Oracle醫(yī)療大數(shù)據(jù)解決方案-----行業(yè)解決方案及案例分享

1、ORACLE-Engineered to Work TogetherORACLeOracle醫(yī)療大數(shù)據(jù)解決方案行業(yè)解決方案及案例分享甲骨文（中國(guó)）軟件系統(tǒng)有限公司2013年07月星11文整合了最好的公司星11文整合了最好的公司ApplicationsORACLe,COMMUNICATIONSPORTAL Nconvergin冷舷USP p辭Asor>HorORACLEFINANCIAL SERVICESrf-llex/m FRmnr frsORACLE*HEALTH SCIENCESINSURANCEPHASEFORWARDi“ Relsys.dminServerskyuiire*ORA

2、CLe*RETAILORACLEUTILITIESMiddlewareDatabasesOperating Systems & Virtual MachineServers & Storage爲(wèi)緡cz KB 0tommerce*IfeopleSoft. Siebel primavera agj|e (和 ha|eq 墜 Global Knowledge Software . Demantfa ， * ：LogicalApps.| D E D WA R DS農(nóng) ConformiaMiddleware Platform and Management -bea善乂 TANGOSOL

3、m AmberPointBusiness IntelligenceSiebel.Data Integration GoldenGateSunopsis svsTBfi金Identity & Access Manageme ntV .OCTETSTRING THORBridgestreamPerforma neeMan agement# HyperionUjmtrbce SystemsHyperRollEnterprise Content Manageme ntSTELLEN*-contextsCaptivationMy7irncj>IcnO SECERNO(pendi ng)RE

4、VENUE TECHMOLOGIESOperating SystemsInnoDiAuptymaTh« ot Fw1orniaftc« ACTIVE REASONINGSystems Management殘 Sun. MC3NIF 口 RCE Afelent K ClearAppVirtual MachinesVirtualiron殘SunStorageTekORACLE4您所知道和不知道的甲骨文：不只是數(shù)據(jù)庫(kù)Middleware楓化Database°Perati"9 Systeni:汁丿應(yīng)用方案-數(shù)據(jù)庫(kù)和中間件基礎(chǔ)設(shè)施數(shù)據(jù)中心的需要：完備的企業(yè)產(chǎn)品體系

5、ORACL&醫(yī)療衛(wèi)生行業(yè)解決方案Four Pillars with solution components協(xié)同醫(yī)療公眾健康管理醫(yī)療資源管理醫(yī)療支付醫(yī)療交互數(shù)據(jù)二次利用健康管理Health SystemRelationshipManagementCare TransitionManagementPopulationHealth ProgramsActive LongTerm Care成本績(jī)效分析運(yùn)營(yíng)效率管理臨床風(fēng)險(xiǎn)控制Patient / PartnerExperienceServiceInnovationOperationalExcellenceORACLG4醫(yī)療大數(shù)據(jù)的特點(diǎn)F=j TJ

6、' 1大容量,高變化的速度,復(fù)雜性,未知價(jià)值/低信號(hào)噪聲(4Vs)VOLUMEVELOCITYVARIETYVALUEORACLE© 2012 Oracle Corporation - Proprietary and Confidential5ORACLE© 2012 Oracle Corporation - Proprietary and Confidential5新興的數(shù)據(jù)源具備“4V's"特征-與“傳統(tǒng)”的結(jié)構(gòu)化數(shù)據(jù)集成的可能-如：傳感器，機(jī)器生成的，社交，圖像，非結(jié)構(gòu)化 可以獲取，整理，處理，分析的海量數(shù)據(jù)-通過(guò)在低成本硬件，非關(guān)系型數(shù)據(jù)模

7、型，API擴(kuò)展ORACLE© 2012 Oracle Corporation - Proprietary and Confidential5ORACLE© 2012 Oracle Corporation - Proprietary and Confidential5NATOORACLE© 2012 Oracle Corporation - Proprietary and Confidential5醫(yī)療大數(shù)據(jù)的價(jià)值提升醫(yī)療質(zhì)量降低醫(yī)療成本© 2012 Oracle Corporation - Proprietary and Confidential

8、9; 2012 Oracle Corporation - Proprietary and Confidential© 2012 Oracle Corporation - Proprietary and Confidential個(gè)體差異性對(duì)待，以 提高醫(yī)療質(zhì)量和結(jié)果。個(gè)體化差異個(gè)體化治療生物識(shí)別技術(shù)了解護(hù)理效果，推廣最佳 實(shí)踐。消除不必要的測(cè)試 /治療。通過(guò)度量和報(bào)告 來(lái)滿足質(zhì)量基準(zhǔn)預(yù)防計(jì)劃護(hù)理模式人口健康遠(yuǎn)程醫(yī)療/生物識(shí)別基于療效的償付© 2012 Oracle Corporation - Proprietary and Confidential在臨床，結(jié)合組學(xué)數(shù) 據(jù)與臨床

9、數(shù)據(jù)，防止 健康問(wèn)題，實(shí)現(xiàn)風(fēng)險(xiǎn) 識(shí)別，實(shí)行診斷及治 療與患者互動(dòng)，從而影響 其行為，監(jiān)控醫(yī)囑遵循 建立信任關(guān)系預(yù)防數(shù)據(jù)管理應(yīng)用研究新的臨床方案行為與生活方式監(jiān)控提升醫(yī)囑遵循預(yù)防社會(huì)媒體互動(dòng)市場(chǎng)營(yíng)銷/品牌ORACLEMTO*ALTHCAMNATOOracle健康科學(xué)解決方案“大數(shù)據(jù)”架構(gòu)數(shù)據(jù)源公有云和私有云proteus DlfitTAL HfALTMORACLE"數(shù)據(jù)集成 ORACL6eDATA INTEGRATOR數(shù)據(jù)整合ORACLE'HEALTH SCIENCESOATAB12c安全的多承租方架構(gòu)數(shù)據(jù)虛擬化數(shù)據(jù)可視化 ORACLE ORACLE10g DATA SERVI

10、CE INTEGRATOR12c DATA VIRTUALIZATIONUnified Modeling and AdministrationJiDBUSINESS INTELLIGENCEllllllllilli ORACLE1湖 q:r*ADF （定制視圖）EVENT PROCESSINGREAL-TIME DECISIONS感覺(jué)、回應(yīng)和決定組織和分析A 価nitration ConsoleCachn、Scant/. K)rfarrg, HrTeitHadoop/HDFSDeveloperTooingSavces 踴 tw 出圍 ftcgraTs FTORACLE ORACLENOSQL

11、DATABASEESSBASEHSGBU虔核數(shù)據(jù)模型B8I08I0M 06獲取©Spotfire曲 + a b | e a itA ft IQlikView開(kāi)放式（第三方視圖）決定ORACLG Oracle從健康科學(xué)到生命科學(xué)貫通解決方案ORACLG2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息P8ORACLG2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息P8數(shù)據(jù)的有效共享數(shù)據(jù)的分析利用臨床和科研的結(jié)合ORACLG2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息P8ORACLG2013 Oracle Corpora

12、tion 版權(quán)所有.屬干機(jī)密信息P8電子健康檔案 /HIE醫(yī)療分析研究分析Clinician & PatientPoKalsSecureCommunicationOracleEHAAppsu.2eklsllxloMauIAbasEMPITerminology ServicesRegistryIntegration &InteroperabilityClinical DataRepositorysecu3.wcocompZTanceJLnTasTuc-ure Mana gem enRopoitingConsolidation. IntegradcHi & Validati

13、onDatabase GridEHA Pannor AppsAd HocQuetyOLAPCustom 81 AppsResearchPortalAnalytics SuiteData MiningRoaP TimecnM nediuiGdreDau warthous#Foundationsamgemem sysmfn EXC9psr.on53naMgecn9n- SystomCohort Explorer for dataquery/analysis and fBedownload with role-basedaccess controlCDC StatisticalComputing S

14、erver (R.SAS. Matlab. HPC withfull traceability functionXHardware / Storage InfrastructureSecurity| N" |扁贏Master Data Management & Other Services數(shù)據(jù) 元數(shù)據(jù)數(shù)據(jù)數(shù)據(jù)醫(yī)院信息系統(tǒng)臨床科研系統(tǒng)BiobanksResearchORACLG2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息P8竈鑿護(hù)換（HIE）ORACLG9©2012 Oracle CorporationORACLG#©2012 Or

15、acle Corporation專家系統(tǒng) （文檔使用者）專科診所RIS/PACS（文檔源跨社區(qū)網(wǎng)關(guān)患者身份管理器RIS/PACS（文檔源）XDS文檔信息庫(kù)通用基礎(chǔ)架構(gòu)審計(jì)記錄信息庫(kù)診所BORACLG10©2012 Oracle Corporation醫(yī)療信息交換(HIE)Oracle解決方案診所B診所B?？圃\所丿XDS 息庫(kù)IHE跨社區(qū)網(wǎng)關(guān)IHE跨社區(qū)網(wǎng)關(guān)Oracle Health Sciences Information GatewayOracle Health Sciences Information GatewayPIX Manager/PDQ SupplierPIX Mana

16、ger/PDQ Supplierracle Healthcare Master Person Indexracle Healthcare Master Person IndexJ一丿廠宙計(jì)說(shuō)理IHEXDS文檔注冊(cè)庫(kù)Oracle Health Information ManagementIHE XDS文檔信息庫(kù)Oracle Healthcare Transaction BaseIHE審計(jì)記錄信息庫(kù)Oracle Healthcare Policy MonitorORACLG12©2012 Oracle Corporation安全與合規(guī)基礎(chǔ)架構(gòu)監(jiān)視和管理醫(yī)療信息交換(HIE) 主要的基礎(chǔ)架

17、構(gòu)組件醫(yī)生/患者門戶Enterprise MasterPerson Index文檔索引和注冊(cè)庫(kù)臨床數(shù)據(jù)信息庫(kù)術(shù)語(yǔ)服務(wù)集成和互操作數(shù)據(jù)庫(kù)網(wǎng)格和數(shù)據(jù)緩存硬件和存儲(chǔ)基礎(chǔ)架構(gòu)ORACLG14©2012 Oracle Corporation醫(yī)生/患者門戶Oracle Identity Management、Security Gateway、Oracle Health Sciences Policy Manager醫(yī)療信息交換(HIE) Oracle技術(shù)體系Oracle Healthcare MPI病人主索引Oracle Healthcare HIM醫(yī)療信息記錄管理Oracle Healthca

18、reTransaction BaseOracle Healthcare TransactionBase 一企業(yè)術(shù)語(yǔ)服務(wù)Oracle HIG/SOA/OSB醫(yī)療信息網(wǎng)關(guān)數(shù)據(jù)庫(kù)網(wǎng)格和Coherence緩存Sun 硬件、Sun 存儲(chǔ)、ExaData、ExaLogicORACLGOracle Healthcare Transaction Base (HTB)臨床集成的基礎(chǔ)事務(wù)性臨床數(shù)據(jù)信息庫(kù)基于HL7參考信息模型（RIM）標(biāo)準(zhǔn)規(guī)范化的醫(yī)療衛(wèi)生數(shù)據(jù)模型適用于多個(gè)標(biāo)準(zhǔn)醫(yī)療衛(wèi)生領(lǐng)域的域模型，例如患者就醫(yī)、實(shí)驗(yàn)室結(jié)果、綜合觀察、開(kāi)處方、醫(yī)務(wù)或病歷、 過(guò)敏癥、結(jié)構(gòu)化文檔（CDA）、診斷、疾病/問(wèn)題臨床文檔架構(gòu)（

19、CDAR2）支持CDA文檔保存和查詢批量提取數(shù)據(jù)將ELT定向到數(shù)據(jù)倉(cāng)庫(kù)或數(shù)據(jù)集市 IHE XDS.b RepositoryORACLGOracle從健康科學(xué)到生命科學(xué)貫通解決方案數(shù)據(jù)的有效共享數(shù)據(jù)的分析利用臨床和科研的結(jié)合電子健康檔案 /HIE醫(yī)療分析研究分析Clinician & PatientPoKalsSecureCommunicationOracleEHAAppsu.2eklsllxloMauIAbasEMPITerminology ServicesRegistryIntegration &InteroperabilityClinical DataRepositorys

20、ecu3.wcocompZTanceJLnfrasTuc-ure Man-RopoitingExttactInterfaceTablesDatabase GridHardware / Storage InfrastructureAd Hoc Quety數(shù)據(jù) 元數(shù)據(jù)OLAPEHA Pannor AppsCustom 81 AppsData MiningRoaP TimeConsolidation. IntegradcHi & ValidationcnM nediuiGdreDau warthous#FoundationEXC9psr.0n53naMgecn9n- SystomBusaoc

21、s RU-*=etMdmsamgemen-冒普ResearchPortalAnalytics SuiteCohort Explorer for dataquery/analysis and fBedownload with role-basedaccess controlCDC StatisticalComputing Server (R.SAS. Matlab. HPC withfull traceability functionX|s犒|朋|即| N" |扁贏Master Data Management & Other Services數(shù)據(jù)數(shù)據(jù)Til Q Q q rn臨床

22、科 研系統(tǒng)(Biobanks1GenomeResearcJEJORACLGP14Oracle醫(yī)療分析解決方案(EHA)EHA平臺(tái)EHA “應(yīng)用”臨床系統(tǒng)醫(yī)生績(jī)效管理高管財(cái)務(wù)系統(tǒng)管理系統(tǒng)Oracle醫(yī)療數(shù)據(jù)模型HDM科研系統(tǒng)Oracle醫(yī)療分析應(yīng)用合作伙伴應(yīng)用定制應(yīng)用OracleCDM供應(yīng)鏈分析研究人員手術(shù)室分析HAIReadmissionsAnalyticsRev CycleCohort Explorer醫(yī)務(wù)人員員工P15ORACLG2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息醫(yī)療分析方案概念架構(gòu)111I!OHADI：接口表到 HDWF1a111:OHADI: HDW

23、F !應(yīng)用：1 :i業(yè)務(wù)規(guī)則，MDM,元數(shù)據(jù)管:到應(yīng)用：報(bào)表，儀表盤，ii理HDW尸I! MDM,規(guī)范,計(jì)量平衡計(jì)分卡等源依賴的與源無(wú)關(guān)的:3NF EDW:Benchmarks,等：臨床數(shù)據(jù)挖掘The NEW ENGLAND JOURNAL of MEDICINEEvidence-Based Medicine in the EMR EraLucile PackardChildren's HospitalAT STANFORD00STANFORD朝IF SCHOOL OF MEDICINE1）患有系統(tǒng)性紅斑狼瘡的某患兒很可能有血栓2）我們是否應(yīng)進(jìn)行抗凝治療？3）沒(méi)有專家共識(shí)，也沒(méi)有 可靠

24、文獻(xiàn)。所以他們查閱了 臨床數(shù)據(jù)倉(cāng)庫(kù)。腎病范圍蛋白尿查詢了數(shù)據(jù)倉(cāng)庫(kù)并找到了 98名類似的總者這98名SLE患者中10名有血栓根據(jù)此數(shù)據(jù)倉(cāng)庫(kù)查詢對(duì)此患者進(jìn)行了抗凝治 療治療情況良好一沒(méi)有血栓，抗凝治療沒(méi)有引 起不良事件?？沽字贵w胰腺炎決翁基于信息而不是直覺(jué)一這是醫(yī)療保健的 未來(lái)趨勢(shì)。Jennifer Frankovich, M.D., Christopher A. Longhurst, M.D., and Scott M. Sutherland, M.D.ORACLG2013 Oracle Corporation 版權(quán)所有.屬于機(jī)密信息曰昌文P17ORACLG2013 Oracle Corpor

25、ation 版權(quán)所有.屬于機(jī)密信息曰昌文P17Frankovich J. Longhurst CA、Sutherland SMa NEJM (2011) 365:1758-1759ORACLG2013 Oracle Corporation 版權(quán)所有.屬于機(jī)密信息曰昌文P17Oracle手術(shù)室分析應(yīng)用解決方案（示例）外科麻醉護(hù)士患者進(jìn)入麻醉醫(yī)師準(zhǔn)備麻醉誘導(dǎo)手術(shù)開(kāi)始醫(yī)生準(zhǔn)備麻醉維持監(jiān)測(cè)結(jié)束患者離開(kāi)手術(shù)過(guò)程結(jié)束縫合清理完畢延遲手術(shù)室準(zhǔn)備護(hù)士患者準(zhǔn)備協(xié)助麻醉醫(yī)師協(xié)助手術(shù)安置患者清理手術(shù)室ORACLG2013 Oracle Corporation 版權(quán)所有.屬于機(jī)密信息ORACLG2013 Oracle

26、 Corporation 版權(quán)所有.屬于機(jī)密信息手術(shù)時(shí)間外科醫(yī)生時(shí)間麻醉師時(shí)間患者時(shí)間-手術(shù)室時(shí)間 包括延長(zhǎng)的手術(shù)室時(shí)間ORACLG2013 Oracle Corporation 版權(quán)所有.屬于機(jī)密信息ORACLG2013 Oracle Corporation 版權(quán)所有.屬于機(jī)密信息P18ORACLG2013 Oracle Corporation 版權(quán)所有.屬于機(jī)密信息Oracle手術(shù)室分析應(yīng)用關(guān)鍵績(jī)效指標(biāo)CDRACLG* Opemtinq Room AnatyticgVy Dasnboard 01 Summary 02 Volume & Utiizstton 03 Erncency

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28、| Reset |Same Day Cancellation RateSove Ooy Concelotcr Rote Admrifetrative Rcmocshysioan ReasonsTends.First Case DelayAverage Frst Case Criay (mh) First Case Delay Rate Adfmestrati/e Rsons Pti/sician ReasonsU43.3%C.S%0.9%TrendsAverage TurnoverAverage Turnover min) Rocedtre with loa$«t lurnovet

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30、rrun (Er Case Overrun Ratew.滬ICC%-Procedure wth longest overrun 烙 BMT (39.0 irin>Add-on RoteAdd-on Rate Non-emergenc>' add-on ratei 1%0.0%ProcedureCategoryPatieni In to Patient OutIncision to CloseIncision to Close % of Total DurationAMominol127as671%Cardflc26S2007S.3%Eye1016160.7%Fcrrote

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32、從健康科學(xué)到生命科學(xué)貫通解決方案2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息P202013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息P20數(shù)據(jù)的有效共享數(shù)據(jù)的分析利用臨床和科研的結(jié)合2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息P202013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息P20電子健康檔案 /HIE醫(yī)療分析ResearchPortal研究分析Clinician & PatientPoKalsSecureCommunicationu.2eklsllxloMauIAbasEMPITermi

33、nology ServicesRegistryIntegration &InteroperabilityClinical DataRepositorysecu3.wcocompZTanceJLnTasTuc-ure Mana gem enExttactDatabase GridHardware / Storage InfrastructureSecurity數(shù)據(jù) 元數(shù)據(jù)"Rear TimoRopoHingLAPMiningAd HocQueryConsolidation. IntegradcHi & ValidationEHAPannoiCustom 8lrftApp

34、s IkAppsOracle EHAAppscnM nediuiGdre Dau warthous# FoundationInterfaceTablesEXC9psr.0n nrnaMgecnn- SystomBus-nocs Ru-ocAnalytics SuiteCohort Explorer for dataquery/analysis and fBedownload with role-basedaccess controlCDC StatisticalComputing Server (R.SAS. Matlab. HPC withfull traceability function

35、Okies| N" |扁贏Master Data Management & Other Services數(shù)據(jù)Q一數(shù)據(jù)2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息P202013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息P20臨床科 研系統(tǒng)(BiobanksIGenomeResearcJEJORACLGBiobanksTil Q _ Q 匚| 2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息P20整合獨(dú)立的信息加速轉(zhuǎn)化醫(yī)學(xué)ORACLG醫(yī)療分析(EHA/TR C)解決方案EHA平臺(tái)EHA “應(yīng)用商店”高管臨床系統(tǒng)O

36、RACLGORACLG財(cái)務(wù)系統(tǒng)研究系統(tǒng)樣品和生 物庫(kù)數(shù)據(jù)Oracle分析應(yīng)用程序組學(xué)數(shù)據(jù)庫(kù)1數(shù)據(jù)集成醫(yī)療保健數(shù)據(jù)il和驗(yàn)證模型合作伙伴應(yīng)用程序管理系統(tǒng)定制應(yīng)用程序數(shù)據(jù)集成和驗(yàn)證轉(zhuǎn)換研究中心下一代測(cè)序一群組資源管理器臨床開(kāi)發(fā)中心比較療效 研究人員1醫(yī)生工作人ORACLGORACLG22 | Copyright © 2012, Oracle and/or its affiliates. All rights reserved.ORACLG Crizotinib (克里醴蒂尼)/XALKORI ®膠囊XALKORI"(crizotinib) capsuto250 mge

37、ocapsyCrizotinibLung Cancer Mutation ConsortiumIncidence of Single Driver MutationsMUTAwz% Mutation found in 54% (280/516) of tumors completely tested (Cl 50-59%)ORACLG2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息ORACLG2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息非小細(xì)胞肺癌（NSCLC）病人中約有1%7%的病人有ALK基因異常，Crizotinib是主要針對(duì)ALK變異蛋白

38、抑制劑。輝瑞（Pfizer）能夠得到美國(guó)食品及藥物管理局的批準(zhǔn)僅基于255名患者（基于生 物標(biāo)志篩選）的臨床試驗(yàn)的基礎(chǔ)上。從2007年發(fā)現(xiàn)基因變異至2010年獲得批準(zhǔn) 只用了3年時(shí)間。P26ORACLG2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息Moffitt癌癥研究中心佛羅里達(dá)州領(lǐng)先的癌癥?？茩C(jī)構(gòu) 與某醫(yī)院聯(lián)合體合作開(kāi)發(fā)了一個(gè)個(gè)性化的癌癥護(hù)理方法 Moffitt Cancer Center積極參與標(biāo)準(zhǔn)委員會(huì)事務(wù)，是指定的臨床試驗(yàn)點(diǎn)ORACLG2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息ORACLG2013 Oracle Corporatio

39、n 版權(quán)所有.屬干機(jī)密信息目標(biāo)：確定將會(huì)預(yù)測(cè)需求和風(fēng)險(xiǎn)的生物標(biāo)志 ,以便能夠提前干預(yù)設(shè)法及早發(fā)現(xiàn)疾病確定可預(yù)測(cè)哪些患者不會(huì)對(duì)護(hù)理治療 標(biāo)準(zhǔn)作出反應(yīng)的標(biāo)志特征通過(guò)在基于證據(jù)的方法中集成新技術(shù) 來(lái)提高所有患者的護(hù)理標(biāo)準(zhǔn)，從而最 大化成效和降低成本預(yù)防護(hù)理危險(xiǎn)人群診斷患者護(hù)理幸存復(fù)發(fā)性疾 病預(yù)后治療P27ORACLG2013 Oracle Corporation 版權(quán)所有.屬干機(jī)密信息患者分類查詢ORACLG- Translational Research Center v2.0 : Cohort Explorer Limited(ibikyin as tester Sign Out CDMy Wo

40、rkspaceDashboardQuery PatientsPat*n： ViewerOmcs ExplorerGeneSeSelect Cohort Criteria > Patient InformationInitial Patient Count <j)500,0002 Clinical DataGenomic DataGene ExpressionVanancsCopy Number Variawn Qutry Library Options Q Save QueryI j回話ery|Patient Count b503(c) 2012 Orade Corporation. Al rights res«rvedORACLG© 2011 Oracle and/or its affiliates. All rights reserved.29集成的基因組學(xué)數(shù)據(jù)展現(xiàn)ORACLG* Translational Research Center v2.0 : Cohort Explorer Limited Homelog