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Oracle® Healthcare Data Model Operations Guide
11g Release 2 (11.2)
Part Number E18027-02
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1 Introduction to Oracle Healthcare Data Model

This chapter introduces the Oracle Healthcare Data Model that gives you a jump-start for the design and implementation of a healthcare data warehouse solution:

See also:

The introduction to Oracle Healthcare Data Model in Oracle Healthcare Data Model Reference.

What is Oracle Healthcare Data Model?

You use the Oracle Healthcare Data Model to jump-start the design and implementation of an Oracle Healthcare Data Model data warehouse to quickly achieve a positive return on investment for your data warehousing and business intelligence project with a predictable implementation effort.

The Oracle Healthcare Data Model consists of logical and physical data models, intra-ETL that maps data from the Oracle Healthcare Data Model 3NF level to the aggregate level, sample reports, and the Oracle Interactive Dashboard using features of Oracle Business Intelligence Suite Enterprise Edition.

The Oracle Healthcare Data Model includes the following components:

Oracle Healthcare Data Model Logical and Physical Models

The logical and physical models of the Oracle Healthcare Data Model have the following characteristics:

Logical Model

The Oracle Healthcare Data Model provides a predefined logical model. The logical data model defines the business entities and their relationships in order provide a clear understanding of the business and data requirements for the data warehouse.

For ease of use, the Oracle Healthcare Data Model is partitioned into three high-level logical categories which, in turn, are divided into functional subject areas. When designing your Healthcare data warehouse, you can implement some or all of these categories or subject areas.

The logical data model is described in detail in Oracle Healthcare Data Model Reference.

Supported Oracle Healthcare Data Model Categories and Subject Areas

The logical categories supported by the Oracle Healthcare Data Model are:

  • Common Infrastructure. For a description of the subject areas in this category, see Table 1-1.

  • Clinical Core. For a description of the subject areas in this category, see Table 1-2.

  • Financial and Billing. For a description of the subject areas in this category, see Table 1-3.

Table 1-1 Subject Areas in the Common Infrastructure

Subject Area Contains the entities and attributes that record the details of....

Encounter

The occurrence between a patient and healthcare participant(s) for the purpose of providing patient service(s) or assessing the health status of a patient. It contains data relevant to all aspects of an encounter such as interventions, results, diagnosis, admission types billing, charges, and reimbursements. This subject area is made up of a subtype to designate the type of encounter (that is to say, inpatient admission, office visit) and multiple relationship types to link the encounter to the activities, results and other clinical/financial occurrences in the encounter (for example, Concern Relationship Type, Facility Relationship Type, Intervention Relationship Type, and Observation Relationship Type). The relationship types are user defined.

Facility - Care Site

The geographical locations and the bricks and mortar qualities of the healthcare organization. It captures data relevant to the care site including such sites as state, region, city, county and all the way to unit, floor, room and bed. This subject area is made up of two subtypes; Facility and Care Site. The Facility subtype represents a licensed, certified, and/or accredited facilities that provides inpatient and outpatient services. Some examples of facilities are hospitals, nursing facilities, and ambulatory surgical facilities. A Care Site is a location within a building where care is delivered to the patient. For example an operating room, examination room, recovery room, bay, room, bed and so on.

Party

The direct and indirect participants in healthcare delivery. It captures data relevant to the care providers from both an individual and organizational perspective. A Party can be an individual or an organization. The Party primary entity is made up of two subtypes; Individual Party and Organization Party. The Individual Party subtype represents individual persons, while the Organization Party subtype represents any type of Organization consisting of zero, one, or more persons. Parties can further be described through the use of roles assumed by the parties in a given context. This is discussed in the following section.

Party and its subtypes are modeled according to a generalization-specialization convention. Attributes that are common to the subtypes, either person or organization are modeled at the level of the Party supertype, such as phone number, email address, street address, and name. The subtypes of Party each have attributes that are specific for that subtype and not applicable to the others.

For example, attributes for Individual Party subtype such as gender, and marital status may have no applicability to the Organization Party subtype.

Roles

(Not specifically a subject area.) A set of entities that are logical extensions to Party subtypes. The Role entities contain attributes that are specific to and necessary for defining a Party Role. The model supports a zero-to-many cardinality for the Party-Role relationship. For example, an Individual Party (Ind) may, at one time be in the role of a service provider, and at another time be in the role of a patient as well as employee and an Organization Party (Org) may be in the role of Service Provider an as a Legal Entity. The use of various roles, defined by the customer are associated to a Party to add role specific functionality as required. Roles are the building blocks that make up the unique characteristics of the individuals and organization in the delivery and receipt of healthcare.

The following are examples of roles: Accreditation Organization (Org), Administrative Analyst (Party), Benefits Provider (Org), Business Unit (Org), Caregiver (Ind), Certification Organization (Org), Contact (Ind), Cost Center (Org), Dependent (Ind), Employee (Ind), Employer (Org), Government Organization (Org), Group Purchasing Organization (Org), Guarantor (Party), Guardian (Party), Insurer (Org), Legal Entity (Org), Licensing Organization (Org), Manufacturer (Org), Member (Ind), Patient (Ind), Payee (Party), Payer (Party), Pharmacy (Org), Recall Authority (Org), Service Provider (Party), and Vendor (Party).

Table 1-2 Subject areas in the Clinical Core Category

Subject Areas Contains the entities and attributes that record the details of....

Advanced Directive

The receipt by a service provider of instructions from a patient regarding future medical care should he or she be unable to participate in medical decisions due to serious illness or incapacity. This subject area includes entities and attributes that support the identification of the recipient service provider and date and time specifics.

Concern

Any matter pertaining to a patient that may require a service provider's attention. Representative examples include any illness, condition, problem, diagnosis, injury, mental condition, disorder, environmental exposure (such as exposure to lead), or other concern.

Consent

The legal agreement or authorization given by a patient to a Service Provider to undergo a type of medical care or treatment. The entities and attributes in this subject area support the obtaining and providing of informed consent such as authorized interventions, related parties, service providers, and related consents among others.

Intervention

The actions taken to alter or achieve a patient's outcome by interfering or interceding. It contains data specific to all types of interventions from the most complex procedure and groups of procedures to simple bedside interventions. The entities in this subject area for which a relationship is provided include Intervention Concern, Intervention Consent, Intervention Service Provider, Intervention Substance, and Intervention Supply, among others.

Observation

Clinical information collected directly or indirectly about a patient. Subtypes of Observation are: ADL, Adverse Event, Complication, Contraindication, Diagnostic Observation, Diagnostic Test Result, Discharge Note, Intolerance, Lab Result, Sign Symptom, Acuity Status, Physical Examination, Urinary, Skin Exam Results, Respiratory Test Result, Diagnostic Test Result, Psychiatric Assessment, Evaluation, Assessment, and Complication.

Order

The healthcare Order, a formal, pre or post documented instruction originated from an authorized party for initiation of actions directly or indirectly related to provision of care to patients. It contains the date relevant to the creation and fulfillment of the order as well as all relationships necessary to preserve the context of the Order. The entities found in the subject area support types of orders such as Laboratory, Radiology, Procedure, Observation, Substance Administration and Nursing Orders as well as relationship entities to Intervention, Service Provider, and Observation among others

Patient

The patient as the individual who receives medical care, attention or treatment from the healthcare service provider. It captures data relevant to the patient that are not represented in the Party subject area. For instance identification number, living arrangements, and birth order are attributes unique to Patient.

Patient History

The information communicated to the provider from the patient that identifies such things as the chief complaint, the history of the present illness, a review of systems, and the past, family and social history, and so on as the components of the patient history, and genetic history.

Specimen

The relevant to the collection and management of a medical patient's tissue, fluid, or other material derived from the patient used for laboratory analysis to assist differential diagnosis or staging of a disease process. The entities and attributes in this subject area support different types of specimens, collection method, anatomical site, specimen groups and specimen transactions.

Table 1-3 Subject areas contained in the Financial and Billing category

Subject Areas Contains the entities and attributes that record the details of. .. .

Accounting and Financial

The financial condition and operating performance of the organization. The entities and attributes included in this subject area include but are not limited to Balance Sheet, Cash Flow Statement, Statement Of Income, Financial Statement, Journal, Ledger, and Ledger Account

Accounts Payable

Accounts of money the organization owes normally that arise from the purchase of products or services. The entities included in this subject area - but not limited to - are Invoice, Voucher, Payment, Return to Vendor.

Claims

An itemized statement of healthcare services and their costs provided by a Service Provider. The entities and attributes support the details of the submitted claims, requests for payment, appeals, and payments.

Contract

The legal agreement between a payer and a subscribing group or individual which specifies rates, performance covenants, the relationship among the parties, schedule of benefits and other pertinent conditions. This subject area contains entities and attributes that support capturing the details of the contract, section, clause, time period among others

Health Plan

The benefits received by a patient consisting of medical care (provided directly or through insurance or reimbursement) under any hospital or medical service policy, plan contract, or HMO contract offered by a health insurance company or a group health plan. Entities and attributes in this subject area include, but are not limited to drug, intervention and product coverage and charges, as well as Service Coverage and Provider Capitation. This subject area contains the entities and attributes that record the details of a specific health plan insurance policy written against a health plan offering.

HR and Payroll

Personnel management, including payroll, compliance with employment law, and human resources including managing the workforce. The entities and attributes included in this subject area include but are not limited to Benefit Plan, Dependent, Employee Certification, Employee Credential, Credential Type, Job, Position, and Employment Status

Inventory

Items stocked by an organization. Entities included are Inventory Transaction, Inventory Balance, Warehouse, Inventory Shipment, Material Stock Request, PAR request among others

Master Catalog

The product catalog, and the drug catalog among others.

Property and Equipment

The management of property, equipment, tooling and physical capital assets that are acquired and used to build, repair and maintain property and equipment. The entities and attributes included in this subject area include but are not limited to Asset, Asset Assessment and Condition, Depreciation and Location.

Purchasing

The organization attempts to acquire goods or services to accomplish the goals of the enterprise. The entities and attributes included in this subject area include but are not limited to Purchase Order, RFI, RFQ, RFP and Requisition.

Common Patterns of Subject Areas

Each subject area is made up of a primary entity, often represented by the name of the subject area, and related entities. Associations, relationships, or intersection entities link the entities, both within and across subject areas. Each type of link between entities describes the nature of the relationship and the cardinality. Intersection entities define and disambiguate a many-to-many relationship between entities. Each entity has the ability to represent concepts represented by coded standardized terminologies and local customer defined and developed terminologies or list of values, such as concern code, gender code, intervention code. These attributes have relationships to the coded entity that contains the following standard attributes: ID, CODE, NAME, and DESCRIPTION. This pattern is also followed for an attribute suffixed with TYPE such as Concern Transaction Type and Intervention Relationship Type. (Note, however, that the Inventory Transaction entity is an exception to this rule. This entity has attributes different from the Transaction pattern entity.)

Most subject areas share common patterns that perform similar functions across the model. These are patterns that are attached, via associations/relationships to the primary entity of a subject area to serve a specific purpose or perform a useful function.

Table 1-4 describes each of the common patterns.

Table 1-4 Common Patterns of Subject Areas

Pattern Description

Related Party

Most relationships to Party are expressed by dedicated Roles such as Service Provider, Patient, and so on. Relationships to additional Party Roles can be created by using the Related Party Common pattern. For example, an implant device sales representative observing a surgical procedure can be represented using the Intervention Related Party entity. The same attributes are present in each Related Party entity across Oracle Healthcare Data Warehouse Foundation.

Transaction

This common pattern can be used to record user defined transactions or events that occur during the lifecycle of the primary entity of a subject area in the source system. The same attributes are present in each Transaction entity across Oracle Healthcare Data Warehouse Foundation.

Group

This common pattern is used to build a collection of instances of primary entities in a subject area. Groups can be named and then associated with one or more entities of the subject area. For example, OBSERVATION GROUP. The same attributes are present in each Group entity across Oracle Healthcare Data Warehouse Foundation.

Related <Primary Entity>

This common pattern is used to associate instances of a primary entity. It is a self-referential intersection entity that allows entities to be linked together in some manner. This pattern is used to support the management and definition of hierarchies. Other relationships are possible such as predecessor, successor, and sequential). The same attributes are present in each Related <Primary Entity> across Oracle Healthcare Data Warehouse Foundation.

Physical Model

Oracle Healthcare Data Model provides a predefined physical data model.

The physical data model includes the following types of tables and views:

  • Oracle Healthcare Data Warehouse tables

  • Reference tables

  • Database sequences

  • Derived tables

  • OLAP dimension and cube views.

The physical data model is described in detail in Oracle Healthcare Data Model Reference.

Notes:

When examining the predefined physical model, keep in mind the naming convention using DW (Data Warehouse) prefixes and suffixes to identify the types of tables and views:

DWC_ for intra-ETL control tables

DWD_ for derived tables

DWR_ for reference data tables

DWX_ for Facility-Shift and Code Repository (lookup) Cross Reference Table

HDM_ for Oracle Healthcare Data Model warehouse tables

Oracle Products That Make Up the Oracle Healthcare Data Model

Several Oracle technologies are involved in building the infrastructure for healthcare business intelligence:

Oracle Database with OLAP, Data Mining and Partitioning Option

The Oracle Healthcare Data Model utilizes a complete Oracle technical stack. It leverages the following data warehousing features of the Oracle database: SQL model, compression, partitioning, advanced statistical functions, cube views, data mining, and online analytical processing (OLAP).

Tip:

To save some money, you can consider using Oracle RAC and commodity hardware.

Oracle Development Tools

The following Oracle tools can be used to customize the predefined logical and physical models provided with the Oracle Healthcare Data Model, or to populate the target tables.

Table 1-5 Oracle Development Tools Used with Oracle Healthcare Data Model

Name Use

Oracle SQL Data Modeler

To modify, customize, and extend the logical model

SQL Developer or SQL*Plus

To modify, customize, and extend database objects

Analytic Workspace Manager

To view, create, develop, and manage OLAP dimensional objects.

Oracle BI EE Presentation Tools

Oracle Business Intelligence Suite Enterprise Edition is a comprehensive suite of enterprise BI products that delivers a full range of analysis and reporting capabilities. You can use Oracle BI EE Answers and Dashboard presentation tools to customize the predefined sample dashboard reports that are provided with the Oracle Healthcare Data Model.

See:

"Customizing the Reports Delivered with Oracle Healthcare Data Model".

Where Oracle Healthcare Data Model Fits in a Data Warehousing Project

The Oracle Healthcare Data Model provides much of the data modeling work that you must do for a healthcare business intelligence solution. The Foundation Layer provides a solid foundation for a healthcare data warehouse. The Derived layer provides the infrastructure for creating KPI's, cube views, and reports.

Each healthcare organization is unique, and therefore the structure of the data warehouse will need to be different in order to match the needs of that unique healthcare environment. The Oracle Healthcare Data Model comes with a generic schema that requires modification. These modifications include, adding, deleting, modifying, or renaming tables and columns; or altering foreign keys, constraints, or indexes.

After the data warehouse is populated, you populate the derived layer and OLAP cube views to support the reporting requirements. The Oracle Healthcare Data Model includes a solid infrastructure for a range of reports.

Prerequisite Knowledge for Customizers

As discussed in "Oracle Products That Make Up the Oracle Healthcare Data Model", the Oracle Healthcare Data Model uses much of the Oracle stack. Consequently, to successfully customize the Oracle Healthcare Data Model, you need:

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