| dc.description.abstract | The intent of the internship was to attempt the design and implementation of a
Decision Support System (DSS) in support of the Primary Healthcare Information
Management (PHIM) program, an initiative within the Nova Scotia Department of
Health and Wellness. The PHIM program supports the deployment of an Electronic
Medical Record (EMR) system to primary healthcare practitioners throughout the
province of Nova Scotia. The EMR system is used to capture information that is
related to patient encounters with primary healthcare providers and community based
specialists. The EMR data store represents a rich source of primary healthcare data
that is sought after by many healthcare stakeholder groups across the province. The
primary goal of the internship was to attempt to design and implement a DSS using
primary healthcare data extracted from the PHIM. Implementation of the DSS would
facilitate improved access to primary healthcare data which would provide unique
opportunities to improve efficiency and decision-making in a wide range of areas
including public and population health (eg chronic disease monitoring), clinical
research, resource utilization and public health planning.
This internship was completed in co-ordination with Concertia Technologies Inc
(Concertia), which was contracted by the Nova Scotia Department of Health and
Wellness to design and implement the DSS for the PHIM program. All work was
completed within the offices of Concertia in Halifax, Nova Scotia. The author was
responsible for completing the following tasks:
1. Understanding the business requirements of the PHIM program as they
pertained to primary care reporting requirements
2. Reverse engineering of the internal data structures of the Nightingale EMR
data store
3. Development of a data mapping document
4. Completion of a high-level technical design for a DSS
Masters of Health Informatics Internship Report
Dalhousie University 4
5. Implementation of some or all of the DSS
The design and implementation of the DSS was only partially completed during the
course of internship engagement due to unforeseen constraints beyond the control of
the author and the project team. Specifically, the project team was not able to gain
access to the EMR production database or a representative thereof, which prevented
the author from performing a definitive data analysis, validation of the design of the
Change Data Capture (CDC) mechanism and stress test of the proposed DSS schema
design. As a result, the internship was limited to the design and partial implementation
of the Primary Operational Decision Support System (PODSS) and to research into
the approach for de-identification of patient data for eventual transfer to the Health
System Decision Support System (HSDSS).
Upon completion of the internship, the student was able to gain knowledge and
experience in the following areas of health informatics:
1. Electronic Medical Record systems.
2. Data Warehouse Design (Normalized versus Dimensional).
3. Data anonymization. | en_US |
