Health Care Information Systems

Module 6: Data Management

The following objectives should be met by the end of this module:

  1. List the types of database models and explain how data are stored in them and how they are retrieved and manipulated.
  2. Discuss advantages and disadvantages of a computer filing system using secondary storage devices.
  3. List the advantages and disadvantages of the hierarchical, network and relational database models.
  4. Discuss issues related to database management such as:
    • Security of information
    • Viruses
    • Information backup
  5. Discuss developments in database technology
  6. Understand the role of data warehouses, clinical data repositories, and the "clinical data-financial data interface" in healthcare.

These notes are intended only to supplement your readings. The best way to ensure each module is absorbed is to complete all the readings prior to reviewing these lecture notes. I will try to highlight what I believe to be the most important topics from your module readings. If you have any questions or concerns or there is something you do not understand, please ask me. You can either post on the web board the question you have (that way others can benefit from the response), or you can e-mail me if you want a more private response. Either way it is extremely important that you have a complete and thorough understanding of the material for the module.

Careful attention must be paid to the process of data management in the health care arena. Data must be collected, stored and easily manipulated to be of use. Since the health care industry is so highly data oriented, this can be a difficult and time consuming job. This module will begin to introduce the basics of data management.

A database is a collection of data that is carefully organized, the associated software is referred to as the database management system. A database that you might be familiar with is Microsoft Access, Internet Search Engines are also a type of database system.

Database management can begin to be understood if you relate it to a filing system. In "ancient times", all data was stored on paper copies and filed in a filing cabinet in it's proper location. The order of filing was determined by what would be most useful by the user, for example alphabetical, chronological, or by subject. Secondary storage devices such as floppy disks, CDs or Zip Drives are electronic substitutes for the filing cabinet. This is called computer filing and was the next step on the path to database management. These secondary storage devices used can be either sequential or direct-access. The file format is based upon the type of device you are using. Examples are found on page 139 of your text.

Computer filing systems have some inherent problems. These include program/file dependence, data redundancy and data inconsistency. These problems led to the development of databases. A database offers several advantages over the computer filing system. These include:

  1. Reduction of redundancy
  2. Avoiding inconsistency of data
  3. Sharing of data by users
  4. Enforcement of standards in data representation, naming of variables and documentation
  5. Increased security
  6. Data integrity
  7. Centralized configuration of data and information
  8. Data independence

A database model can be either hierarchical, network or relational. The hierarchical model stores data as nodes in a tree structure. The root node is always placed at the top of the "tree". Other nodes are referred to as parent, child or terminal based upon their relationships. A network model stores its data in nodes in a network structure. Other nodes are referred to as owners and members, links are called pointers which connect the owners and members. Thus, forming a relationship set. "Many-to-many" relationships are possible in the network model as opposed to only "one-to-one" relationships in the hierarchical model. A relational model stores data in tables with data items arranged in rows and columns. Each row contains data for a particular record and each column or field contains one piece of data. This model seems to be the most widely used in health care information administration.

A database management system allows someone to build and maintain a unique database structure as well as gather desired information. The data definition language, the data manipulation language and the data dictionary are used to perform these tasks in the data management system.

Health care information administrators must address data security as one of the top issues in information management. It has now become a public issue with legislation pending in Congress to set updated rules and regulations. Data security is also a large part in organization accreditation in health care today. Three areas of data security are addressed, these include privacy/confidentiality protection, virus protection and data backup/recovery procedures.

New technology in the area of health care databases are being used more frequently today. The Object-oriented Database is defined as "an information retrieval system that manages complex objects containing both data (referred to as properties) and procedures for manipulating this data (called methods)." This type of database has been used to create genetic and physical maps and play an important role in decision support systems. The Hypermedia Database is found frequently on the Internet. It uses hypertext databases which links words (highlighted and underlined) to other text or graphics. In a hypermedia database, links are set to text, graphics, motion pictures, audio or programming code. A use of this in healthcare is the multimedia patient record set with links to radiology films, video from a cardiac catheterization, as well as other medical records.

 

 That is it for notes for module #6! Let me know if you have any questions.

 

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