Dashboards Make Sense of Scattered EHR Data

Savvy health IT customers understand that business intelligence tools are needed to leverage electronic health records data to the fullest.

Sometimes, we are at the mercy of technology.

Some years back, I was helping a nonprofit understand its customer relationship management system, as part of its intent to migrate from one CRM to another. In my naiveté, I sought to understand the underlying data structure of the CRM, which would help us figure out where the data lived, which data we had to move, and how best to arrange it after the move.

But the nonprofit's CRM, like the average CRM, and for that matter, like the average EHR, was populated with thousands of tables. Nine thousand tables.

It was daunting.

It is no wonder that the average nonprofit, community hospital, or health clinic is at the mercy of such a CRM or EHR, and why, once an organization selects such a technology, switching costs are prohibitively high.

The key, by the way, is often to try to leave the data where it already is and to use every modern analytics method to work with it.

I kept this all in mind recently when I spoke with Clark Carpenter, infrastructure supervisor at Southeastern Ohio Regional Medical Center, a 99-licensed bed facility in Cambridge, OH.

In 2012, Southeastern moved onto the Meditech EHR system and discovered that something was lacking in the reporting capabilities within Meditech, Carpenter told me.

To help, he brought in Tess McKahan to write the needed reports. "One was for our infection prevention department," McKahan explains. "There are a lot of things that they track on a daily basis, and with Meditech, the information was in there, and was just very hard to get to." It was also hard for the director to find easily.

So McKahan consolidated everything onto a dashboard. With one click a user could view data on all the patients to be seen that day. "Or," she says, "we can make another tab where it details it for her, so she doesn't have to go into the system."

As the self-service business intelligence tool it selected to write these reports, Southeastern chose Datawatch, a technology which IBM just selected as its preferred tool for IBM Watson Analytics and IBM Cognos Analytics users.

Datawatch also allows Southeastern to generate reports to track computerized physician order entry, (CPOE) not only to help reduce infections, but also to perform needed reporting for compliance purposes, McKahan says. "We have grown our business intelligence department, and now we are able to create dashboards for all over the hospital," she says.

Carpenter adds that the dashboards track where physicians stand as far as orders for lab, pharmacy, and diagnostic imaging. "There were certain criteria they had to meet in order to meet the meaningful use stages," he says.

"There's a percentage of those orders [that] had to be electronic. With this, we've been able to identify where we were as far as the meaningful use stage was concerned, but we've also been able to identify which physicians maybe needed some additional training, some additional help doing their electronic orders and training and so forth."

"And then [we were able to] really dive into those particular physicians instead of doing across the board saying, 'OK we need to get these numbers up. We were able to target those physicians and get them to the point where they're comfortable using order entry, therefore raising our numbers moving forward.'"

The dashboards also identified and explained a discrepancy between numbers being reported by one department director and what was actually happening. "What we ended up finding out… is that there were a lot of cancellations in that particular area," Carpenter says. "Since then, we've purchased appointment reminding software to decrease our levels of cancellation and increase our shows to that particular department. That's been a big one as well."

At this point I tossed in my usual observation that many in healthcare would presume the EHR itself does all this, and there should be no need for external business intelligence technology to do it.

"Without a dashboard to bring instances of different areas together, this information is scattered throughout Meditech," Carpenter says. "You look at Epic, which is competition for Meditech. They run into the same issues. There still has to be that front-end dashboard piece to be able to take that information together. I know other Epic hospitals, huge product for huge hospitals, and they run into the same situation we do."

Even in the most demanding situation, no EHR implementation would use all of the 9,000 tables I mentioned earlier. But business intelligence exists not only to make better sense of the data, but also to zoom in on important data where it lives.

Savvy health IT customers understand this and, like Southeastern Ohio Regional Medical Center, are finding the tools needed to leverage EHR data to its fullest.