Research Computing Infrastructure Systems Architecture - NCBI

Children's Primary Care Research Group Research Computing Infrastructure Systems Architecture Peter Margolis, M.D., University of North Carolina, Chapel Hill, NC, Craig Schlusberg, First Consulting Group, Somerset, NJ, and Mark Diehl, MPH, First Consulting Group, Washington, D.C. The Children's Primary Care Research Group (CPCRG) at the University ofNorth Carolina is a leader in improving the quality of health services for women, children and adolescents through development and use of evidence-based outcomes information and process interventions. CPCRG is bringing the process intervention into the practice setting and to the home through its Research Computing Infrastructure (RCI). The CPCRG has two principal areas of initiatives supported by the RCI, Preventive Services and Intensive Home Visiting. Web-enabling allows CPCRG to provide these services without geographic constraint.

each page of form data is collected via the web user interface, this transactional information is written to the staging database. The staged transactional data is periodically loaded to a data repository, which is optimized for data analysis. It is from this repository that SAS and other data analyses are performed.

Operational flexibility is designed into the system through a web forms editor. Web forms are built based on the definitional data (Study, Form, Question, etc.) described in the RCI Conceptual Data Model. The process is initiated when a system administrator selects the study for which the Web forms are to be generated. The RCI responds by reading the Project (e.g. study), Form, Form Element, and related data necessary to build the HTML (and/or Cold Fusion) files that make up the web-based user interface for form data entry. These generated files are then saved to the appropriate web server.

The Preventive Services initiatives comprise a number of similar projects with the same goal - to provide office-based assistance to populations of pediatrics practices. Current Preventive Services initiatives include a group of 44 pediatrics practices in North Carolina and 25 practices in Vermont. Other Preventive Services programs are planned for the next 3 years.

A Web-enabled prototype demonstrated Web-based forms data entry, along with on-the-fly forms creation and modification. This prototype developed user consensus and confirmed systems analysis conclusions. The prototype demonstrated:

The Intensive Home Visiting project aims to improve outcomes in children's health by providing low income expectant mothers with intensive education, monitoring and medical referrals both before and after childbirth. 14 counties in North Carolina are currently participating in the project and rapid growth is expected over the next 4 years. After each home visit and at other regular intervals, home visitors are required to complete a number of data collection forms.

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The on-line prototype employs cascading Active Server Pages while the stand-alone version uses the same scripts on a Personal Web Server.

The RCI consists of a conventional three-tier client/server system architecture. A model-based design and development approach was employed to implement this architecture. The target hardware platform consisted of the systems available at the UNC School of Public Health Sun Center. Individual Web and database servers are employed.

The CPCRG Research Computing Infrastructure at the University of North Carolina demonstrates how technology may be harnessed to improve the care delivery process and patient health. As a Web-based data collection and analysis system the RCI provides an optimal combination of efficiency, flexibility, responsiveness and capacity to enhance and expand evidence-based outcomes research, process interventions and outreach programs. By using Web technology the RCI brings process imwprovement directly into the practice and health improvement programs into the home.

The staging database area holds boet the study/form

defimition information and the transactional data that is collected as data is entered into web-based forms. The RCI uses web pages from a web server and data from the staging database to define the browser-based user interface that is presented to the web client. As

1067-5027/00/$5.00 C) 2000 AMIA, Inc.

Web-enabled data entry with edit checks, Off-line data entry using identical forms, Creation and modification of forms through a Web-based forms engine, Instantaneous updating of Web-forms.

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