On a very small budget, Vancouver Coastal Health developed a robust data infrastructure to increase analysis in support of improved patient care and system improvement. One unique feature is that VCH’s enterprise data warehouse uses a patient-centric design. 

“Having the patient-centric warehouse has allowed us to develop the Patient Continuum,” says Dianne Sharma, decision support advisor at VCH. The Continuum has standardized a lot of the joins between various data sets. “Now we can look at those at either a patient level or a visit level, and having standardized those joins has been a very big benefit.”

The Patient Continuum creates a single patient record based on data gathered from EDW feeder systems and uses a business rule engine to create logic that explains relationships between different data domains.

“Most of the work we did around the warehouse was about the complexity of the data and how to transform the data into something that is used more at an enterprise level,” says Grant Stephens, former VCH technical operations manager.

Developed in-house by the Decision Support team at VCH using readily available Microsoft tools, the Patient Continuum facilitates longitudinal patient tracking across the entire health authority according to preset criteria.

“Now we have a way to quickly and easily [handle requests that involve joins of multiple data sets] and we know that the result of joining the data will be helpful for other people,” says Jany Chan, decision support advisor at VCH.

The Patient Continuum facilitates understanding of patient interactions from both vertical and horizontal perspectives. It not only captures a patient’s journey across the health care system but also many patients’ journeys regardless of system or facility in order to analyze overall service patterns.  

“The way that the Continuum is actually implemented, the data that we create in the Continuum is usable even outside of linking to other data sets because it gives you an entire lifecycle of a patient visit or a patient’s interaction with our facilities,” says Alan Knox, VCH technical operations manager.

The initiative has resulted in master data management on a budget, improved data quality, analytical efficiency through standardization, and agility to support strategic hospital and government initiatives without additional resources and in a timely fashion. Additionally, VCH now has the capacity to examine impacts and consequences of patient care patterns more quickly and easily. By analyzing such data, VCH can assess the impact of continuity of care and improve process, outcomes and costs.

It was a team effort, and Patricia Chung, director, data management and report, is extremely proud the team. “It was really just our brainpower and our time to come up with an innovative solution to the issues, for example, taking all the data that we have and link it in a standardized manner,” says Joleen Wright, director, data release management.

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