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DATAVISION IN THE REAL
WORLD Betsy Stauffer
Lancaster General Hospital Lancaster, PA
LANCASTER GENERAL HOSPITAL
Presenter Name Presenter Title
Presenter Name Presenter Title
AWARDS
• Midas+ implemented in 1999
• DataVision implemented in 2003
• EMR – Epic – Implemented in 2011 – HAR-based
• J A Thomas for Clinical Documentation Improvement
• Advisory Board products – Crimson Clinical Advantage and Continuum of Care
– Crimson Realtime Readmissions
– Quality Compass
History of Midas+, DataVision, and
Other Applications Used with DataVision
Midas+ & DataVision Access
• Electronic Intranet form
• Midas+ Care Management Training
– Department-specific training
– Midas+ COW self-paced learning
• System Access and Conventions
• DataVision Server and Web applications
– Midas+ sponsored training WebEx participation
• Midas+ and DataVision access monitored
USER ACCESS REQUEST
Departments with DataVision Access
• Business Intelligence–Analytics
• Performance Improvement
• Quality and Patient Safety
• Case Management
• Health Information Management
• Heart and Vascular Institute
• Disease Management
• Financial Decision Support
• Medical Data Analysis
• Administration
• Nursing
• Stroke Coordinator
• Social Work
• Risk Management
4/2014
Primary Care &
HospitalistCEC
ED/Urgent Care CEC
Critical Care CEC
Surgical CEC
Trauma CEC
Heart & Vascular
CEC
Behavioral Health CEC
Women & Pediatrics
CEC
Oncology
CEC
Gen. Surgery CM team
Colorectal/GI CM team
Thoracic CM team
Orthopedics CM team
Neurosurgical CM team
Bariatric CM team
OB/GYN CM team
Pediatric CM team
NICU/Newborn CM team
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Vascular CM team
Cardiac Surgery CM team
System-wide Clinical PI Teams
PERFORMANCE IMPROVEMENT COMMITTEE (PIC)
PIC Membership to also include: • VP of Medical staff (chair)
• President, Medical staff
• Quality Medical Directors
• Chief Physician Executive
• Sr. VP, Hospital Operations
Journey – Quality Department to IT
• New Division of IT Department – Business Intelligence – Reporting
– Analytics – Clinical Reporting
– Database Services
– Several employees transitioned from Quality Department to IT – Business Intelligence
– Midas+ and DataVision transitioned from Quality to IT – Business Intelligence
• Business Intelligence Healthcare Data Analysts to the rescue!
• They receive a project and/or request – Validate request – Analyze request
• Determine which systems to use
• Explore DataVision Indicators
• Validate Indicators by using the DV Measure Definition
• Access DataVision, Toolpacks, Report Data Transfer
• Use Excel tools – pivot tables, filters, V-lookup, and so on
• Determine optimal method of display – delivery
• Request profiles of specific Indicators for trending
• Healthcare Data Analyst updates Quality
Indicator slide deck for senior leadership
trending (monthly) displaying historical
graphics
– 85 slides from various systems
– 57 of the 85 slides originate
from DataVision
INDICATOR METRIC INVENTORY
DataVision Functions Used at LGH
• DataVision 3M PPR Toolpack
• DataVision Navigator
• DataVision Provider profiles
• DataVision Readmission Toolpack
• DataVision SmartReport
• DataVision Value-Based Purchasing
• DataVision User-selectable Indicator Functions
Easy Access to Standard Reports
Report Toolpack based on
user-created Indicators
DataVision Reporting – Ongoing
• Pay-for-performance Metrics
• Senior Leadership Slide Deck – updated monthly
• Disease-specific profiles
• Hospitalist provider group volumes and metrics
• Scorecard data elements
• Bundled payment metrics
Reports Generated
by Healthcare Data Analyst
• DV Web Application
– Provide Stroke Program Coordinator with GMLOS data, as well as Comparative Database information for stroke population
• DataVision Toolpacks
– Update Quality Metrics for Senior Leadership
· 30-day All-cause Readmissions
· 30-day Unscheduled Readmissions
• Readmission Report for Transition of Care Committee
Reports Generated
by Healthcare Data Analyst
DV Server application (1) Update Quality Metrics for Senior Leadership including:
· Hospital-acquired pulmonary embolism
· Hospital-acquired pressure ulcer
· Major birth trauma
· Elective deliveries
· All-or-None Bundles for Acute MI, Heart Failure, Pneumonia, SCIP, Children's Asthma, Stroke, and VTE
· Clinical Processes of Care for AMI, Heart Failure, Pneumonia, SCIP
· AHRQ Patient Safety Indicators
· Median ED Times
· IQR Measures for Stroke, VTE, and Immunization
(2) Hospitalist Scorecard – VTE and Stroke Bundle (group specific)
(3) Highmark Quality Blue data for VTE
(4) ED Scorecard components – Core measures for AMI, Stroke, Pneumonia
DataVision Reports Used to Report
Pay-for-Performance Metrics
• READMISSION PERFORMANCE MEASURES
– Defined by payer – DataVision populations and
Toolpacks used for monthly reporting of
• Readmission rates for 3, 7, and 30 day readmissions
• Readmissions with present on admission infections
• Readmissions due to complications of care
• Principal DX of Heart Failure readmitted within 30 days to
inpatient or observation
DataVision Readmission Toolpack
DataVision Readmission Metrics
Adjusted for Specific Payer Report
• Standard Report – DataVision Readmission Toolpack
• CDB:009 – All Acute Care Inpatients – Denominator
• Separate numerator (readmissions) and denominator (All Acute Care Inpts)
• Delete cases under age 18
• Create a month column for the start date for readmission encounter
• Filter on MAPPED DISCHARGE DISPOSTION for first encounter – Exclude discharge disposition for first encounter per metric instructions
Use the column in the Toolpack entitled Days Between Encounters to determine the
3-day readmissions
7-day readmissions
30-day readmissions
AHRQ Indicators in DataVision
• MEASURE AND DEFINITION
• AHRQ Pt. Safety Indicator - Composite - ADULT (Rate per 100 Adult Discharges)
– Risk-adjusted ratio of observed-to-expected encounters that qualify for selected AHRQ PSI measures for potentially preventable adverse events
SOURCE
Midas+ > Function> DataVision >DV Navigator > Safety > Patient Safety > AHRQ Patient Safety Indicators - Adult ACA > PSI 90 Patient Safety Indicators Composite, Adult (CDRB:1408)
INDICATORS CHANGE
• AHRQ DEFINITIONS CHANGED – May 2013
– Historical values in DataVision change
• AHRQ PSI-90 – definition changed
– NOTE: PSI- 90 Indicators changed in May 2013 when AHRQ made modifications to adjust the risk-adjusted coefficients for these two PSIs. When Midas+ applied the values, a historical update was made (noted in DataVision Release Notes) modifying the historical trending.
Healthcare Infection Prevention
• DataVision Indicators utilized
– OP6 – Timing of preoperative antibiotics
– OP7 – Antibiotic selection
• Surgical Safety Indicators utilized • SCIP-Inf-9 – Urinary catheter removal
• SCIP-Inf -10 – Normothermia
• SCIP-Card 2 – Perioperative beta-blocker usage
Worklist Based on DV Indicators
Examples of Worklists Based on
DV Indicators
• Pulmonary Embolus NPOA – worklist created to
monitor DV Indicator
• DVT-NPOA worklist created to monitor DV
Indicator
In conclusion…