Understanding Data, Databases, Information & Information Systems in Nursing Informatics

1. CHAPTER 7 DATA PROCESSING Nursing Informatics

2. Defining Data, Databases, Information & Information Systems • Data - raw uninterrupted facts that are without meaning e.g. a patient’s weight is recorded as 140 lb When data is interpreted , information is produced. While data are meaningless, information by definition is meaningful. For data to be interpreted and information produced, the data must be processed. This means that the data are organized so that patterns and relationship between the data can be identified. Nursing Informatics

3. Defining Data, Databases, Information & Information Systems (continued) Approaches to organizing data: • Sorting • Classifying • Summarizing • Calculating e.g. students notes & handouts, checkbook Nursing Informatics

4. Defining Data, Databases, Information & Information Systems (continued) What is a database? Database is an organized collection of related data. e.g. placing notes in folders and folders in file cabinets & phonebook Four factors in finding information in the database: • how the data are named (indexed) and organized • the size and complexity of the database • the type of data within the database • the methodology or tools used to research the database Nursing Informatics

5. Defining Data, Databases, Information & Information Systems (continued) Information systems are used to process data and produce information. • The systematic approach used to name, organize & store data in a database has a major impact on how easy it is to find information in the database. Nursing Informatics

6. Defining Data, Databases, Information & Information Systems (continued) Types of Data Two primary approaches in classifying data in a database system: • classified in terms of how these data will be used by the user e.g. financial data, patient data or human resource data • classified by their computerized data type e.g. data can be numbers or letters or combination of both Nursing Informatics

7. Defining Data, Databases, Information & Information Systems (continued) Computer-Based Data Types • alphanumeric data – includes letters & numbers in any combination e.g. address, social security number, memo – a specific type of alphanumeric data • numeric data are used to perform numeric functions format options – the number of digits after the decimal or the presence of commas in a number - it can be long integer, currency, scientific date & time are special types of numeric data Nursing Informatics

8. Defining Data, Databases, Information & Information Systems (continued) • logic data are limited to two options e.g. YES or NO, TRUE or FALSE, 1 or 2, and ON or OFF Conceptual Data Types • reflect how users view data • based on the source of the data • based on the event that the data are attempting to capture. e.g. image data from x-ray, lab data, assessment data, intervention data and outcome data Nursing Informatics

9. Defining Data, Databases, Information & Information Systems (continued) Database Management Systems (DBMS) - computer programs used to input, store, modify, process, and access data in a database. • Before a DBMS can be used, a DBM software must first be configured to manage the data specific to the project. • This process of configuring the database software is called database system design. Nursing Informatics

10. Defining Data, Databases, Information & Information Systems (continued) DBMS interacting parts • Data • DBMS configured software program • Query language used to access the data Advantages of Automated DBMS • Decrease data redundancy • Increase data consistency • Improve access to all data Nursing Informatics

11. Defining Data, Databases, Information & Information Systems (continued) Fields, Records, and Files record field field attribute Nursing Informatics

12. Defining Data, Databases, Information & Information Systems (continued) • Field attribute is the specific datum for that field for that record. • Each row represents a record. • Each row is assigned a primary identifier. • A primary identifier is unique to that record. • A file is defined as a set of related records that have the same data fields. To summary, a database is made up of files, files are made up of records, records are made up of fields, and fields contain data. Nursing Informatics

13. Defining Data, Databases, Information & Information Systems (continued) Types of Files • Processing Files - executable files consists of a computer program or set of instructions that, when executed, causes the computer to open or start a specific computer program or function- these are the files that tell a computer what actions a computer should perform when running a program. Nursing Informatics

14. Defining Data, Databases, Information & Information Systems (continued) Command files are a set of instructions that perform a set of functions as opposed to running a whole program. A batch file contains a set of operating system commands. e.g. SET UP. EXE, AUTOEXEC.BAT,CONFIG.SYS • Data Files - contain data that have been captured and stored on a computer using a software program e.g. document created in MS Word with the extension .DOC Nursing Informatics

15. Defining Data, Databases, Information & Information Systems (continued) Database Models A database system provides access to both the data in the database and to the interrelationship within and between the various data elements. Conceptual Models • includes diagram and narrative description of the data elements, their attributes and the relationships between the data. Nursing Informatics

16. Defining Data, Databases, Information & Information Systems (continued) • Conceptual Models • it defines the structure of the whole database in terms of the attributes of the entities (data elements) relationships, constraints and operations. Amoxicillin 500 mg q 8hrs. Times 10 days Dose 1 Dose 30 Dose 2 Dose 6 Dose 3 Dose 5 Dose 4 Nursing Informatics

17. Defining Data, Databases, Information & Information Systems (continued) Examples: One-to-one relationship Medication Order Medication Administration One-to-many relationship Individual medication order Individual patient Medication Name Dose Frequency Route Medication Name Dose Time Route Nursing Informatics

18. Defining Data, Databases, Information & Information Systems (continued) Structural or Physical Data Models There are four primary approaches: • Hierarchical • Network • Relational Database Models • Object-Oriented Model Nursing Informatics

19. Defining Data, Databases, Information & Information Systems (continued) Hierarchical -have been compared to inverted trees. All access to data starts at the top of the hierarchy or at the root. The table at the root will have pointers called branches that will point to tables with data that relate hierarchically to the root. Nursing Informatics

20. Defining Data, Databases, Information & Information Systems (continued) Network -developed from hierarchical models, the child note is not limited to one parent making it possible for a network model to represent many-to-many relationships. Nursing Informatics

21. Defining Data, Databases, Information & Information Systems (continued) Relational Database Models -consists of a series of files set up as tables. Each column represents an attribute , and each row is a record. The intersection of the row and the column is a cell. Nursing Informatics

22. Defining Data, Databases, Information & Information Systems (continued) Object-Oriented Model - developed because the relational model has a limited ability to deal with binary large objects or BLOBS, these are complex data types such as images, sounds, spreadsheets, or text messages. The entity and the attributes are stored within an object. Nursing Informatics

23. Database Life Cycle The development and use of a DBMS follow a systematic process called the life cycle of a database system. • Initiation - occurs when a need or problem is identified and the development of a DBMS is seen as a potential solution Nursing Informatics

24. Planning And Analysis The step begins with an assessment of the users view and the development of the conceptual model. what information…? how does…? Diagrams and narrative reports will be used to describe the data elements, their attributes, and the overall ideal information flow in the conceptual model Nursing Informatics

25. Detailed Systems Design - It begins with the selection of the physical model. • Data entry screens & the format for all output reports will be carefully designed. • Revisions are to be expected. Implementation - includes training the users, testing the system, developing a procedure manual for use of the system Nursing Informatics

26. Detailed Systems Design(continued) Evaluation and Maintenance The 1st evaluations should be informal & focus more on troubleshooting specific problems. Common Database Operations • Data input • Data processing • Data output Nursing Informatics

27. Detailed Systems Design(continued) Data Input Operations - used to enter new data, update data in the system, or change/modify data in the DBMS • common errors involves inconsistent data entry format Data Processing Processes - DBMS directed actions that the computer performs on the data once entered into the system e.g. OLTP( Online transaction processing) that supports day-to-day operation of the institution. Nursing Informatics

28. Detailed Systems Design(continued) Data Output Operations - includes online and written reports Reports that are clear and concise help the reader see the information in the data. On the other hand, poorly designed reports can mislead and confuse the reader. The development of a database system within a department serves 2 important purposes: • Both the developers & the users create a new level of knowledge and skills • As individual departments develop databases, institutional data are being created Nursing Informatics

29. The Development of Data Warehouses Data Warehouse - is defined as a large collection of data imported from several different systems within one database. -smaller collections of data are referred to as data marts. - Bill Immon, the father of the data warehouse concept, defined a data warehouse as a subject-oriented, integrated, time variant, nonvolatile collection of data used to support the management decision-making process. Nursing Informatics

30. Purposes of a Data Warehouse • A data warehouse makes it possible to separate the analytical and operational processing. • With this separation the architectural design of the data warehouse is designed to support decisional information needs. Nursing Informatics

31. Functions of a Data Warehouse • Must be able to extract data from various computer systems and import that data into the data warehouse. • Must function as a database able to store and process all of the data in the database. • Must be able to deliver the data in the warehouse back to the users on the form of information. Nursing Informatics

32. Functions of a Data Warehouse (continued) It support a number of activities: • Decision support for caregivers at the point of care • Outcome measurements and quality improvement • Clinical research and professional education • Reporting to external agencies • Market trend analysis and strategic planning • Health services management and process reengineering • Targeted outreach to patients, professionals, and other community groups Nursing Informatics

33. Data to Knowledge (D2K) The process of extracting information and knowledge from large-scale databases has been referred to as knowledge discovery and data mining (KDD) or D2K applications. The CRISP-DM model describes the life cycle of a data mining project in six phases: • Understanding the business • Understanding the data • Data preparation • Modeling • Evaluation • Deployment Nursing Informatics

34. The Nursing Context Wisdom Understanding, Applying, applying with compassion Increasing complexity Knowledge Interpreting, Integrating, understanding Information Organizing, Interpreting Increasing interactions and inter-relationships Data Naming, Collecting and organizing Nursing Informatics