web & data warehouse to evaluate and control activities of ... · and control activities of...

Banche Dati SEUGI 2002 13/06/2002 1

Web & Data Warehouse to evaluate

and control activities of Regione

Piemonte Cancer Screening Programs

Patrick JEGOU CSI-Piemonte

Corrado MAROZZO SAS Italy


An increasing reality since 1977

Promoting University PolytechnicBodies of Turin of Turin

Supporting CityBodies of Turin

Ordinary 39 Local AuthoritiesBodies (Provinces, Municipalities, Agencies, Health Institution

and Hospitals, 1 Mountain Community, 1 Municipality Association)

The CSI-Piemonte is a regionalregionalregionalregional public Consortiumpublic Consortiumpublic Consortiumpublic Consortium


! Key instrument for Public Administration reform of Piedmont through the interaction of public information systems by means of RUPAR (Integrated regional public administration network)

! Manager of information systems for Consortium members

! Among the top 30 information service companies in Italy

The role of Consortium


Activity fields

Operational

Decision Support

CSI-Piemonte handles all information system processes


Territory and EnvironmentLand Register and Taxes

Health and Public AssistanceAgriculture

Administrative-managerial processes

Activity fields

Libraries and Cultural HeritageJustice

Job and Education Research and University

Internet and ICT


! Decision support and statistical analysis

! Several work groups

! Basic themes✔ Pharmaceutical✔ Health indicators✔ Oncological Centres network✔ Centralisation pathological anatomies✔ Screening programs (cytological and mammographical)

CSI-Piemonte Health activity


Regione Piemonte put in action on its own territory, the screening programs for Breast Cancer and Cervix Carcinoma, in the ambit of cancer secondary prevention.

Female population is invited to undergo a mammography every two years and a Pap smear every three years.

Screening program


On the whole regional territory act 9 Screening Departments whose goals and needs are to evaluate, monitor and quantify the programs activities.

The Reference Centre for Cancer Epidemiologist and Prevention in Piedmont (CPO) co-ordinate and evaluate programs at regional level

Screening program


regions partially activated

Scheduled activation

Approved activation

TorinoMoncalieriCollegnoVercelliAlessandriaNovaraIvreaCuneoAsti

Mantova prov.

114

1

13

9

6

2

42

1

3

regions fully activated

1

1

2

1

Screening Departments in Piedmont and Italy

9


Target populationTarget populationFemale population in Regione Piemonte: 2,207,727

Target population (female 25- 64 years old) : 1,226,714 55.5%

ASL

1-4

ASL

8

ASL

5-10

ASL

6-7-

9

ASL

11-1

2

ASL

13-1

4

ASL

15-1

6-17

-18

ASL

19-2

1

ASL

20-2

2

Piedm

ont R

egion

2 5 -3 4 6 9 .5 3 9 2 3 .0 7 3 3 7 .4 7 4 4 1 .2 3 6 2 5 .3 6 6 3 7 .9 3 5 4 0 .4 9 5 2 2 .0 5 0 2 1 .9 5 9 3 1 9 .1 2 7

3 5 -4 4 6 5 .4 6 1 2 2 .1 3 8 3 8 .1 0 7 4 2 .6 6 6 2 5 .8 6 7 3 7 .4 0 9 4 0 .2 6 3 2 2 .7 7 8 2 3 .4 7 7 3 1 8 .1 6 6

4 5 -5 4 6 4 .0 3 7 2 1 .5 7 2 3 7 .1 3 7 4 0 .1 2 6 2 4 .8 1 7 3 3 .7 4 4 3 6 .7 3 5 2 1 .6 6 2 2 2 .4 5 8 3 0 2 .2 8 8

5 5 -6 4 6 5 .2 2 3 1 8 .8 5 8 3 3 .5 6 5 3 5 .7 6 5 2 3 .9 9 5 3 1 .9 6 9 3 4 .3 3 4 2 0 .6 3 8 2 2 .7 8 6 2 8 7 .1 3 3

To ta le 2 6 4 .2 6 0 8 5 .6 4 1 1 4 6 .2 8 3 1 5 9 .7 9 3 1 0 0 .0 4 5 1 4 1 .0 5 7 1 5 1 .8 2 7 8 7 .1 2 8 9 0 .6 8 0 1 .2 2 6 .7 1 4

Target Population


UniverseWomen of age comprised in the defined range

To be Invited and Excluded

Invited womenwomen whom the invitation letter has

been sent

Participating womenWomen presenting themselves to the test

Examined womenwomen undergoing a 1st

level examination

Invited womento 2nd level examination

Positive to Biopsy

Participating women colposcopy

cytological Screening - referential population


1,226,714

408,904

260,937

99,365

2,027

326

1,700

Cytological Screening - referential population


Regional IndicatorsRegional Indicators

! Number of invited women! Number of partecipating women! Unsatisfactory Pap Smears! Elapsed time between execution and medical report! Recall Rate! 1st level cytological diagnosis distribution! Cytological Positive Predictable Value (PPV)! Detection Rate

Indicators for evaluate and monitor the program


Project Objectives

CPO

Co-ordination Evaluation

PIEDMONT REGION


Project Objectives

Department1

Co-ordination

Department

Department n

Department 9

Quantification Evaluation


Project Architecture

Back-End

Front-End

(Web based)

•Sun Solaris

•SAS with SAS/WA

•Sun Solaris

•Apache/ Tomcat

•JSP Technology with AppDevStudio


Why data Warehouse ?Why data Warehouse ?

Project Definition

! Data standardisation (9 departments)

! Periodical analysis

! Automation of creation/maintenance of processes

! Easy data access


Why SAS ?Why SAS ?

Project Definition

! Unique solution from Back-End to Front-End

! Regional data in SAS format

! Easy access to various data formats (Oracle, txt)

! Rapid development

! Development team Know-How

! Help of SAS Consulting in data warehousing design

! CPO is already a SAS user


! Subject Definition

! Operational Data sources extraction

! Definition and creation DB for decisional support

Data Warehouse Architecture


Project Management : Subjects

! ID information

! Invitation date

! Level 1 test date

! Recall date

! Diagnosis date

! Round

Evaluation SubjectEvaluation Subject


Project Management : data flow

Data Warehouse

Operational data

(invited, attendants, examined)

from 9 departments

Regional Population DB


Departments operational DB

Back-End

MDDB Indicators

Data warehouse Data Validation

Summary and Transformation Data

Detailed Data


Front-End

MDDB Detail data Indicators

Multidimensional Analysis

Query & Reporting Custom Indicators

Static Indicators


Front-End Development

WEB/AF WEB/EIS

Privacy control (ACL)

MDDBIndicators Detail data


! 9 departments

! 50 users

! Direct access via web

! Authentication

System Delivery


Front-End Delivery


Mammographical Main Menu


Cytological Main Menu


Indicator Selection


Indicator Reporting


Cytological Multidimensional Reporting


Cytological Detail Data


Front-End Delivery


Data Flow Documentation


! CPO evaluate and co-ordinate programs faster

! Departments evaluate programs faster

! Scheduled indicators construction

! Enhanced visibility of indicators from all users

with respect of privacy

! More time to follow patients

Conclusion


Team Project :

!Mancini E. CPO!Senore C. CPO

!Favero C. CSI-Piemonte!Crosetto L. CSI-Piemonte!Jegou P. CSI-Piemonte

!SAS Italia

Conclusion

Process and algorithms definition

Design & realisation of the IT solutions

Support for new technologies

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