Starting and sustaining an enterprise data warehouse (EDW) for a sizeable healthcare organization might seem as challenging as, say, forming a new country. While it is an arduous undertaking, there are plenty who have gone before. In this article, one EDW operations manager shares five steps for success: Start with a Leadership Commitment to Outcomes Improvement Build the Right Team Establish Effective Partnerships with IT Develop Interest and Gain Buy-In Pivot Toward Maintaining Success Successfully implementing and sustaining EDW operations is about establishing and managing priorities and understanding the enterprise-wide implications.

1. A 5-Step Guide for Successful Healthcare
Data Warehouse Operations
̶ Peter Johnson

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Healthcare Enterprise Data Warehouse (EDW)
A healthcare enterprise data warehouse
(EDW) is a fundamental component of a
robust analytics platform.
It brings together data from multiple sources
in a healthcare system: EMR, claims, supply
chain, cost accounting systems, and more.
It allows healthcare organizations to
comprehensively and systematically
measure many different disease conditions,
care delivery processes and operations,
and then produce analytics that lead to
decisions for improvement.

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Healthcare Enterprise Data Warehouse (EDW)
Once established, a considerable challenge
for any healthcare data warehouse operations
team is maintaining the performance of the
analytics platform while simultaneously
building new content to satisfy constantly
evolving needs in outcomes improvement.
Getting to an optimal state of ongoing
outcomes improvement is a multi-stage
process executed by effective partnerships
between the various business units, subject
matter experts, analysts, information services,
and the data warehousing team.

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A Five-Step Guide for Successful EDW Operations
I have the privilege of managing the EDW
for a large not-for-profit healthcare system
that handles more than 8.5 million clinic
visits, and hospital inpatient and outpatient
admissions annually. All this activity
generates a lot of data.
I’ve served multiple roles on our EDW team
over the past 11 years and have developed
a unique perspective on the EDW
implementation lifecycle and the lessons
learned through its many maturity levels.
I have been a Health Catalyst® team
member since 2015.

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A Five-Step Guide for Successful EDW Operations
This perspective can be distilled into a five-step guide for
successfully implementing and sustaining an EDW operations unit:
1) Start with a Leadership Commitment to Outcomes Improvement
2) Build the Right Team
3) Establish Effective Partnerships with IT
4) Develop Interest and Gain Buy-In
5) Pivot Toward Maintaining Success

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A Five-Step Guide for Successful EDW Operations
1) Start with a Leadership Commitment to Outcomes Improvement
A successful EDW begins with a sustained
commitment by leadership to outcomes
improvement.
Ours benefited from the vision of a former
Medical Director, who is now the CEO, to
place the EDW team within a department
of our organization focused on creating
clinical outcomes improvement.

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A Five-Step Guide for Successful EDW Operations
1) Start with a Leadership Commitment to Outcomes Improvement
Our leadership team made the critical
decision to team with Health Catalyst to
develop and implement the very first version
of its Catalyst Analytics Platform (CAP).
Health Catalyst founders’ experience in data
warehousing and outcomes improvement
helped us to quickly implement core data
content and the organizational structure
necessary to translate our data assets into
actionable information.

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A Five-Step Guide for Successful EDW Operations
1) Start with a Leadership Commitment to Outcomes Improvement
After getting our start with Health Catalyst,
we’ve come back together again.
As part of a 10-year partnership, we’re
implementing the latest version of CAP,
discovering new ways to challenge what the
technical platform can do, and making sure it
continues to meet its promises of
performance and extensibility.
This type of long-term commitment is typical
between Health Catalyst and its healthcare
system partners.

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A Five-Step Guide for Successful EDW Operations
2) Build the Right Team
Implementing and sustaining a successful
EDW platform likewise requires a talented
and committed team of professionals.
Our team consists of Health Catalyst and
health system team members who occupy
the following roles:
• Data Architects
• Business Intelligence Developers
• Data Stewards and Subject Matter Experts

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A Five-Step Guide for Successful EDW Operations
2) Build the Right Team
Data Architects
To implement the Health Catalyst platform,
the first step for our data architects is building
a robust set of source data marts containing
varied clinical and operational content from
across the health system.
Source data marts provide the foundation for
integrating content into focused subject
areas, which are leveraged by business
intelligence developers and analysts to
create analytic tools.

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A Five-Step Guide for Successful EDW Operations
2) Build the Right Team
Business Intelligence Developers
Our business intelligence (BI) developers
share similar responsibilities to the data
architect in that both roles involve integrating
source data into Subject Area Marts (SAM).
The BI developer’s specialty is in leveraging
SAMs to build dashboards and other
visualization tools, transforming data to
actionable information for a diverse audience
ranging from analysts with focused clinical
expertise to executive-level leadership.

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A Five-Step Guide for Successful EDW Operations
2) Build the Right Team
Data Stewards and Subject Matter Experts
Data stewards govern access to content in
the data warehouse and work in concert with
subject matter experts to ensure the
appropriate use and quality of data.
Subject matter experts are essential for
helping data architects, BI developers, and
analysts properly use data from the EDW
in their respective roles; they typically
have expertise in specific areas, like
finance or pharmacy data.

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A Five-Step Guide for Successful EDW Operations
2) Build the Right Team
Data Stewards and Subject Matter Experts
Our team serves a collection of 160 clinics,
rehab locations, pharmacies, hospitals, and
over 25,000 employees and physicians.
We are located onsite at the health system’s
corporate office.
If our daily EDW load is running late in
the morning, or if there are data issues of
a technical nature or that require triaging
with a data steward, we are accountable
and available to our customers.

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A Five-Step Guide for Successful EDW Operations
3) Establish Effective Partnerships with IT
EDW operations could not be
sustained without strong partners in
information services including:
• Systems administrators
• Operations programmers
• Database administrator

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A Five-Step Guide for Successful EDW Operations
3) Establish Effective Partnerships with IT
Our data warehouse benefits from a
responsive and technically proficient
team of IT professionals.
Through consistent communication
and processes, our IT team has
developed a solid understanding
operational needs so that technology
can be applied in a pragmatic and
effective manner.

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A Five-Step Guide for Successful EDW Operations
4) Develop Interest and Gain Buy-In
In 2008, we were retiring a 10-year-old data
warehouse platform with a smaller user base
than what we have today.
As our health system transitioned to an EMR,
it presented new opportunities to augment
our EDW with a significantly greater depth
and breadth of clinical data.
Fortunately, our organization benefited from
a mature and dedicated user base from the
previous data warehouse, providing a
significant head start on user engagement.

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A Five-Step Guide for Successful EDW Operations
4) Develop Interest and Gain Buy-In
To realize the potential of our current platform,
we had to generate interest and gain buy-in
among a new set of clinical data users.
We met this challenge by integrating our new
clinical data along with other sources,
broadening our analytic toolset to include
dashboards, and providing education to help
our users put these new tools into action.
Combined with training and ongoing support,
we have developed an audience of over
1,000 distinct users.

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A Five-Step Guide for Successful EDW Operations
5) Pivot Toward Maintaining Success
In the early years of a new platform, success
can be marked by developing robust content
and tools, finding influential early adopters,
and establishing a dedicated user base.
Ironically, these same markers can leave an
EDW team feeling like the victim of its own
success during the platform’s middle years.
As content expands, the same morning
deadline for refreshing data that had been
easily achieved becomes harder to meet
and sometimes missed.

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A Five-Step Guide for Successful EDW Operations
5) Pivot Toward Maintaining Success
The EDW team faces challenges in
balancing priorities between maintaining
existing and adding new data content.
Unintended consequences from decisions
made in the early years may unfold.
It’s essential to channel the trials of this
experience toward future success by
placing greater focus on work prioritization,
performance monitoring, and sustainable,
supportable design and controls to avoid
repeating past mistakes.

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A Five-Step Guide for Successful EDW Operations
5) Pivot Toward Maintaining Success
Now, as we are migrating to a new version
of CAP we are benefitting from previous
lessons learned.
Though the tools and capabilities we’re
working with have advanced significantly,
experience has taught us to foresee the
challenges of growth and manage
expectations appropriately.

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Blueprint for Outcomes Improvement Architecture
Going through the different stages of
maturity in building an EDW creates
evolving challenges and tensions, and
they are moving targets.
The tension stems from prioritizing
initiatives and content within the EDW,
and then keeping it operationally
sound and performing well daily.

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Blueprint for Outcomes Improvement Architecture
Knowing what to expect at the outset
and managing the expectations of
others goes a long way toward
successfully implementing an EDW.
Developing and sustaining an effective
EDW operations unit is a substantial
effort and long-term commitment.
Hopefully the five steps outlined here
create a blueprint for facilitating a
speedy, and ultimately successful,
implementation.

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For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

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More about this topic
Link to original article for a more in-depth discussion.
A 5-Step Guide for Successful Healthcare Data Warehouse Operations
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6 Surprising Benefits of Healthcare Data Warehouses: Getting More Than You Expected
Mike Doyle, Senior VP

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Mike Doyle joined Health Catalyst in May of 2013 as a Vice President. He has been
connected with the Health Catalyst senior leadership team since 2006. Prior to Health
Catalyst, Mike led the Enterprise Data Warehouse (EDW) program at Allina Health as
Director of Healthcare Intelligence. He helped Allina grow its EDW program from a nascent
clinical improvement initiative to an enterprise-wide strategic asset, in heavy demand by
thousands of users across all of Allina’s 11 hospitals and 100+ clinics. Prior to his work with
Allina, Mike was employed on the Northwestern Medicine campus in Chicago, beginning as a Systems
Administrator at the Medical School and eventually leading the Analytics and Systems Integration team
at Northwestern Medical Faculty Foundation. In addition to his experience building strong technology
teams, Mike has experience in technical roles such as database administrator, web programmer, data
architect, and business intelligence developer. Mike holds a Master of Music degree from Northwestern
University and a Bachelor of Fine Arts degree from Carnegie Mellon University.
Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com