Healthcare data and criteria for case finding

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Healthcare data and criteria for case finding

Post  pzajkowski on Thu Jan 05, 2012 12:58 pm

The process of "case finding" in healthcare essentially serves to identify patients who may need assistance in optimizing their health. For example, a person with diabetes who doesn't get their blood sugar levels measured regularly is in great risk of incurring additional health complications. Rules can be put in place to identify these types of patients so that clinicians can coordinate care to optimize such patients' overall health.

The company I work for has a need to ramp up the criteria they use for case finding. The list of additional criteria looks something like this:

* identify patients with their last known A1c test that's over 12 months old
* identify patients where the last two A1c test results are greater than 8%
* identify patients where the last A1c test result is unknown (i.e., test happened-result unknown) and the previous A1c test is greater than 8%
* identify patients where the last two A1c test results are unknown (i.e., health claims data indicates tests were done, but we don't have the actual test results)
* identify patients where the last two LDL test results were greater than 100
* identify patients where the last two LDL test results are unknown
* identify patients where the last LDL test result is greater than 100, and the previous LDL test results is known
.... etc.

Approximately 18 different criteria need to be implemented as part of the case finding report. I imagine there will be additions in the future as well.

Ultimately, I'm struggling with how best to implement these various criteria. When only two criteria existed, it was very easy to make the SQL dynamic to retrieve the data. But with so many additional criteria, I'm wondering if it makes sense to create some sort of "Dim_CaseFindingCriteria" dimension, and stamp the keys onto relevant fact rows or perhaps use a factless bridge table that categorizes a given fact/test into the relevent case finding criteria similar to the way diagnoses are managed as a multi-valued dimension.

So, for any of you that have experience working with healthcare data, particularly with case finding, what suggestions might you have?

My goal is to continue to maintain a single report that merely has a dropdown box whereby a user can select one of the case finding criteria. The criteria is essentially a filter -- i.e. part of a "where" clause in sql. The criteria doesn't change the fields returned to the report, just the content based on the criteria selected.

(Also, my supervisor is wondering if we need to move to OLAP to best handle these kinds of criteria. )


Thanks in advance,
Pete

pzajkowski

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