Data Driven Practice with e-MDs
Upcoming SlideShare
Loading in...5
×

Like this? Share it with your network

Share

Data Driven Practice with e-MDs

  • 2,319 views
Uploaded on

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.

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.

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
2,319
On Slideshare
2,043
From Embeds
276
Number of Embeds
1

Actions

Shares
Downloads
6
Comments
0
Likes
0

Embeds 276

http://unchart.com 276

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide
  • \n
  • \n
  • Geek vs Fuzzy Perspective.\nHacks vs Keywords\n\nLet’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’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’d. Order Tracking Efficiency. Scan’s fastest? 99213/4 Ratio.\nTaskman Bottleneck. Sign Off issues. Holdups on Refills. Overdue Coumadin.\nBest Continuity.\n
  • More than ‘Running Reports’. Not predictable like cows. Herding Cats.\nYou need to do it for your own needs.\n
  • Rare Opportunity. It’s coming.\nToo good for “I’m busy” or “Maybe Later”\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’s taking the 80mg Dose.\n
  • Some problems you know you have the data, you just need to get it.\nLet’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
  • \n
  • Joining is a key aspect of relational database.\n
  • \n
  • So obviously, it’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’ve got a list dumped out of the database.\nNow it’s time to do something with the data.\n
  • Continuity is a benchmark of quality care. Let’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
  • \n
  • \n
  • \n
  • \n
  • \n
  • So Dump a flat file list of data\nAnalyze horizontally with logic and lookups\nAnalyze vertically with a pivot table\nYou’re not done! You have to present it for ‘humans’\n
  • Needs Color, Organization.\nNot too many numbers.\nNot too few either.\n
  • Although you won’t master it now:\nDoable as a ‘hobby’.\n
  • \n
  • \n
  • Allow lots of data \n
  • \n
  • \n
  • \n
  • \n
  • \n
  • So what’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’s smiles\n
  • Counterexample: Lookups\n
  • Counterexample: Outliers\n
  • Patient Continuity, not provider continuity\n
  • This isn’t in your e-MDs Database\n
  • You can’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’re lucky to have mounds of data\n
  • This is a rare opportunity\nIt’s doable; it’s not a career change.\n
  • \n

Transcript

  • 1. Data-driven practice with e-MDs User Conference, 2010 Jonathan Ploudré, MD
  • 2. Jonathan Ploudré, MD
  • 3. Geek?
  • 4. 2008 Any EMRYes No
  • 5. 2008 “Full” EMR Yes No
  • 6. Health IT
  • 7. Analytics: Secret Sauce
  • 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 $2720 minutes 4 hours
  • 15. Reporting Setup
  • 16. Reporting Setup
  • 17. More Reporting Setup
  • 18. More Reporting Setup
  • 19. Inside the Database
  • 20. Views are Legos
  • 21. Joining…
  • 22. From Blank slate to ‘Zocor Report’ in 2 minutes
  • 23. Zip Code CatchmentSELECT…addr.Address_ZipCode as Zip…FROM…JOIN VIEW_Address addr on(a.Entity_ID = addr.Entity_ID)…
  • 24. 3 Steps• Dump (Crystal Reports)• Dice (Excel)• Design (Excel)
  • 25. Do I see my patients?Pt DOB DOS ICD CPT Doc PCP… … … … … … …… … … … … … …… … … … … … …… … … … … … …
  • 26. Dice
  • 27. Autofilter
  • 28. Autofilter
  • 29. AutofilterFlat File becomes Sortable/Filterable
  • 30. AutofilterFlat File becomes Sortable/Filterable
  • 31. Logic for Formulas• AND, NOT, OR, IF• =, !=, >, <, >=, <=,• True, False Focus Horizontally Pt DOB DOS ICD CPT Doc PCP … … … … … … … … … … … … … … … … … … … … … … … … … … … …
  • 32. 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
  • 33. Lookups• Allows Non-Math, Non-Logical Groups.• Say, do OB docs have worse continuity? Pt DOB DOS ICD CPT Doc PCP … … … … … … … … … … … … … … … … … … … … … … … … … … … …
  • 34. Pivot Tables• Summarize & Group• Ridiculously Powerful. Focus Vertical Pt DOB DOS ICD CPT Doc PCP … … … … … … … … … … … … … … … … … … … … … … … … … … … …
  • 35. 5 Access/Billing Reports in 90 Seconds
  • 36. 3 Steps• Dump (Crystal Reports)• Dice (Excel)• Design (Excel)
  • 37. Design
  • 38. 30DAYSto 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 MonWEEK 1 READ Is Information Visualization the Next Frontier for Design? http://bit.ly/30Days-InfoViz WATCH Hans Rosling shows the best stats youve ever seen http://bit.ly/30Days-Rosling Tue READ Business Intelligence isnt 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 MonWEEK 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
  • 39. 224
  • 40. Sparklines“Intense, Word-like” —Tufte
  • 41. Conditional Formatting Highlight results, direct attention.
  • 42. NormalizeMake results comparable, eliminate quibbles
  • 43. Analytics ≠ Tech Tech PolitcsExpectation Reality
  • 44. Pitfalls Biases SystemsMeasuring CowboyCounting Breathing Room Average ActiontasticHealthcare
  • 45. Measurability BiasWhat’s important but hard to measure?
  • 46. Counting BiasNot everything you can count should count
  • 47. Average BiasOutliers might be your best source for improvement
  • 48. Healthcare BiasSee things through the patient’s eyes
  • 49. Healthgrades.comNot much of this is in the e-MDs database.
  • 50. CowboyDon’t do it alone, it takes a team.
  • 51. Breathing RoomPeople need space to think and decide.
  • 52. Actiontastic?Measure what matters, manage what you measure.
  • 53. Go Forth
  • 54. Data-driven practice with e-MDs User Conference, 2010 Jonathan Ploudré, MD