Data Driven Practice with e-MDs
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Data Driven Practice in e-MDs. This covers custom crystal reports from scratch, slicing and dicing data in Excel, Visualizing Data, and understanding that change isn't really a technical problem.
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Data Driven Practice with e-MDs
- 1. Data-driven practice with e-MDs User Conference, 2010 Jonathan Ploudré, MD
- 3. Geek?
- 4. 2008 Any EMR Yes No
- 5. 2008 “Full” EMR Yes No
- 6. Health IT
- 8. Brainstorm…
- 9. Herding Cats
- 10. Innovation
- 11. 3 Steps • Dump (Crystal Reports) • Dice (Excel) • Design (Excel)
- 12. FDA Warning
- 13. Dump
- 14. Where to Start? $500 $27 20 minutes 4 hours
- 15. Reporting Setup
- 16. Reporting Setup
- 20. Views are Legos
- 21. Joining…
- 22. From Blank slate to ‘Zocor Report’ in 2 minutes
- 24. Zip Code Catchment SELECT … addr.Address_ZipCode as 'Zip' … FROM … JOIN VIEW_Address addr on(a.Entity_ID = addr.Entity_ID) …
- 25. 3 Steps • Dump (Crystal Reports) • Dice (Excel) • Design (Excel)
- 26. Do I see my patients? Pt DOB DOS ICD CPT Doc PCP … … … … … … … … … … … … … … … … … … … … … … … … … … … …
- 27. Dice
- 29. Autofilter
- 30. Autofilter
- 31. Autofilter Flat File becomes Sortable/Filterable
- 32. Autofilter Flat File becomes Sortable/Filterable
- 33. Logic for Formulas • AND, NOT, OR, IF • =, !=, >, <, >=, <=, • True, False Focus Horizontally Pt DOB DOS ICD CPT Doc PCP … … … … … … … … … … … … … … … … … … … … … … … … … … … …
- 34. 1/0/Nothing =IF(OR(E2=99213,E2=99212,E2=99214),IF(E2=99214,1,0),"") Nesting Logic gets tricky. To simplify your life: •Consider $5 on fiverr.com •Consider a Excel geek
- 35. Lookups • Allows Non-Math, Non-Logical Groups. • Say, do OB docs have worse continuity? Pt DOB DOS ICD CPT Doc PCP … … … … … … … … … … … … … … … … … … … … … … … … … … … …
- 36. Pivot Tables • Summarize & Group • Ridiculously Powerful. Focus Vertical Pt DOB DOS ICD CPT Doc PCP … … … … … … … … … … … … … … … … … … … … … … … … … … … …
- 37. 5 Access/Billing Reports in 90 Seconds
- 39. 3 Steps • Dump (Crystal Reports) • Dice (Excel) • Design (Excel)
- 40. Design
- 41. 30DAYS to context connection Use this practical guide to engage with visualization and build great context connection skills over the next 30 days. est. minutes ACTION, Content, *web address completion 30 0 Mon WEEK 1 READ Is Information Visualization the Next Frontier for Design? http://bit.ly/30Days-InfoViz WATCH Hans Rosling shows the best stats you've ever seen http://bit.ly/30Days-Rosling Tue READ Business Intelligence isn't a technical problem, it is a Social Problem http://bit.ly/30Days-Problem Wed READ Who is Edward Tufte? http://bit.ly/30Days-Tufte Thu READ The Economist: New Ways of Visualising Data http://bit.ly/30Days-Visualize Fri PLAY New York Times Visualization Lab http://bit.ly/30Days-NYTimes Mon WEEK 2 WATCH Before trying to communicate information, first understand it. http://bit.ly/30Days-Information READ Part 1 Foundation: Guide to Creating Dashboards People Love http://bit.ly/30Days-DashboardLove1 Tue READ The Best of Business Intellgience: Innovation at the Fringe http://bit.ly/30Days-BI Wed READ Think Like a Designer http://bit.ly/30Days-Think Thu DO 30 Resources to Find the Data you Need http://bit.ly/30Days-GetData Fri PLAY Indexed. Fun with communication of Data http://bit.ly/30Days-Indexed DO Create your own visualization http://bit.ly/30Days-ManyEyes
- 43. 224
- 45. Sparklines “Intense, Word-like” —Tufte
- 47. Conditional Formatting Highlight results, direct attention.
- 49. Normalize Make results comparable, eliminate quibbles
- 52. Analytics ≠ Tech Tech Politcs Expectation Reality
- 53. Pitfalls Biases Systems Measuring Cowboy Counting Breathing Room Average Actiontastic Healthcare
- 54. Measurability Bias What’s important but hard to measure?
- 55. Counting Bias Not everything you can count should count
- 56. Average Bias Outliers might be your best source for improvement
- 57. Healthcare Bias See things through the patient’s eyes
- 58. Healthgrades.com Not much of this is in the e-MDs database.
- 59. Cowboy Don’t do it alone, it takes a team.
- 60. Breathing Room People need space to think and decide.
- 61. Actiontastic? Measure what matters, manage what you measure.
- 63. Go Forth
- 64. Data-driven practice with e-MDs User Conference, 2010 Jonathan Ploudré, MD
Notas del editor
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- Geek vs Fuzzy Perspective.\nHacks vs Keywords\n\nLet&#x2019;s get started\n
- Healthcare = least analytical industry\nPathetically un-analytical\n
- So, anyone here is probably an Early Adopter\n
- With focus, early adoption advantage won&#x2019;t last.\nWhy Health IT? Giga? Multipositive\n
- Makes win-win possible. Better decisions & better insights.\nAnd only 4% even have the possibility of kicking up the heat.\nWho uses the mounds of data?\n\n
- Most Rx&#x2019;d. Order Tracking Efficiency. Scan&#x2019;s fastest? 99213/4 Ratio.\nTaskman Bottleneck. Sign Off issues. Holdups on Refills. Overdue Coumadin.\nBest Continuity.\n
- More than &#x2018;Running Reports&#x2019;. Not predictable like cows. Herding Cats.\nYou need to do it for your own needs.\n
- Rare Opportunity. It&#x2019;s coming.\nToo good for &#x201C;I&#x2019;m busy&#x201D; or &#x201C;Maybe Later&#x201D;\n
- So how do you do this?\nKeep steps separate.\n
- Reading email, Oh-no, one of my favorite meds has a new warning.\nNone of the built-in reports get me pt&#x2019;s taking the 80mg Dose.\n
- Some problems you know you have the data, you just need to get it.\nLet&#x2019;s Face It: not in 20 minutes. Takes time/persistence.\nSimple version, doable. \nThink simple list or flat file as output.\n
- These are investments/hurdles.\nOvertime ROI improves\n
- How to get my Simvastatin Data?\nConnecting to Database\n
- Same details but in Crystal.\n
- In general use Views where possible.\nFor Zocor: You need these 3.\n
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- Joining is a key aspect of relational database.\n
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- So obviously, it&#x2019;s not this fast your first time!\nBut responding to an FDA announcement is actually doable even with a busy schedule.\n
- If you can do SQL, maybe use the built-in reports.\nFor when you need just one more column\n
- So we&#x2019;ve got a list dumped out of the database.\nNow it&#x2019;s time to do something with the data.\n
- Continuity is a benchmark of quality care. Let&#x2019;s say I can dump out a list of visits from a report. How do we dice that info into something?\n
- Let Face it 2: Excel takes more than 20 minutes to master.\nI think of dicing the list as adding a bit more logic/interpretation to data.\n\n
- Spreadsheets are more approachable than Crystal.\nSubset of functions can be combined in multiple ways.\n\n
- Quick Look around.\n\n
- Top ten ICDs or CPTs, etc.\n
- Horizontal Analysis!\n
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- So Dump a flat file list of data\nAnalyze horizontally with logic and lookups\nAnalyze vertically with a pivot table\nYou&#x2019;re not done! You have to present it for &#x2018;humans&#x2019;\n
- Needs Color, Organization.\nNot too many numbers.\nNot too few either.\n
- Although you won&#x2019;t master it now:\nDoable as a &#x2018;hobby&#x2019;.\n
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- Allow lots of data \n
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- So what&#x2019;s the problem with my 3 step process?\n
- This is not a tech problem.\nEMR transition is like this.\n
- Cognitive Biases: Mistakes you make at the beginning\nSystems Errors: Mistakes you make on follow through\n
- Counterexample: Receptionist&#x2019;s smiles\n
- Counterexample: Lookups\n
- Counterexample: Outliers\n
- Patient Continuity, not provider continuity\n
- This isn&#x2019;t in your e-MDs Database\n
- You can&#x2019;t do it alone. Need a team.\n
- You need space to think.\n
- Measure what matters\nManage what you measure.\n
- Here we are again:\nWe&#x2019;re lucky to have mounds of data\n
- This is a rare opportunity\nIt&#x2019;s doable; it&#x2019;s not a career change.\n
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