Data Warehouses

A data warehouse is used to store and organize clinical information, often from multiple sources. It does not have to be real-time but often is refreshed nightly to provide near-real-time clinical support. A data warehouse can be linked to a single EHR and practice management system or shared across a network. Large data warehouses are being developed to support accountable care organizations and other large health systems. Health plans have data warehouses that integrate claims data; patient registry data; some clinical data, such as prescriptions and laboratory test results; and provider data. A number of applications use the data warehouse to provide reports, such as to profile providers, provide cost analysis, and provide a structure for pay-for-performance.

An example of the usefulness of a data warehouse is its ability to track a patient’s current drugs and attainment of associated metric targets. Health care professionals gain a complete understanding of the need for treatment intensification and opportunities for improvement by titration, or initiation of another drug class to advance treatment. In addition, adding medication adherence data, such as proportion of days covered,1 can be useful for helping to achieve the Healthcare Effectiveness Data and Information Set (HEDIS) metrics. The warehouse may also include email addresses, which can increase patient-provider communication while being more convenient and simpler for both the patient and the provider.2