1. Funded by:
Conrad Ng (c.ng@dal.ca), Anatoliy Gruzd (gruzd@dal.ca) – School of Information Management, Dalhousie University
Calvino Cheng, Bryan Crocker, Don Doiron, Kent Stevens – Capital District Health Authority, Halifax, Nova Scotia, Canada
Introduction Seasonal Patterns Clinic to Clinic Network Physician to Clinic Network
This research uses data visualization techniques and Average Weekly Referrals
social network analysis to determine the status and 12000
efficiency of laboratory ordering for the outpatient 10000
system in Nova Scotia, Canada.
Average # of Referrals
8000
Currently, the Capital District Health Authority (CDHA)
6000
model demonstrates that approximately 60% of
laboratory ordering originates in the outpatient setting 4000
and is costing the province approximately $3.3 million 2000
May 2009 - April 2010
per month. May 2010 - April 2011
0
The goal of this pilot project is to turn the vast amount
May
May
Feb
Aug
Sep
Mar
Jun
Jan
Jul
Oct
Nov
Dec
Apr
of data in the CDHA’s laboratory information system
into usable information and allow the CDHA to identify
usage trends to better understand the future demands  This chart confirms seasonal patterns based on  The nodes (dots) are clinics; the size of the nodes
on lab testing and allow policymakers more insight holidays and long weekends. represents the total number of unique referrals from
that clinic.  Connection = physician’s affiliation with a clinic(s)
into the Nova Scotia primary care landscape.  There are consistently less tests ordered during  Node Size = # of patients
major holidays (see the “valleys” in the chart), often  Two nodes (clinics) are connected if they share 50 or  Most physicians who work at the Family Focus and
Method followed by a spike of these orders. more patients (“strong” connections). Walk-in clinic groups also work at other clinics.
1. Extracted anonymized, outpatient lab test orders  While the Family Focus and Walk-in clinics only
account for about 10% of all lab testing referrals, they
Conclusions
from CDHA’s Laboratory Information Systems for Demographic by Clinic Type
the period from May 2009 to May 2011 appear to be relatively “central” in this network.  Even relatively simple visualizations can offer useful
2. Re-indexed and cleaned records (e.g. assign  This network visualization can be used to identify insights to managers and other health professionals
unique identifiers and work addresses to physicians “well connected” clinics, ideal for disseminating new while helping them build a predictive model of
and clinics) information to physicians and patients. laboratory utilization.
Network Density of Clinic-to-Clinic Networks
 The network visualizations uncovered hidden
Dataset Summary
for Different Age Groups connections between clinics and provided some
# of Records 925,680 0.12
additional insights into the migration practices of
# of Clinics 196
0.1
0.08 patients among clinics.
Density
0.06
# of Physicians 426 0.04
0.02  These visualizations can also be applied to make
# of Patients 278,689 more effective health spending and planning decisions
0
Patients' Age Group
in other similar healthcare systems.
3. Descriptive analysis & visualization with Microsoft
 Density = # of actual connections in the network
Excel 2010  Walk-in, Family Focus, and Specialist type clinics are divided by the number of possible connections.
Acknowledgements
4. Network analysis & visualization with ORA 2.3.2 more likely to refer younger patients (18-30 years of This project is funded by MITACS and CDHA. We also thank
 The densest networks corresponded to the age
(developed by CASOS at Carnegie Mellon age) to the outpatient laboratory testing facilities, while the CDHA Pathology Informatics Group for assisting in the data
General-type clinics are more likely to refer older group between ~20 and 35.
University) based on the 3 networks: extraction and verification process.
 Clinic to Clinic (C2C), Physician to Clinic (P2C), patients (48-66 years of age).  This suggests that young adults are less likely to
More information on this and related projects can be found at
Physician to Physician (P2P) stay with the same clinic. www.SocialMediaLab.ca
TEMPLATE DESIGN © 2008
www.PosterPresentations.com