDS) Methods of collection (forms) Coding structures ICD-10, E-coding Severity scoring (AIS, ISS, ICU indices) Laboratory reporting units (SI units) Ranges for “normal” StandardizationWhy do we need it? Databases March 17, 2008

12. Funneling InformationWhat if we misclassify a record? Client Ward Hospital Area Province Nation World Databases March 17, 2008

13. How do we fit in to the big picture? Canadian representation on HL7 international board, Toronto, March 6, 2008 - • Canada Health Infoway's (Infoway) Chief Technology Officer, Dennis Giokas, was recently appointed to the Health Level 7 (HL7) International board. • Giokas' appointment will help Canada shape the strategic direction of HL7, which is critical to the interoperability and standardization that is fundamental to the success of the interoperable electronic health record (iEHR). • "Canada is a strong contributor to the global acceleration of electronic health records and we look forward to their continued collaboration, and to leveraging their strengths and experience," said HL7 Board Chair Dr. Ed Hammond.  • Infoway uses HL7 in defining the interoperability standards that are used in every clinical domain and demographic registry Infoway invests in. Thus they are critical to the 245 Infoway-funded electronic health projects currently underway across Canada.  The appointment of Mr. Giokas will ensure the needs of Canadian patients, clinicians and vendors are well represented on the international stage. 

14. Some of the Challenges of Maintaining Databases Optimizing RELIABILITY • Trained personnel • Inter-rater reliability • Commitment to end product • Timeliness on data entry • Up-to-date on standards changes • Responsive to client needs • Multiple stake holders Databases March 17, 2008

15. Plan it well and things may actually roll your way.GOOD LUCK !