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A hybrid method in healthcare information warehousing with Amazon Redshift

Information warehouses play a significant function in healthcare decision-making and function a repository of historic information. A healthcare information warehouse is usually a single supply of reality for medical high quality management techniques. Information warehouses are largely constructed utilizing the dimensional mannequin method, which has constantly met enterprise wants.

Loading complicated multi-point datasets right into a dimensional mannequin, figuring out points, and validating information integrity of the aggregated and merged information factors are the most important challenges that medical high quality administration techniques face. Moreover, scalability of the dimensional mannequin is complicated and poses a excessive threat of knowledge integrity points.

The info vault method solves many of the issues related to dimensional fashions, nevertheless it brings different challenges in medical high quality management purposes and regulatory stories. As a result of information is nearer to the supply and saved in uncooked format, it must be remodeled earlier than it may be used for reporting and different utility functions. This is among the largest hurdles with the info vault method.

On this put up, we talk about a few of the primary challenges enterprise information warehouses face when working with dimensional fashions and information vaults. We dive deep right into a hybrid method that goals to avoid the problems posed by these two and in addition present suggestions to reap the benefits of this method for healthcare information warehouses utilizing Amazon Redshift.

What’s a dimensional information mannequin?

Dimensional modeling is a method for storing information in a knowledge warehouse utilizing dimensions and details. It optimizes the database for quicker information retrieval. Dimensional fashions have a definite construction and set up information to supply stories that enhance efficiency.

In a dimensional mannequin, a transaction report is split both into details (typically numerical), additive transactional information, or dimensions (referential info that offers context to the details). This categorization of knowledge into details and dimensions, in addition to the entity-relationship framework of the dimensional mannequin, presents complicated enterprise processes in a method that’s simple for analysts to know.

A dimensional mannequin in information warehousing is designed for studying, summarizing, and analyzing numerical info corresponding to affected person important stats, lab studying values, counts, and so forth. Whatever the division or use case it’s associated to, dimensional information fashions can be utilized to retailer information obtained from monitoring varied processes like affected person encounters, supplier apply metrics, aftercare surveys, and extra.

The vast majority of healthcare medical high quality information warehouses are constructed on high of dimensional modeling strategies. The good thing about utilizing dimensional information modeling is that, when information is saved in a knowledge warehouse, it’s simpler to persist and extract it.

Though it’s a reliable information construction method, there are challenges in scalability, supply monitoring, and troubleshooting with the dimensional modeling method. Monitoring and validating the supply of aggregated and compute information factors is vital in medical high quality regulatory reporting techniques. Any mistake in regulatory stories might lead to a big penalty from regulatory and compliance businesses. These challenges exist as a result of the info factors are labeled utilizing meaningless numeric surrogate keys, and any minor error can impair prediction accuracy, and consequently have an effect on the standard of judgments. The methods to countervail these challenges are by refactoring and bridging the size. However that provides information noise over time and reduces accuracy.

Let’s have a look at an instance of a typical dimensional information warehouse structure in healthcare, as proven within the following logical mannequin.

The next diagram illustrates a pattern dimensional mannequin entity-relationship diagram.

This information mannequin accommodates dimensions and reality tables. You should utilize the next question to retrieve primary supplier and affected person relationship information from the dimensional mannequin:

SELECT * FROM Fac_PatientEncounter FP

JOIN Dim_PatientEncounter DP ON FP.EncounterKey = DP.EncounterKey

JOIN Dim_Provider PR ON PR.ProviderKey = FP.ProviderKey

Challenges of dimensional modeling

Dimensional modeling requires information preprocessing earlier than producing a star schema, which entails a considerable amount of information processing. Any change to the dimension definition ends in a prolonged and time-consuming reprocessing of the dimension information, which frequently ends in information redundancy.

One other subject is that, when relying merely on dimensional modeling, analysts can’t guarantee the consistency and accuracy of knowledge sources. Particularly in healthcare, the place lineage, compliance, historical past, and traceability are of prime significance due to the laws in place.

An information vault seeks to supply an enterprise information warehouse whereas fixing the shortcomings of dimensional modeling approaches. It’s a information modeling methodology designed for large-scale information warehouse platforms.

What’s a knowledge vault?

The information vault method is a technique and architectural framework for offering a enterprise with information analytics companies to assist enterprise intelligence, information warehousing, analytics, and information science wants. The info vault is constructed round enterprise keys (hubs) outlined by the corporate; the keys obtained from the sources are usually not the identical.

Amazon Redshift RA3 cases and Amazon Redshift Serverless are excellent decisions for a knowledge vault. And when mixed with Amazon Redshift Spectrum, a knowledge vault can ship extra worth.

There are three layers to the info vault:

  • Staging
  • Information vault
  • Enterprise vault

Staging entails the creation of a reproduction of the unique information, which is primarily used to assist the method of transporting information from varied sources to the info warehouse. There are not any restrictions on this layer, and it’s usually not persistent. It’s 1:1 with the supply techniques, usually in the identical format as that of the sources.

The info vault relies on enterprise keys (hubs), that are outlined by the enterprise. All in-scope information is loaded, and auditability is maintained. On the coronary heart of all information warehousing is integration, and this layer accommodates built-in information from a number of sources constructed across the enterprise-wide enterprise keys. Though information lakes resemble information vaults, a knowledge vault gives extra options of a knowledge warehouse. Nonetheless, it combines the functionalities of each.

The enterprise vault shops the end result of enterprise guidelines, together with deduplication, conforming outcomes, and even computations. When outcomes are calculated for 2 or extra information marts, this helps eradicate redundant computation and related inconsistencies.

As a result of enterprise vaults nonetheless don’t fulfill reporting wants, enterprises create a knowledge mart after the enterprise vault to fulfill dashboarding wants.

Information marts are ephemeral views that may be carried out straight on high of the enterprise and uncooked vaults. This makes it simple to adapt over time and eliminates the hazard of inconsistent outcomes. If views don’t give the required degree of efficiency, the outcomes might be saved in a desk. That is the presentation layer and is designed to be requirements-driven and scope-specific subsets of the warehouse information. Though dimensional modeling is usually used to ship this layer, marts may also be flat information, .xml information, or in different varieties.

The next diagram exhibits the standard information vault mannequin utilized in medical high quality repositories.

When the dimensional mannequin as proven earlier is transformed into a knowledge vault utilizing the identical construction, it may be represented as follows.

Benefits of a knowledge vault

Though any information warehouse must be constructed inside the context of an overarching firm technique, information vaults allow incremental supply. You can begin small and regularly add extra sources over time, similar to Kimball’s dimensional design method.

With a knowledge vault, you don’t have to revamp the construction when including new sources, in contrast to dimensional modeling. Enterprise guidelines might be simply modified as a result of uncooked and business-generated information is stored impartial of one another in a knowledge vault.

An information vault isolates technical information reorganization from enterprise guidelines, thereby facilitating the separation of those doubtlessly tough processes. Equally, information cleansing might be maintained individually from information import.

An information vault accommodates adjustments over time. Not like a pure dimensional design, a knowledge vault separates uncooked and business-generated information and accepts adjustments from each sources.

Information vaults make it simple to keep up information lineage as a result of it contains metadata figuring out the supply techniques. In distinction to dimensional design, the place information is cleansed earlier than loading, information vault updates are all the time gradual, and outcomes are by no means misplaced, offering an automated audit path.

When uncooked information is saved in a knowledge vault, historic attributes that weren’t initially obtainable might be added to the presentation space. Information marts might be carried out as views by including a brand new column to an current view.

In information vault 2.0, hash keys eradicate information load dependencies, which permits near-real-time information loading, in addition to concurrent information a great deal of terabytes to petabytes. The method of mastering each entity-relationship modeling and dimensional design takes time and apply, however the means of automating a knowledge vault is less complicated.

Challenges of a knowledge vault

An information vault will not be a one-size-fits-all answer for information warehouses, and it does have a couple of limitations.

To start with, when straight feeding the info vault mannequin right into a report on one topic space, you should mix a number of sorts of information. Because of the incapability of reporting applied sciences to carry out such information processing, this integration can cut back report efficiency and enhance the chance of errors. Nonetheless, information vault fashions might enhance report efficiency by incorporating dimensional fashions or including extra reporting layers. And for information fashions that may be straight reported, a dimensional mannequin might be developed.

Moreover, if the info is static or if it comes from a single supply, it reduces the efficacy of knowledge vaults. They typically negate many advantages of knowledge vaults, and require extra enterprise logic, which might be prevented.

The storage requirement for a knowledge vault can also be considerably larger. Three separate tables for a similar topic space can successfully enhance the variety of tables by three, and when they’re inserts solely. If the info is primary, you’ll be able to obtain the advantages listed right here with a less complicated dimensional mannequin fairly than deploying a knowledge vault.

The next pattern question retrieves supplier and affected person information from a knowledge vault utilizing the pattern mannequin we mentioned on this part:

SELECT * FROM Lnk_PatientEncounter LP

JOIN Hub_Provider HP ON LP.ProviderKey = HP.ProviderKey

JOIN Dim_Sat_Provider DSP ON HP.ProviderKey = DSP.ProviderKey AND _Current=1

JOIN Hub_Patient Pt ON Pt.PatientEncounterKey = LP.PatientEncounterKey

JOIN Dim_Sat_PatientEncounter DPt ON DPt.PatientEncounterKey = Pt.PatientEncounterKey AND _Current=1

The question entails many joins, which will increase the depth and time for the question run, as illustrated within the following chart.

This following desk exhibits that the SQL depth and runtime is proportional, the place depth is the variety of joins. If the variety of joins enhance, then the runtime additionally will increase and due to this fact the associated fee.

SQL Depth Runtime in Seconds Price per Question in Seconds
14 80 40,000
12 60 30,000
5 30 15,000
3 25 12,500

The hybrid mannequin addresses main points raised by the info vault and dimensional mannequin approaches that we’ve mentioned on this put up, whereas additionally permitting enhancements in information assortment, together with IoT information streaming.

What’s a hybrid mannequin?

The hybrid mannequin combines the info vault and a portion of the star schema to supply the benefits of each the info vault and dimensional mannequin, and is especially supposed for logical enterprise information warehouses.

The hybrid method is designed from the underside as much as be gradual and modular, and it may be used for large information, structured, and unstructured datasets. The first information accommodates the enterprise guidelines and enterprise-level information requirements norms, in addition to extra metadata wanted to rework, validate, and enrich information for dimensional approaches. On this mannequin, information processes from left to proper present information vault benefits, and information processes from proper to left present dimensional mannequin benefits. Right here, the info vault satellite tv for pc tables function each satellite tv for pc tables and dimensional tables.

After combining the dimensional and the info vault fashions, the hybrid mannequin might be seen as follows.

The next is an instance entity-relation diagram of the hybrid mannequin, which consists of a reality desk from the dimensional mannequin and all different entities from the info vault. The satellite tv for pc entity from the info vault performs the twin function. When it’s linked to an information vault, it acts as a sat desk, and when linked to a reality desk, it acts as a dimension desk. To serve this twin function, sat tables have two keys: a international key to attach with the info vault, and a major key to attach with the very fact desk.

The next diagram illustrates the bodily hybrid information mannequin.

The next diagram illustrates a typical hybrid information warehouse structure.

The next question retrieves supplier and affected person information from the hybrid mannequin:

SELECT * FROM Fac_PatientEncounter FP

JOIN Dim_Sat_Provider DSP ON FP.DimProviderID =DSP.DimProviderID

JOIN Dim_Sat_PatientEncounter DPt ON DPt.DimPatientEncounterID = Pt.DimPatientEncounterID

The variety of joins is diminished from 5 to a few through the use of the hybrid mannequin.

Benefits of utilizing the hybrid mannequin

With this mannequin, structural info is segregated from descriptive info to advertise flexibility and keep away from re-engineering within the occasion of a change. It maintains information integrity, permitting organizations to keep away from hefty fines when information integrity is compromised.

The hybrid paradigm allows non-data professionals to work together with uncooked information by permitting customers to replace or create metadata and information enrichment guidelines. The hybrid method simplifies the method of gathering and evaluating datasets for enterprise purposes. It allows concurrent information loading and eliminates the necessity for a company vault.

The hybrid mannequin additionally advantages from the truth that there isn’t a dependency between objects within the information storage. With hybrid information warehousing, scalability is multiplied.

You may construct the hybrid mannequin on AWS and reap the benefits of the advantages of Amazon Redshift, which is a totally managed, scalable cloud information warehouse that accelerates your time to insights with quick, easy, and safe analytics at scale. Amazon Redshift repeatedly provides options that make it quicker, extra elastic, and simpler to make use of:

  • Amazon Redshift information sharing enhances the hybrid mannequin by eliminating the necessity for copying information throughout departments. It additionally simplifies the work of maintaining the only supply of reality, saving reminiscence and limiting redundancy. It allows on the spot, granular, and quick information entry throughout Amazon Redshift clusters with out the necessity to copy or transfer it. Information sharing gives reside entry to information in order that customers all the time see probably the most up-to-date and constant info because it’s up to date within the information warehouse.
  • Redshift Spectrum lets you question open format information straight within the Amazon Easy Storage Service (Amazon S3) information lake with out having to load the info or duplicate your infrastructure, and it integrates effectively with the info lake.
  • With Amazon Redshift concurrency scaling, you may get constantly quick efficiency for hundreds of concurrent queries and customers. It immediately provides capability to assist extra customers and removes it when the load subsides, with nothing to handle at your finish.
  • To understand the advantages of utilizing a hybrid mannequin on AWS, you may get began in the present day without having to provision and handle information warehouse clusters utilizing Redshift Serverless. All of the associated companies that Amazon Redshift integrates with (corresponding to Amazon Kinesis, AWS Lambda, Amazon QuickSight, Amazon SageMaker, Amazon EMR, AWS Lake Formation, and AWS Glue) can be found to work with Redshift Serverless.


With the hybrid mannequin, information might be remodeled and loaded right into a goal information mannequin effectively and transparently. With this method, information companions can analysis information networks extra effectively and promote comparative effectiveness. And with the a number of newly launched options of Amazon Redshift, plenty of heavy lifting is completed by AWS to deal with your workload calls for, and also you solely pay for what you employ.

You may get began with the next steps:

  1. Create an Amazon Redshift RA3 occasion to your major medical information repository and information marts.
  2. Construct a knowledge vault schema for the uncooked vault and create materialized views for the enterprise vault.
  3. Allow Amazon Redshift information shares to share information between the producer cluster and shopper cluster.
  4. Load the structed and unstructured information into the producer cluster information vault for enterprise use.

In regards to the Authors

Bindhu Chinnadurai is a Senior Associate Options Architect in AWS based mostly out of London, United Kingdom. She has spent 18+ years working in every part for giant scale enterprise environments. At present she engages with AWS accomplice to assist prospects migrate their workloads to AWS with concentrate on scalability, resiliency, efficiency and sustainability. Her experience is DevSecOps.

 Sarathi Balakrishnan was the International Associate Options Architect, specializing in Information, Analytics and AI/ML at AWS. He labored carefully with AWS accomplice globally to construct options and platforms on AWS to speed up prospects’ enterprise outcomes with state-of-the-art cloud applied sciences and obtain extra of their cloud explorations. He helped with answer structure, technical steering, and greatest practices to construct cloud-native options. He joined AWS with over 20 years of huge enterprise expertise in agriculture, insurance coverage, well being care and life science, advertising and commercial industries to develop and implement information and AI methods.

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