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Data Management

January 28, 2019 By Laurie Lafleur Leave a Comment

Normalization has become an essential activity for any data-driven organization. While it does require an investment in time and resources to define and apply the policies, structures, and values you will find that it is well worth the effort. Not only will you see measurable improvements in the quality and efficiency of clinical workflow, stakeholder satisfaction, and your bottom line – you will also unlock the untapped potential of what could prove to be one of your organization’s biggest assets – your data! That being said, let’s take a look at the various methods that can be used to make sure your data falls in line and conforms to your new norms.

What does normal look like anyway?

The first step is identifying and defining the attributes to be normalized. This begins with a close look at your organization’s key challenges and goals. Having trouble with data integrity, fragmentation, and collisions? Take a look at how unique ID’s are assigned, reconciled, and managed at the facility, system, device, and patient levels. Hearing lots of complaints from your clinical team about broken and inefficient workflow? Consider looking at the variations in procedure, exam, and diagnostic naming conventions across your enterprise. Once the troublesome attributes have been defined key stakeholders should be engaged to define what the ‘gold standard’ values should be, and map these to the ‘dirty’ values that are plaguing your system.

Keeping it clean on-the-fly

Once the normalized values have been defined transient systems, such as DICOM and HL7 routers, or destination systems, such as EHR/EMRs, Picture Archiving and Communication Systems (PACS) or Vendor Neutral Archives (VNA), can often be configured to inspect the data as it arrives to dynamically identify and adjust any inconsistencies and ensure what is stored and shared adheres to normalization policies. This is accomplished through a normalization or ‘tag morphing’ rules engines that are able to inspect incoming data on-the-fly, identify deviations from normalization policies using pattern matching algorithms, and apply the appropriate transformations based on the pre-defined set of consistent values. This ensures incoming data is clean, consistent, and reliable – regardless of its original source or format.

As well, it enables rapid integration of outside facilities and systems resulting from mergers or acquisitions as new systems and modalities can be integrated quickly without requiring updates to hanging protocols, routing and retention policies, reporting systems, etc.

Finally, it mitigates the impact of any unforeseen changes that may occur due to vendor updates at the modality, which can sometimes alter attribute values such as series descriptions. This is most common among complex multi-slice acquisition devices, and ultimately results in broken hanging protocols and frustrated radiologists.

Garbage in, garbage out

In some cases, it may be necessary to enforce data normalization policies at the modalities themselves. This is especially important if receiving systems do not provide robust tag morphing capabilities, leaving you without the ability to enforce normalization policies on-the-fly. As well, if you find that your technologists are frequently required to manually enter or adjust data values at the modality, then added variability and potential for error in the resulting data sets are more likely to occur. This may not always be caught by a discerning rules engine. In either case, why not take the opportunity to ensure your modalities are sending clean data from the get-go? As the old adage says: garbage in, garbage out.

When you’re going where the grass is greener

If you’re considering a retiring and replacing ageing systems, data migrations present an excellent opportunity to clean and normalize existing data as it moves between systems, providing immediate benefits like better access and filtering of relevant priors, improved reading efficiency through consistent and reliable hanging protocols, and the ability to incorporate historic data into analytics, AI, and deep learning applications.

As well, it positions you to minimize the effort involved in any future system replacement or migration activity by simplifying the configuration of any system features that rely on specific attribute values or structures to function effectively. For instance, hanging protocols are not typically transferrable between vendors’ systems and therefore need to be re-created whenever a PACS replacement or viewer change occurs. The consistency of normalized data facilitates rapid configuration of protocols within a new system, as the complexity associated with configuring multiple protocols for each distinct layout, or the viewer provided lexicons required to accommodate or ‘map’ the various combinations and permutations of inconsistent protocol, study, or series information is eliminated. The same holds true for other attribute-driven features including but not limited to reading worklists, routing or forwarding rules, information lifecycle management policies, and analytics and deep learning.

That sounds like a lot of work…

More often than not the perceived effort of defining such practices and data structures seems overwhelming to many already busy IT departments and project teams. This often results in a choice to forego data normalization activities in favour of saving some time and effort, or simply due to lack of financial and human resources.

While it may be true that data normalization is no small task, the benefits far outweigh the cost of the initial investment, and many organizations are now realizing the strategic value of data normalization initiatives. The heaviest lift, by far, is the process of gathering and analyzing existing data and distilling it into normalized data structures and values, which is a one-time effort that will yield immediate and recurring dividends by creating an actionable data repository that supports clinical and business continuous improvement initiatives.

By now you might be thinking, “this sounds good in theory, but it’s pretty anecdotal. Where’s the real-life evidence that data normalization is worth the effort?”

Our next posts will include real-world examples of how some luminary healthcare organizations have leveraged data normalization to achieve a variety of measurable benefits. Subscribe to our blog to be notified when the next post becomes available!


Filed Under: Analytics, Data Management, Healthcare IT, Workflow Tagged With: data migration, data normalization, Enterprise Imaging, health data, Health IT, healthcare data, healthcare IT

January 14, 2019 By Laurie Lafleur Leave a Comment

Why Be Normal?

There are many times when it’s important to be unique and stand out. For example, when attending a job interview, showing off your costume for a Halloween competition, or when you’re auditioning for American Idol. The creation of healthcare data, however, is not one of them.

Unfortunately, unique is often the default state of imaging and other health data as it is generated across modalities, systems, departments, and facilities – where the presence of diverse vendors and local policies result in bespoke data management practices and attribute values such as procedure or study names, series descriptors, disease characteristics, and in which format, tag, or sequence data is stored. Such inconsistency in data structure and content leads to a number of workflow and operational challenges, and significantly reduces the value of underlying health data, for instance:

  1. It complicates the creation and maintenance of reliable and consistent hanging protocols that are required for efficient reading workflow, forcing a never ending and hard to manage set of rules that require a complex set of rules to maintain consistent hanging protocols
  2. It limits the ability to effectively curate and analyze data for clinical and business improvement purposes
  3. It inhibits effective artificial intelligence (AI) and machine learning algorithm training
  4. It results in difficult and costly migration implications when considering system retirement or replacement

Data normalization – the process of defining standards and applying them to the structure and content of health data – overcomes these challenges by ensuring incoming data arrives in a consistent and predictable manner. The resulting clean, standardized data can be leveraged to:

  1. Inform continuous improvement initiatives to improve workflow efficiency, quality, and cost
  2. Better support interoperability between existing applications, and simplifies implementation and integration of new enterprise imaging systems
  3. Reduce the cost and complexity of future data migration projects
  4. Allow data to be more easily be inspected and mined to unlock valuable insights at departmental, organizational, and population levels

The value of being normal(ized)

Whether undertaken as part of a larger Enterprise Imaging initiative, or a standalone project, data normalization has the potential to yield a huge return on investment. Not only can it realize measurable improvements in the quality and efficiency of clinical workflow, stakeholder satisfaction, and your bottom line, it can also unlock the untapped value of what could prove to be one of your organization’s biggest assets – your data.

You may be wondering – this all sounds good in theory, but how exactly can data be normalized and what are the practical business and clinical applications? To address these questions, we will be posting a series of articles that will explore the methods of data normalization and dive deeper into the clinical, operational, and fiscal use cases and benefits for data normalization at the enterprise, departmental, and modality level.

Subscribe to our blog to be notified when a new post is available and learn more about how data normalization can better support workflow optimization, interoperability, data curation and migration, artificial intelligence and machine learning, and data analysis and intelligence.

 

Filed Under: Analytics, Data Management, Healthcare IT, Imaging, Workflow

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