Copyright © 2011 Allscripts Healthcare Solutions, Inc.

Copyright © 2011 Allscripts Healthcare Solutions, Inc.

Reporting on Steroids: Alternatives to Cognos Impromptu

Kenneth N. Sable, MD, FACEPVice Chairman for Operations, Department of Emergency Medicine,Maimonides Medical Center

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| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Presentation Outline

• Who Are We?

• What Are We Trying to Do?

• Cognos: The Good and Bad

• Custom Reporting Framework

• Real Applications

• Questions?

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Who Are We?

• Kenneth N. Sable, MD, FACEP

• Vice Chairman for Operations

• University of Pennsylvania, Bachelor’s Degree in

Computer Science and Engineering

• Corey M. Weiner, MD

• Director, Division of Medical Informatics

• Duke University, Bachelor’s Degree in Biomedical

Engineering

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What Are We Trying to Do?• Your Allscripts ED database contains a wealth of

data that can be effectively and efficiently mined

to improve: patient care, administrative

management, and financial operations

• With some creativity and the right tools, you can

take full advantage of your vast data warehouse

that is Allscripts ED

• Focus on patient safety, quality assurance,

performance metrics, and mitigating liability and

risk5


What Are We Trying to Do?• Create an automated, graphical dashboard for key

performance metrics for daily distribution to

clinical and administrative leadership

• Create automated, dynamic reports to assist

quality assurance and improvement activities

• Automate process of managing both physician

and nursing signoff for the Incomplete Board!

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Cognos: The Good and Bad• Our experience with Cognos Impromptu

• Pros:

• Catalog provides user-friendly method of generating SQL queries

• Cons:

• Still on version 7.0 in Allscripts ED

• Output limited to PDF format within Allscripts ED

• No ability to add URL or other dynamic content

• Slow to process

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Custom Reporting Framework• Custom reporting framework

• Pros:

• Allows for maximal customization and control

• Fast to process

• Increased flexibility to meet future demands and requirements

• Cons:

• Requires a fair amount of technical background

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Technology

• Perl: Practical Extraction and Report Language

• SQL functions and procedures

• Google Charts API

• Reporting Formats: XLS, CVS, PDF

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Real Applications

• Daily Dashboard

• Automated Dynamic Reports

• Managing Incomplete Board

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Internal Medicine and Orthopedics Central Lines

Pediatric Cultures Congestive Heart Failure

Rapid HIV Durable Medical Equipment

Stress Tests Domestic Violence


Daily Dashboard

• Goals:

• Automated and consistent measurement and delivery of

key performance indicators (KPI) to department staff and

hospital leadership

• Proactive monitoring for trends affecting clinical, non-

clinical, and financial operations

• Increase overall transparency of ED operations

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Daily Dashboard

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Daily Dashboard

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Daily Dashboard

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Daily Dashboard

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Daily Dashboard

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Daily Dashboard

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Daily Dashboard

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Daily Dashboard

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Daily Dashboard

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Automated Dynamic Reports• Goals:

• Deliver focused, customized reports to support both

internal and external clinical and financial operations

(Internal Medicine, Orthopedics, Durable Medical

Equipment)

• Increase efficiency in specific patient care activities

(Rapid HIV, Stress Tests, Congestive Heart Failure)

• Assist with hospital-wide quality assurance and

improvement activities (Central Lines, Pediatric Cultures,

Domestic Violence)

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Automated Dynamic Reports

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Acct # MR # Patient Name Current Address Phone # Age/Sex Insurance Arrival DateChief

ComplaintStatus Primary Dx Secondary Dx Order Date Result ED MD Disposition MD

123456789 12345678 TEST, PATIENT4802 10TH AVENUE

BROOKLYN, NY 112197185551212 34y/M

WORKMAN'S COMP OTHER (-123456-)

2011-07-09 00:02:47.620

P-FOOT:T PDSCHG Infection - wound

status post trauma

HIV test - negative

2011-07-09 00:09:15.000

Negative Cohen,Hillary (MD) Cohen,Hillary (MD)


BROOKLYN, NY 112197185551212 26y/F

BLUE CROSS PPO (ABC-12345678-)

2011-07-09 01:30:33.333

CHECKUP PDSCHG Worried - well

HIV test - negative

2011-07-09 01:37:05.000

Negative Dickman,Eitan (MD)Bialeck,Suzanne

(MDRES)


BROOKLYN, NY 112197185551212 18y/M

HLTH1ST MCD HMO NONMMC (-123456789-)

2011-07-09 02:11:17.777

P-TOES:NT PDSCHG Laceration - toe(s), right

HIV test - negative

2011-07-09 02:18:23.000

Negative Cohen,Hillary (MD) Cohen,Hillary (MD)


BROOKLYN, NY 112197185551212 32y/M SELF-PAY ()

2011-07-09 15:00:07.943

FOUNDSTREE PDSCHG Drunkenness

HIV test - negative

2011-07-09 15:03:03.000

Negative Barriac,Fiona (MD) Barriac,Fiona (MD)


BROOKLYN, NY 112197185551212 19y/F

UNITED HEALTHCARE COMMUNITY PL (-

AB12345A-)

2011-07-09 20:56:50.113

ANXIETY HIV test - negative

Routine medical exam

2011-07-09 20:59:52.000

Negative Suau,Salvador (MD)


BROOKLYN, NY 112197185551212 25y/F

HLTH1ST MEDICAID HMO MMC (-AB12345U-)

2011-07-09 21:25:25.867

HEMATURIA PDSCHG Infection - urinary

tract (UTI)

HIV test - negative

2011-07-09 21:26:50.000

Negative Barriac,Fiona (MD) Barriac,Fiona (MD)


BROOKLYN, NY 112197185551212 39y/M SELF-PAY ()

2011-07-09 22:21:22.630

ABDOMPAIN HIV test - negative

2011-07-09 22:23:06.000

Negative Barriac,Fiona (MD)

Rapid HIV

http://hos-hmedrsch/hmed/redirect.asp?src=182160B4-3D83-49F1-81E6-8B42322D6D4D&chart=pin=10119%7Cacctnum=501346736%7Cmrn=11469764%7Cuser=701125%7CFROMWHERE=31101









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Central Lines

Acct # MR # Patient Name Admission Date Bed Location Procedure Date Procedure Note

123456789 12345678 TEST, PATIENT2011-05-01

11:15:29.597Telemetry - Medical

2011-05-01 23:49:26.397

The right femoral area was anesthetized with The skin was not anesthetized. . Catheter introduced via Saldinger technique. A large bore single lumen catheter was placed . The procedure was

performed without complications . With good blood return from all ports. The patient tolerated the procedure well. CPT-4 Code: Percutaneous child/adult - 36489 without using ultrasound guidance

123456789 12345678 TEST, PATIENT2011-05-01

12:09:00.000MICU

2011-05-01 19:20:37.707

The right internal jugular area was anesthetized with . Using the anterior approach the vein was punctured. Catheter introduced via Saldinger technique. A triple lumen catheter was placed using

ultrasound guidance . The procedure was performed without complications . With good blood return from all ports. Chest x-ray ordered. The patient tolerated the procedure well.

123456789 12345678 TEST, PATIENT2011-05-01

21:03:24.313Urology

2011-05-02 07:45:16.493

The right internal jugular area was anesthetized with 5 ml's of lidocaine . Using the anterior approach the vein was punctured. A triple lumen catheter was placed using ultrasound guidance . The procedure was performed without complications . With good blood return from all ports. Chest

x-ray ordered. The patient tolerated the procedure well.

123456789 12345678 TEST, PATIENT2011-05-02

08:57:00.000SICU

2011-05-02 12:24:47.850

The right femoral area was anesthetized with . Using the anterior lateral/posterior approach the vein was punctured. Catheter introduced via Saldinger technique. A large bore single lumen

catheter was placed without using ultrasound guidance . The procedure was performed without complications . With good blood return from all ports. The patient tolerated the procedure well.

123456789 12345678 TEST, PATIENT2011-05-02

10:14:43.070CICU

2011-05-02 11:12:15.063

The right internal jugular area was anesthetized with 5 ml's of lidocaine 1% . Using the anterior lateral/posterior approach the vein was punctured. Catheter introduced via Saldinger technique. A

large bore single lumen catheter was placed using ultrasound guidance . The procedure was performed without complications . With good blood return from all ports. Chest x-ray ordered. The

patient tolerated the procedure well.

123456789 12345678 TEST, PATIENT2011-05-04

08:23:33.910MICU

2011-05-04 11:12:50.560

The left femoral area was anesthetized with 3 ml's of lidocaine 1% . Catheter introduced via Saldinger technique. A triple lumen catheter was placed using ultrasound guidance . The procedure was performed without complications . With good blood return from all ports. The patient tolerated

the procedure well.

123456789 12345678 TEST, PATIENT2011-05-04

15:32:07.740CICU ^ K41801

2011-05-04 21:38:38.667

The right internal jugular area was anesthetized with 2 ml's of lidocaine 1% without Epinephrine . Using the anterior approach the vein was punctured. Catheter introduced via Saldinger technique.

A large bore single lumen catheter was placed using ultrasound guidance . The procedure was performed without complications . With good blood return from all ports. The patient tolerated the

procedure well.










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Pediatric CulturesAcct # MR # Patient Name Age Arrival Date Culture Type Culture Date Culture Result Culture Status

123456789 12345678 TEST, PATIENT 6w/F Jul 6 2011 1:53AM Blood Culture Jul 6 2011 2:56AM NO GROWTH 3 DAYS Pending

123456789 12345678 TEST, PATIENT 6w/F Jul 6 2011 1:53AMUrine Culture - URINE

RANDOM - Catheterized

Jul 6 2011 2:56AMNO GROWTH 1 DAY

(ET: 1 DAY 6 HOURS)

Final

123456789 12345678 TEST, PATIENT 3y/F Jul 6 2011 2:30AM Throat Culture - Throat Jul 6 2011 4:29AM

NO BETA HEMOLYTIC STREPTOCOCCUS GP A ISOLATED

(ET: 1 DAY 4 HOURS)

Final

123456789 12345678 TEST, PATIENT 18m/M Jul 6 2011 8:21AM Throat Culture - Throat Jul 6 2011 10:59AM


(ET: 21 HOURS)

Final

123456789 12345678 TEST, PATIENT 7y/F Jul 6 2011 9:26AM Throat Culture - Throat Jul 6 2011 11:08AM


(ET: 21 HOURS)

Final

123456789 12345678 TEST, PATIENT 5y/F Jul 6 2011 10:00AMUrine Culture - URINE

RANDOM Jul 6 2011 10:34AMNO GROWTH 1 DAY

(ET: 22 HOURS) Final

123456789 12345678 TEST, PATIENT 11m/F Jul 6 2011 12:22PMUrine Culture - URINE

RANDOM Jul 6 2011 1:11PM

ESCHERICHIA COLITHIS ALERT

VALUE WAS CALLED TO AND READ BACK BY DR.BAZIAZ 7/7/11

Final

123456789 12345678 TEST, PATIENT 4y/F Jul 6 2011 1:00PM Throat Culture - Throat Jul 6 2011 2:40PM


(ET: 18 HOURS)

Final

123456789 12345678 TEST, PATIENT 17m/M Jul 6 2011 1:14PMBlood Culture - Venous Blood Jul 6 2011 3:26PM NO GROWTH 3 DAYS Pending

123456789 12345678 TEST, PATIENT 3y/M Jul 6 2011 6:47PM Blood Culture Jul 6 2011 7:17PM NO GROWTH 3 DAYS Pending












Managing Incomplete Board

• Goals:

• Automate the process of tracking and notifying

physicians and nurses about remaining charts on the

incomplete board after a defined period of time

• Mitigate liability and risk from incomplete charts

• Improve CQI

• Improve cash collections by faster turnaround times on

entire coding/billing process

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Questions?

• Kenneth N. Sable, MD, FACEP

[email protected]

718.283.1419

• Corey M. Weiner, MD

[email protected]

718.283.8661

• Emil Soleyman-Zomalan, MD

[email protected]

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mailto:[email protected]



Copyright © 2011 Allscripts Healthcare Solutions, Inc.

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Transcript of Copyright © 2011 Allscripts Healthcare Solutions, Inc.