Appl Clin Inform 2019; 10(05): 794-803
DOI: 10.1055/s-0039-1697598
Research Article
Georg Thieme Verlag KG Stuttgart · New York

Incrementally Transforming Electronic Medical Records into the Observational Medical Outcomes Partnership Common Data Model: A Multidimensional Quality Assurance Approach

Kristine E. Lynch
1  VA Salt Lake City Health Care System, Salt Lake City, Utah, United States
2  Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, Utah, United States
,
Stephen A. Deppen
3  Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Scott L. DuVall
1  VA Salt Lake City Health Care System, Salt Lake City, Utah, United States
2  Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, Utah, United States
,
Benjamin Viernes
1  VA Salt Lake City Health Care System, Salt Lake City, Utah, United States
2  Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, Utah, United States
,
Aize Cao
3  Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Daniel Park
4  Tennessee Valley Healthcare System, Nashville, Tennessee, United States
,
Elizabeth Hanchrow
3  Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Kushan Hewa
3  Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Peter Greaves
3  Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Michael E. Matheny
3  Vanderbilt University Medical Center, Nashville, Tennessee, United States
4  Tennessee Valley Healthcare System, Nashville, Tennessee, United States
› Author Affiliations
Funding This work was supported using resources and facilities at the VA Salt Lake City Health Care System and the VA Informatics and Computing Infrastructure (VINCI), VA HSR RES 13–457.
Further Information

Publication History

26 April 2019

08 August 2019

Publication Date:
23 October 2019 (online)

Abstract

Background The development and adoption of health care common data models (CDMs) has addressed some of the logistical challenges of performing research on data generated from disparate health care systems by standardizing data representations and leveraging standardized terminology to express clinical information consistently. However, transforming a data system into a CDM is not a trivial task, and maintaining an operational, enterprise capable CDM that is incrementally updated within a data warehouse is challenging.

Objectives To develop a quality assurance (QA) process and code base to accompany our incremental transformation of the Department of Veterans Affairs Corporate Data Warehouse health care database into the Observational Medical Outcomes Partnership (OMOP) CDM to prevent incremental load errors.

Methods We designed and implemented a multistage QA) approach centered on completeness, value conformance, and relational conformance data-quality elements. For each element we describe key incremental load challenges, our extract, transform, and load (ETL) solution of data to overcome those challenges, and potential impacts of incremental load failure.

Results Completeness and value conformance data-quality elements are most affected by incremental changes to the CDW, while updates to source identifiers impact relational conformance. ETL failures surrounding these elements lead to incomplete and inaccurate capture of clinical concepts as well as data fragmentation across patients, providers, and locations.

Conclusion Development of robust QA processes supporting accurate transformation of OMOP and other CDMs from source data is still in evolution, and opportunities exist to extend the existing QA framework and tools used for incremental ETL QA processes.

Authors' Contributions

Conception and design: K.E.L., S.A.D., M.E.M.; acquisition of data: K.E.L., B.V., A.C., D.P., K.H.; analysis: K.E.L., B.V., A.C., D.P., E.H., K.H.; interpretation: K.E.L., S.A.D., S.L.D., M.E.M.; drafting of manuscript: K.E.L., S.A.D., M.E.M.; and critical revision of the manuscript for important intellectual content: all authors.


Protection of Human and Animal Subjects

The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects. All research was conducted with the approval by the University of Utah Institutional Review Board and the VA Salt Lake City Health Care System Research and Development Committee.


Supplementary Material