Timeline of Data Access Capabilities at Penn Medicine Data Access

Timeline of Data Access Capabilities at Penn Medicine Data Access Capabilities Expand Population Health & Value Based Care EPIC Cosmos – Research Network Penn Data Lake EPIC Caboodle - Integrated EMR DW Analytics Self-Service Storefront Princeton Medical Center Pathways of Care Executive Analytics Prioritization Enterprise Registries and Alerts EPIC - Fully Integrated EMR Common Dashboards for Ambulatory KPI’s Consolidated Data Access Requests Across Organization Integrate External Claims Data Consolidate EMR CCH and Practices Consolidate and Expand Data Access Resources TriNetX - Research Network Facilitating Clinical Trial Recruitment Integrate Phenotype and Genotype Data PennOmics - Research Data Warehouse Executive Analytics Governance PennSeek - Search and Discovery of Clinical Notes DAC - Centralized Data Access Team Specialized Datamarts and Dashboards PDS - Aggregate Patient Data into EDW EPIC - Common Ambulatory Applications Financial DW 2005 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Data Analytics/Access Center (DAC) shared enterprise resource Patrick Farrell, Senior Director Nebo Mirkovic, Associate Director 1 Enterprise Data Architect; 1 Solutions Architect Data Architecture & Development Team Data warehousing (SQL, HANA , Hadoop), models, marts, feeds Brent Moore, Senior Manager 4 Data Architects, 14 Data Engineers Reporting & Research Analytics Team Data analysis and visualization (reports, dashboards), registries Liat Shimoni, Senior Manager 19 Information analysts/report developers (3 leads), Scrum masters Product Development & Optimization Team Long-term solutions, application implementation and ownership Amy Trenton, Business Manager; Jesse Zlatsin, Manager 4 Product owners, 2 Dev-Ops analysts, 2 Dev-ops engineers

Data Analytics/Access Center (DAC) https://www.med.upenn.edu/dac

DAC Strategic Initiatives FY2018 Technology Focus Epic Caboodle Analytics Operational Store Consolidate data visualization solutions Reevaluate data mining and discovery tools New research platform People Focus Collaborative relationships (IBI, PennChart team, CV service line, CPUP Operations, Professional billing office, etc.) PennChart Analytics team Educational outreach Staff training: Epic, domain knowledge, data science, cloud, new technologies

Data Available Through Epic Clarity and/or PDS visits scheduling provider Info allergies orders Rx procedures MAR vaccinations coded diagnoses problem list history notes flowsheets labs blood bank POC services radiology reports pathology reports endoscopy reports ECG reports echo reports cath reports electrophys reports RadOnc patient flow CTMS hosp. acq. infections transplant labor & delivery anesthesia PeriOP geolocation patient surveys SSA DMF tumor stage and grade oncology infusion genomic data hospital & prof. billing general ledger external claims other financial demographics

Data Access & Analytics Governance Strategic Direction Review with Executive Leadership (Bi-Monthly) Prioritization of Data Access with Executive Leadership (Monthly) Stewardship of Domain Data and Metric Definitions Hospital operations, ambulatory, finance, QI, research Dashboard & Reporting Governance Stewardship and education related to data visualization Data Architecture Stewardship of technologies enabling data access and analytics

Data Access Request Types Clinical Care, Operations, Quality Improvement – All necessary information – Provision mode: reports, dashboards, data files Preparatory Research – Aggregates, counts – Provision mode: reports, self-service applications (PennOmics) IRB Approved Protocols – All approved elements of PHI – Provision mode: data files, self-service applications (PennSeek, PennOmics)

Clinical Care, Operations & QI Support Dashboards (interactive) visualization of quality and performance metrics PennChart Internal Registries cohorts of Penn patients and metrics related to them SAP Universes & Web-Intelligence Universe – semantic layer that interprets raw data through business rules, created for general purpose analysis or to drive focused analysis applications WebI – reporting tool used to display data from Universes

Internal Penn Registries in PennChart www.med.upenn.edu/dac/registries ACTIVE Collaborative Care Behavioral Health Cancer (P Gabriel) ACO (JT Howell) ACS NSQIP (S Diem) Adult HIV (A Norris) Anesthesia Record ESS/Trauma Asthma (A Apter) Interstitial Lung Disease (M Porteous) Case Management Irritable Bowel Disease (C Klock) Major Lower Joint Replacement (J Piscitello E Hume) Chronic Care Management (JT Howell) Congestive Heart Failure (L Goldberg) Medicare Advantage (JT Howell) COPD (M Sims) Opioid Therapy (M Ashburn) Coronary Artery Disease Princeton Horizon (T Fisch) Diabetes (M Schutta) Sickle Cell (D Christopher) Emergency Encounters (C Edwards) Stroke (L Leibowitz) Hypertension (R Townsend) Superutilizers (JT Howell, S Honeywell) Osteoporosis UPHS IBC Warranty (G Kruse, C Vanzandbergen) Wellness Registry-All (JT Howell) UPHS Inpatient Readmission Build In Progress: CPC , MBSAQIP Build Planned: Roster Management, ICU, ICU-Sepsis (sub), Penn Metabolic Medicine, Heart Safe Motherhood, ACS NSQIP, ACS TransQIP, Active Patients

Research Request Process Report Request Finalize Requirements Development/ Delivery Obtain IRB Approval (if applicable) Complete request form (initial requirements) Compliance Review Interactive finalization of specifications Initial report development and delivery Refinement as needed

DAC Data Request Form

Covered Entity - only Penn Medicine staff allowed to see PHI without legal contract - third parties may see de-identified data, and are required to sign Data Use Agreement (DUA)

PennOmics https://pennomics.med.upenn.edu Components: Cohort Explorer / Translational Research Center (TRC) Oracle Healthcare DW Foundation (HDWF) Healthcare Data Model (HDM) Omics database (ODB) Cohort Data Mart (CDM) Oracle Healthcare Analytics Data Integration (OHADI) Oracle Data Integrator (ODI)

PennOmics - Data Flow Clinical Data EHR CTMS PennOmics Genomic Data Center for Personalized Diagnostics Internal Research Labs Cohort Explorer Tumor Registry Reference Datasets Oracle Healthcare Data Warehouse API Access

PennOmics - Data Classes Data class Patients Encounters Medications Diagnosis Procedures Labs, microbiology MAR Vitals Tumor Stage & Grade Studies Clinical Genomics (CPD, PMBB) Research Genomics (CNDR) Data Since 2005 2008 2008 2008 2008 2008 2008 2011 2010 2001 2013 Various

PennSeek Based on Oracle Endeca Intuitive e-shopping-like user interface Reduces data sourcing burden Reduces data abstraction turnaround by up to 80% Inspires unanticipated questions

PennSeek - User Interface

PennSeek - Guided Navigation

PennSeek - Search Terms Highlighted in Context

TriNetX https://live.trinetx.com Global research network: 11 countries, 100M patients, 70 HCOs (e.g. Penn, TJ, Drexel, Temple, Penn State) Over 50% of CTSA program hub sites use TNX Optimizes / lowers cost / speeds up clinical research design and patient recruitment Value to participants: Attract sponsored studies from pharma and CROs, by finding and recruiting patients that match protocol criteria Free-of-charge (TNX provides servers) Design protocols with inclusion and exclusion criteria

TriNetX https://live.trinetx.com Penn Data: Demographics, Encounters, Px, Dx, Rx, Labs, Cardiology tests (LVEF, QTc, NYHA), some Vitals, PFT, Tumor Registry data TNX schema can incorporate genomic data Data mapped onto standard vocabularies (HL7, LOINC, NDFRT, RxNorm, CPT, ICD, ICD-O) Data Security: data stays behind Penn firewall, data deidentified, pharma see only counts (rounded), cannot search by ZIP, HCO sees only own patient-level data

Clinical Data Access for PSOM Researchers Access Point Access Type Data Available Time for access prerequisites HIPAA training? CITI training? UPHS account required IRB approval required PennOmics Web dashboard, self-service de-identified clinical data no clinical notes some genomic data (upon request) 1 week Yes No No No PennSeek Web dashboard, self-service. identifiable clinical data, including free-text notes 7-8 weeks Yes Yes Yes Yes Custom Data Requests Work with UPHS data analyst who retrieves data and provides in desired format. identifiable clinical data 10k tables in EPIC Clarity PDS: subset of EPIC, historical and current nonEPIC 1-2 weeks for simple requests, highly variable for complex requests No No No Yes, unless requesting aggregate or deidentified data Schemas and dictionaries: www.med.upenn.edu/dac/ penn-data-store-warehouse .html

DAC contacts Custom Reporting – Info: http://www.med.upenn.edu/dac/about-reporting.html – Requests: http://www.med.upenn.edu/dac/data-request.html – Support: [email protected] – Open Office: Tuesdays 1-4pm (schedule at least week before) PennOmics – Info: www.med.upenn.edu/dac/cohort-explorer.html – Training: https ://performancemanager4.successfactors.com/sf/learning?company 71508P& s.crb Pr1juTwaOuTClazXhmXHVWiU 85I%253d – Owner: [email protected] – Support: [email protected] PennSeek – Info: www.med.upenn.edu/dac/pennseek.html – Owner: [email protected] – Support: [email protected]