Dimensional Warehouse Model Data Model

Entity

Entity Professional Practitioner Quality Analysis

Description

The analysis of the overall performance of the health plan's physicians and physician groups, including outcomes, care and administrative quality, innovation in patient care, communication, and consumer-driven initiatives. A wide variety of dimensions allow the health plan to easily correlate many different factors to better understand the impact of these factors on performance measures. These insights can then be used to tune the networks, or to develop appropriate provider and provider staff training. Provider performance analysis can also be used for marketing and sales, which depend on the quality of the plan's providers.

Attributes
Calendar Dk
Formulary Compliance Percentage
Geographic Area Dk
Level Of Specialty Board Certification
Number Of Board Certified Professional Practitioners
Number Of Claims Received
Number Of Claims Received Electronically
Number Of Complications
Number Of Complications Per Thousand Patients Treated
Number Of E-visits
Number Of Medical Errors
Number Of Members In Roster
Number Of Negative Incidents In National Provider Database
Number Of Outlier Outcomes
Number Of Patients Treated
Number Of PHRs Maintained
Number Of Practitioner Calls To Payer Help Desk
Number Of Prescriptions
Number Of Prescriptions For Formulary Drugs
Number Of Prescriptions Transmitted Electronically
Number Of Prescriptions Written Electronically
Number Of Primary Care Practitioners
Number Of Procedures
Number Of Professional Practitioners
Number Of Referrals
Number Of Submissions To PHRs
Outlier Percentage
Percentage Of Claims Submitted Electronically
Percentage Of Members With PHRs
Percentage Of Prescriptions Submitted Electronically
Percentage Of Prescriptions Written Electronically
Practitioner Dk
Provider Dk

Relationship
Professional Practitioner Quality Analysis_Calendar Dimension_FK
Professional Practitioner Quality Analysis_Geographic Area Dimension_FK
Professional Practitioner Quality Analysis_Provider Dimension_FK
Professional Practitioner Quality Analysis_Practitioner Dimension_FK

Primary Key
Professional Practitioner Quality Analysis PK

Dependencies
NONE

Reverse Dependencies

Attribute Details

Calendar Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Formulary Compliance Percentage

Description	The ratio of the number of prescriptions written by a provider that comply with the health plan organization's formulary to total number of prescriptions written for patients that are members of the health plan. Formula: [(A/B)*100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Geographic Area Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Level Of Specialty Board Certification

Description	The percentage of professional practitioners that provide care to member's upon nomination from the health plan, that are board certified in each of their specialties. Formula: [(A/B)*100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Board Certified Professional Practitioners

Description	The number of professional practitioners that provide care to member's upon nomination from the health plan who are board certified.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Claims Received

Description	Total the number of claims received from the provider.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Claims Received Electronically

Description	Number of claims received electronically from the provider.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Complications

Description	Overall number of complications recorded in the analysis.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Complications Per Thousand Patients Treated

Description	A quality measure for institutional providers allowing comparison of its experience treating people with a certain disease to others. Formula: [(A/B)*1000] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of E-visits

Description	Number of eVisits performed by this practitioner during the measurement period.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Medical Errors

Description	Number of medical errors during the measurement period.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Members In Roster

Description	The number of members assigned to a primary care practitioner (PCP).
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Negative Incidents In National Provider Database

Description	The number of negative incidents that are recorded in the National Provider Data Bank and Healthcare Integrity & Protection Data Bank.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Outlier Outcomes

Description	The number of times that the outcomes a provider achieves are more than 2 standard deviations from the outcomes off all providers for the same procedures, treatment or diagnosis.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Patients Treated

Description	Overall count of patients treated in the analysis.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of PHRs Maintained

Description	The number of Personal health records (PHR)s that are created and maintained by members on this practitioner's panel.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Practitioner Calls To Payer Help Desk

Description	The number of times a Healthcare Practitioner has contacted a help desk or provider relations area made available by a health plan organization during the measurement period.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Prescriptions

Description	The count of prescriptions for drugs or other treatments. A prescription is typically an order written by a healthcare professional for a drug or other treatment for a patient.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Prescriptions For Formulary Drugs

Description	Number of prescriptions for formulary drugs.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Prescriptions Transmitted Electronically

Description	Number of prescriptions transmitted to the pharmacy electronically.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Prescriptions Written Electronically

Description	Number of prescriptions written using an electronic prescribing system or the ordering modules of an electronic medical record system.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Primary Care Practitioners

Description	The number of primary care practitioners in a particular network or geographic area. Primary care practitioners generally would include physicians with taxonomy types general practice, family practice, internal medicine, pediatrics, obstetrics and gynecology OBGYN, geriatrics and may include advance practice nurses or other mid-level providers with similar taxonomy.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Procedures

Description	Number of procedures performed.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Professional Practitioners

Description	The number of practitioners who participate in the networks of the health plan organization.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Referrals

Description	Total number of referrals.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Number Of Submissions To PHRs

Description	A count of the number of times a healthcare practitioner submits member data on the personal health record,(PHR) provided by a health plan organization.
Data Type	Standards - Data Domains.ddm/Data Domains/Count [INTEGER]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Outlier Percentage

Description	The percentage of times that the outcomes a provider achieves are more than 2 standard deviations from the outcomes off all providers for the same procedures, treatment or diagnosis. Formula: [(A/B)*100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Percentage Of Claims Submitted Electronically

Description	Percent of claims submitted electronically. Formula: [(A/B)*100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Percentage Of Members With PHRs

Description	The number of members on this provider's panel that have an electronic personal health record (PHR) expressed as a percentage of the total number of members on this provider's panel. Formula: [(A/B)*100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Percentage Of Prescriptions Submitted Electronically

Description	Percent of prescriptions transmitted to the pharmacy electronically. Formula: [(A/B)*100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Percentage Of Prescriptions Written Electronically

Description	Percent of prescriptions written using an electronic prescribing system or the ordering modules of an electronic medical record system. Formula: [(A/B)*100] (see dependencies and their labels for measures used in the formula)
Data Type	Standards - Data Domains.ddm/Data Domains/Percentage [FLOAT(2)]
Is Part Of PrimaryKey	false
Is Required	false
Is Derived	false
Is Surrogate Key	false

Practitioner Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Provider Dk

Description	A numeric surrogate key used to uniquely identify entities in the dimensional model.
Data Type	Standards - Data Domains.ddm/Data Domains/Surrogate Key Large [LONG]
Is Part Of PrimaryKey	true
Is Required	true
Is Derived	false
Is Surrogate Key	false

Relationship Details

Professional Practitioner Quality Analysis_Calendar Dimension_FK

Is Identifying Relationship	true
Child Table	Professional Practitioner Quality Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Calendar Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Professional Practitioner Quality Analysis_Geographic Area Dimension_FK

Is Identifying Relationship	true
Child Table	Professional Practitioner Quality Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Geographic Area Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Professional Practitioner Quality Analysis_Provider Dimension_FK

Is Identifying Relationship	true
Child Table	Professional Practitioner Quality Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Provider Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Professional Practitioner Quality Analysis_Practitioner Dimension_FK

Is Identifying Relationship	true
Child Table	Professional Practitioner Quality Analysis
Child Multiplicity	ZERO_TO_MANY
Child Referential Integrity: On Delete	NONE
Child Referential Integrity: On Insert	NONE
Child Referential Integrity: On Update	NONE
Parent Table	Practitioner Dimension
Parent Multiplicity	ONE
Parent Referential Integrity: On Delete	NONE
Parent Referential Integrity: On Insert	NONE
Parent Referential Integrity: On Update	NONE

Primary Key Details

Professional Practitioner Quality Analysis PK

Key Attribute	Calendar Dk
Key Attribute	Geographic Area Dk
Key Attribute	Provider Dk
Key Attribute	Practitioner Dk

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