Translated and updated from the original presentation at the seminar of “Openness and the Future of Healthcare IS” by Service Factory, Aalto University School of Business at 18th of March 2014.

OPEN DATA - Critical Capability in Healthcare Information Production Processes

Sami Laine, Doctoral StudentDepartment of Computer Science and Engineering, Aalto UniversityEmail: sami.k.laine@aalto.fi

University of Turku, Finland• Information systems

• Empirical field studies in hospital focusing on the use of IT.

Turku University Hospital, Finland• Healthcare datawarehousing

• Project management, system and service design.

Aalto University, Finland• Usability Research

• Healthcare data quality research across contexts.

Personal background combines technical, social and healthcare perspectives

Over 10 years involvement in healthcare sector

Idealistic View – Open Data is Completely Free

Completely Free - Availability and Access

Completely Free - Reuse and Redistribution

Completely Free - Universal Participation

http://okfn.org/ http://fi.okfn.org/

This is not Enough nor always Possible

Benchmarking claimed significant productivity differences in neurology

specialty

Pirkanmaa Hospital District

Hospital District of Southwest

Finland

1,120,71

Laine, S., Niemi, E. (2013), “Transparency of Hospital Productivity Benchmarking in Two Finnish Hospital Districts”, In the Proceedings of the 29th annual Patient Classification Systems International (PCSI) Conference , Helsinki, Finland.

For example, fragmentation bias rewards splitting and heterogeneity

Hospital District

Hospital District

32

DRG X

Episode A

DRG X

DRG A

DRG B

DRG C

Less productio

n but more

health for same money!

More production but less

health for same money!

Laine, S., Niemi, E. (2013), “Transparency of Hospital Productivity Benchmarking in Two Finnish Hospital Districts”, In the Proceedings of the 29th annual Patient Classification Systems International (PCSI) Conference , Helsinki, Finland.

Enters data for primary

purpose

Builds data sets for

secondary use

Analyses and reports data

Interprets data and makes

decisions

Medical Imaging System

Electronic Patient Record

Scriptscollect data

Scripts collect data

Internal Service Reports

Scripts produce internal reports

Finnish Hospital

Productivity Benchmarki

ng

Scripts produce

data external

sets

DATA SUPPLY DATA MANUFACTURING DATA CONSUMPTION

IPP has three problem themes: Human Errors, Software Features and Obscurity

Data Warehous

e

Scripts produce external reports

Data Warehous

e

Data Entry Errors

Application Feature Bias

Architecture Bias

Scripting Error

Interpretation Mismatch

Laine, S., Niemi, E. (2013), “Transparency of Hospital Productivity Benchmarking in Two Finnish Hospital Districts”, In the Proceedings of the 29th annual Patient Classification Systems International (PCSI) Conference , Helsinki, Finland.

Enters data for primary

purpose

Builds data sets for

secondary use

Analyses and reports data

Interprets data and makes

decisions

Medical Imaging System

Electronic Patient Record

Scriptscollect data

Scripts collect data

Internal Service Reports

Scripts produce internal reports

Finnish Hospital

Productivity Benchmarki

ng

Scripts produce

data external

sets

DATA SUPPLY DATA MANUFACTURING DATA CONSUMPTION

IPP has three problem themes: Human Errors, Software Features and Obscurity

Data Warehous

e

Scripts produce external reports

Data Warehous

e

Data Entry Errors

Application Feature Bias

Architecture Bias

Scripting Error

Scripting Error

Obscurity Obscurity

Obscurity

Obscurity

Laine, S., Niemi, E. (2013), “Transparency of Hospital Productivity Benchmarking in Two Finnish Hospital Districts”, In the Proceedings of the 29th annual Patient Classification Systems International (PCSI) Conference , Helsinki, Finland.

Inconsistent figures have been produced about the same issue at the same time…

Ambulatory Procedures in

Administrative Reports

Ambulatory Procedures in Operation

Room Reports

15687

10726

Which one is correct

?Laine, S. (2012), "APC-SIMULATOR: Demonstrating the Effects of Technical and Semantic Errors in the Accuracy of Hospital Reporting" In the Proceedings of the 17th International Conference on Information Quality (ICIQ), Paris, France.

Inaccuracies and semantic mismatches exist in healthcare data

“Patient bills”“Manually duplicated

codes”

“Planned procedures”

15687

10726

Both are more accurate than

expected but only for a specific

purpose.

”Actually PerformedAmbulatory Procedures”

- X %+ Y %

There exists semantic

mismatches and error rates between contexts for good

reasons.Laine, S. (2012), "APC-SIMULATOR: Demonstrating the Effects of Technical and Semantic Errors in the Accuracy of Hospital Reporting" In the Proceedings of the 17th International Conference on Information Quality (ICIQ), Paris, France.

You cannot trust Open Data unless you know exactly where data comes from and how it is

actually created!

All Ambulatory Procedures Planned or Billed

Patient Bills or Municipality

Invoices?

Detailed level in actual socio-technical reality!

Processes and Work Practices

User Interfaces and Data Entry Protocols

Data Models and Application Structures

One must also describe the Information Production Process behind the interface to avoid black boxes

Enters data for primary

purpose

Builds data sets for secondary

use

Analyses and reports data

Interprets data and makes

decisions for secondary purposes

Medical Imaging System

Electronic Patient Record

Scriptscollect data

Scripts collect data

Datawarehouse

Monthly Service Reports

Scripts produce internal reports

National Hospital

Benchmarking

Scripts produce data external

sets

DATA SUPPLY DATA MANUFACTURING DATA CONSUMPTION

Information Production Process (IPP) consists of three phases based on Total Quality Management

Wang, R. Y., Lee, Y. W., Pipino, L. L., Strong, D. M. (1998) “Manage Your Information as a Product”, Sloan Management Review, 39, 4, pp. 95-105.

National Registry

Medical Imaging System

Electronic Patient Record

Scriptscollect data

Scriptscollect data

Management Reports

Scripts produce internal reports

Research Results

DATA SUPPLY DATA MANUFACTURING DATA CONSUMPTION

Open Data means also Open Methods and Open Processes

Local Data Warehous

e

National Hospital

Benchmarking

Scripts produce external data sets

National Data

Registry

Scripts produce public reports

DATA METHODSOPEN DATA

Scripts produce external data sets

Scientific Data Set

Scripts produce external analysis

PROCESS

Information Production Process of Researchers

Information Production Process of Health Service Providers

Information Production Process of National Organizations

The problem is often the

obscurity of actual data

creation situations

Another problem is earlier

information production processes

Medical Imaging System

Electronic Patient Record

Scriptscollect data

Scriptscollect data

Management Reports

Scripts produce internal reports

Research Results

DATA SUPPLY DATA MANUFACTURING DATA CONSUMPTION

IPP capable for openness can be secured or opened at any phase

Local Data Warehous

e

National Hospital

Benchmarking

Scripts produce external data sets

National Data

Registry

Scripts produce public reports

PRIVATEOPENNES

S

Scripts produce external data sets

Scientific Data Set

Scripts produce external analysis

Information Production Process of Researchers

Information Production Process of Health Service Providers

Information Production Process of National Organizations

What aggregation level can be opened to

confidential or even public use?

“Truly Ideologically Open Data”

CONFIDENTIAL

OPEN

Medical Imaging System

Electronic Patient Record

Scriptscollect data

Scriptscollect data

Management Reports

Scripts produce internal reports

Research Results

DATA SUPPLY DATA MANUFACTURING DATA CONSUMPTION

Interfaces, Processes and Methods can be always made open

Local Data Warehous

e

National Hospital

Benchmarking

Scripts produce external data sets

National Data

Registry

Scripts produce public reports

DATA MODELS!APPLICATION INTERFACES!

TOOLS!SCRIPTS!

ALL OPEN!

Scripts produce external data sets

Scientific Data Set

Scripts produce external analysis

PROCESSES

WORKFLOWS

Information Production Process of Researchers

Information Production Process of Health Service Providers

Information Production Process of National Organizations

These should be OPEN at least for INTERNAL USE!

Medical Imaging System

Electronic Patient Record

Scriptscollect data

Scriptscollect data

Management Reports

Scripts produce internal reports

Research Results

DATA SUPPLY DATA MANUFACTURING DATA CONSUMPTION

Open Data supports Evidence-Based Management, Open Government and Open Science

Local Data Warehous

e

National Hospital

Benchmarking

Scripts produce external data sets

National Data

Registry

Scripts produce public reports

DATA METHODS OPEN X!

Scripts produce external data sets

Scientific Data Set

Scripts produce external analysis

PROCESSES

OPEN SCIENCE

EVIDENCE-BASED MANAGEMENT

OPEN GOVERNMENT

Medical Imaging System

Electronic Patient Record

Scriptscollect data

Scriptscollect data

Management Reports

Scripts produce internal reports

Research Results

DATA SUPPLY DATA MANUFACTURING DATA CONSUMPTION

Closed Data leads to traditional habits and beliefs, insider power politics and flawed science.

Local Data Warehous

e

National Hospital

Benchmarking

Scripts produce external data sets

National Data

Registry

Scripts produce public reports

DATA METHODSClosed & Obscure

Scripts produce external data sets

Scientific Data Set

Scripts produce external analysis

PROCESSES

OBSCURITY

OBSCURITY

OBSCURITY

Flawed Science

Habits and Beliefs

Insider Politics

Distributing Data

Typically Open Data Product Data Organization Data Service Data Administrative Data Customer

Instructions

Potential but challenging Open Data Distributing Sensitive

Data by using External Authorization

Distributing Sensitive Data in Aggregated Form

Acquiring Data

04/11/2023Laitoksen nimi 18

Typically Open Data Geographical data Aggregated

demographical data Aggregated statistics News and social

media feeds Reference data

Potential but challenging Open Data Full-scale master data

(i.e. customers, services etc)

External service transactions (i.e. Health services, transportation services etc)

Sensitive individual level demographical data

All Information Production Processes should have Open Data capability

Laitoksen nimi

Open Data should not be ”ideological product” but ”practical capability” that is utilized everywhere

Open Data as capability means Open Data, Open Methods and Open Processes For internal use For external users

However, The level of Openness of Data Sets is controlled according their content requirements.

Data SetsData ModelsApplication Interfaces

ToolsWorkflowsDocuments

Open Data Capability

All processes

Every workflow

Prevents Vendor-lock-in• Open standards and Application Interfaces• Open collaboration between stakeholders and use cases

Improves Transparency• To own healthcare service production• To own information management and software systems

Supports Quality Control• Own internal activity (patient services or medical device

maintenance)• Service providers (e.g. software or logistics)• External Benchmarking (e.g. international productivity

benchmarking)

Open Information Production brings Transparency and Interoperability to Software Systems and Healthcare

Application for Strategic Research Opening at 11.6.2012

Project time schedule 1.9.2012-31.8.2014

QUALIDAT

QUALITY OF DATA FOR VALID DECISIONS

Supporting Diverse Uses and UsersNieminen, Marko (prof.)Rossi, Matti (prof.)Borgman, JukkaKaipio, JohannaLaine, SamiMahlamäki, KatrineNiemi, Erkkahttp://qualidat.aalto.fi/

Enters data for primary

purpose

Builds data sets for secondary

use

Analyses and reports data

Interprets data and makes

decisions for secondary purposes

Big Data(e.g. medical

device)

Social Data(e.g. Facebook)

Operative Data(e.g. hospital ERP) Scripts

collect manually

entered data

Application inspects machine

generated event data

Analytical Datawarehous

e

Statistical Reports

Innovative algorithms produce

analyses

QUALIDAT RESEARCH = Tracking down the entire information flow

Open Data

Scripts construct data sets for external use

DATA GENERATION DATA MANIPULATION DATA UTILIZATION

http://qualidat.aalto.fi/

The Researched Domains in the Information Production Process

USER INTERFACE”Screens”

”Interactions”

DATA FLOW”Script logic”

DATA UTILIZATIONDATA MANIPULATIONDATA GENERATION

WORK PRACTICES”Processes”,”Guideline

s”

APPLICATION LOGIC”Data model” ”Interfaces”

DATA MODEL”Models” ”Descriptions”

ANALYTICS”Business rules” ”Aggregation

logic”

MEASUREMENT”Method”

BUSINESS FUNCTION”Domain terminology”

BUSINESS CASE”Situation”

”Conclusions”

Enters data for primary purpose

Builds data sets for secondary

use Analyses and reports data

Interprets data and makes decisions

for secondary purposes

http://qualidat.aalto.fi/

Scientific publications about open data and open science

Nosek, B. A., & Bar-Anan, Y. (2012), Scientific Utopia: I. Opening scientific communication. Psychological Inquiry, 23, pp. 217–243.

Nosek, B. A., Spies, J. R. and Motyl, M. (2012), Scientific Utopia: II. Restructuring Incentives and Practices to Promote Truth Over Publishability. Perspectives on Psychological Science, 7(6), pp. 615-631.

Some webpages about Openness

Open Science National Research Data Initiative  (TTA)

Open activism Open Knowledge Finland ry

Openness of ICT The Roadmap for Open ICT Ecosystems,

Berkman Center for Internet & Society at Harvard Law School

Questions?sami.k.laine@aalto.fi

https://www.researchgate.net/profile/Sami_Laine/http://www.linkedin.com/pub/sami-laine/2/a61/970

Versio 19.1.2014

Sami Laine, Doctoral StudentDepartment of Computer Science and EngineeringEmail: sami.k.laine@aalto.fi