---
title: "Clinical operations intelligence belongs on the Lakehouse"
description: "The Site Feasibility Workbench addresses fragmented clinical operations data by placing a site-selection decision-support application, its models, and data on Databricks. Released as a fully open-source Databricks App, it combines a FastAPI backend, React frontend, Unity Catalog-governed data, Lakebase operational state, and AI/BI Genie within the workspace. TA-segmented LightGBM models use the organization’s CTMS, EDC, and IRT history alongside real-world evidence, patient access, qualification, Open Payments, and protocol-execution signals to rank sites. Each prediction stores SHAP attributions in a governed Unity Catalog Delta table, while MLflow tracks training runs and model versions; saved shortlists persist to Lakebase and Genie answers governed-data questions. The six-step workflow supports protocol selection through final shortlisting, including diversity considerations; the release is a decision-support layer rather than a source of record, and deployment reportedly takes about 30 minutes before security review and validation."
---

# Clinical operations intelligence belongs on the Lakehouse

[Databricks](https://yomu.fyi/company/databricks) · Nicholas Siebenlist, Surya Sai Turaga · May 13, 2026

**Type:** Problem & solution

## Summary

The Site Feasibility Workbench addresses fragmented clinical operations data by placing a site-selection decision-support application, its models, and data on Databricks. Released as a fully open-source Databricks App, it combines a FastAPI backend, React frontend, Unity Catalog-governed data, Lakebase operational state, and AI/BI Genie within the workspace. TA-segmented LightGBM models use the organization’s CTMS, EDC, and IRT history alongside real-world evidence, patient access, qualification, Open Payments, and protocol-execution signals to rank sites. Each prediction stores SHAP attributions in a governed Unity Catalog Delta table, while MLflow tracks training runs and model versions; saved shortlists persist to Lakebase and Genie answers governed-data questions. The six-step workflow supports protocol selection through final shortlisting, including diversity considerations; the release is a decision-support layer rather than a source of record, and deployment reportedly takes about 30 minutes before security review and validation.

## Context

Clinical operations data is distributed across warehouses, CTMS, EDC, BI layers, and separate application databases that do not support connected decision-making. The resulting synchronization lag, integration overhead, and reliance on spreadsheets weaken trust in site-feasibility decisions.

## Approach / What changed

The workbench runs as an open-source Databricks App with FastAPI, React, Unity Catalog, Lakebase, AI/BI Genie, LightGBM models, SHAP explanations, and MLflow tracking. It uses organization-specific clinical history and related signals to guide site selection, preserve shortlists, and provide governed prediction lineage.

## Takeaways

- SHAP attributions for each site prediction are stored in a governed Unity Catalog Delta table, allowing recommendations to be examined for systematic under-weighting of community sites, minority-serving institutions, or first-time investigators.
- The six-step workflow covers protocol selection, scoring constraints, geographic overview, site ranking, SHAP-based site analysis, and final shortlist creation, with diversity included as a scoring dimension.
- The workbench is explicitly a decision-support layer; CTMS, EDC, and IRT remain the authoritative source-of-record systems, while saved shortlists are persisted in Lakebase for team sharing.

**Tags:** [Databricks](https://yomu.fyi/topic/databricks), [Genie](https://yomu.fyi/topic/genie), [Lakebase](https://yomu.fyi/topic/lakebase), [MLflow](https://yomu.fyi/topic/mlflow)

- Source: [Databricks](https://www.databricks.com/blog/clinical-operations-intelligence-belongs-lakehouse)
- Source URL: https://www.databricks.com/blog/clinical-operations-intelligence-belongs-lakehouse
- Ingested by Yomu: 2026-08-31T03:34:44.693Z

[Read original post](https://www.databricks.com/blog/clinical-operations-intelligence-belongs-lakehouse)