W16 Data Mining Workshop

Transcription

1 W16 Data Mining Workshop Brantley Synco, Director, Internal Audit and Compliance, Baptist Health System Jim Donaldson, Director of Compliance/Privacy and Security Officer, Baptist Health Care Corporation Agenda Introduction and Overview Databases Primer Scope and Parameters Seven Steps for Data Extraction Data Analysis and Application Data Sources and Manipulation Tools Question Period 1

2 Introduction and Overview Session will show how to combine data from multiple sources into one report Presentation is aimed toward compliance professionals, NOT IT SPECIALIST Techniques can be applied to multiple extractions and analyses. At then of this section of the workshop, participants will be equipped to import data, join tables, and create simple reports. Database Primer What is a database? A comprehensive collection of related data organized for convenient access, generally in a computer. Dictionary.com 2

3 Database Primer related data Database Primer Poor Database Design 3

4 Database Primer Poor Database Design (Result) EVENT National ID Last Nam e First Name Address City State Zip HIRE SSN1 LN1 FN1 ADD1 CITY1 ST1 ZIP1 MAR SSN1 LN2 FN1 ADD2 CITY2 ST1 ZIP2 CHG SSN1 LN2 FN1 ADD3 CITY3 ST1 ZIP3 DIV SSN1 LN1 FN1 ADD4 CITY4 ST1 ZIP4 MAR SSN1 LN3 FN2 ADD5 CITY5 ST1 ZIP5 Database Primer Data Normalization is the process of dividing datasets to reduce dependency and duplication. 4

5 Scope and Parameters Deliverable: OIG monitoring reports Employees Physicians Application: MS Access Source Files: OIG exclusion database Employee File (from HR) Doctor Master file (from credentialing) Step 1: Get your head on straight Must have the confidence you can acquire and use the data 5

6 Step 1: Get your head on straight 1. "It's not held in only one table. 2. "It's a large and complicated database with about 142 million tables. 3. "You will have to get the OK from the database owner before I give you that." Step 1: Get your head on straight 4. "Bill Lumburger asked for this same data last week for his new TPS report. Have you ask him for it? 5. "I don't know if we can pull data out of that database." 6

7 Step 1: Get your head on straight 6. "No problem! We can write a SQL script to pull the data you need. Then we can set up an ODBC connection to transport the data. We can drop the data into Oracle, SQL Server, or DB2 format and then you can extract it out into XLS, CSV, XML, or HTML. All I need is your DBMS license and the network location of your server. Just call me back when you have those and I'll get right on it." Step 2: Start at the End What do you want to know? "Do we have any employees or doctors who are excluded from participation by the OIG" 7

8 Step 2: Start at the End What do you want the report show? All parties and OIG status? Employees separate from doctors? Only employees with possible matches? Step 2: Start at the End What data do you want to show? Provider Data Employee Name Employee Address Employee DOB Physician UPIN OIG Data OIG Name OIG Address OIG DOB 8

9 Step 2: Start at the End How do you want the data grouped, ordered, or sorted? Source OIG Provider Similarity By Name By Address Step 2: Start at the End Ordered by Similar Employee OIG Name Name Employee OIG Address Address Employee DOB OIG DOB Smith Smith 123 Maple 123 Oak 3/3/68 3/3/68 Ordered by Source Employee Employee Employee OIG Name Address DOB Name OIG Address OIG DOB Smith 123 Maple 3/3/68 Smith 123 Oak 3/3/68 9

10 Step Three: Locate the data "Where is the information I need? We determined: Exclusions are in the OIG exclusion database. HR has the employee details Credentialing has a list of all active physicians. Step Four: Reach out to IT Specialist "Who can I call who would know where I can get this information?" What format is the data? "Who is the database administrator or IT employee that supports these databases and applications? 10

11 Step Four: Reach out to IT Specialist We determine the following: OIG Database is available from the OIG is a.dbf format. HR uses PeopleSoft built on a DB2 database. Credentialing uses a commercially available system that regularly exports data to the EMR. Step Five: Design Extract Determine what elements are needed. Names Addresses UPINs Limit size of extract Date Active/Inactive records Other element 11

12 Step Six: Turn Data into Information Import Data Modify data Create Joins Export Data Import Data 12

13 Import Data Other data types: Import Data Import OIG Data Short cut: Access will open.dbf format 13

14 Import Data Import Data Data in design view 14

15 Import Data Open Query Wizard Open Query in design view Data Import 15

16 Data Import Modify Data 16

17 Datasheet View Modify Data Design View Modify Data 17

18 Modify Data Modify Table Changes to Employee table: Upper for First Name (v_first_name) Upper for Last Name (v_last_name_ First 5 characters of Zip code (v_postal 18

19 Create Joins/Relationships Create Joins/Relationships 19

20 Create Joins/Relationships Create Joins/Relationships 20

21 Export Data Step Seven: Don't Re Invent The Wheel By using linked tables, you can update the tables and use the same queries. Follow these steps: Open Linked Table Manager Update all tables Execute the make table queries Open the matched queries. 21

22 Step Seven: Don't Re Invent The Wheel Comments 1. The actions we performed can be used across almost any data. 2. Practice. You can t break anything. 3. Remember you CAN do this. 22

23 Data Sources to Consider and Monitoring Tools Disclaimer You will see screen shots from specific information systems used at Baptist Health Care Corporation We are making no express or implied recommendation for these systems or the companies that offer them. 23

24 Some Data Sources to Consider Network Logs Time and Attendance Logs Instant Messaging Internet Logs Clinical System Logs s Real Time Archived Door/Access Controllers Video Surveillance Electronic Payment System Logs Enterprise Data Warehouse Before Using a Source, Consider Your Organizations Culture What expectation of privacy do your employees have? What degree of monitoring will your leadership allow? Are you a union shop? Are you a governmental organization? If you find something bad will the C suite act on it? 24

25 E mail Logs E mail Logs 25

26 E mail Logs E mail Automatic Compliance Monitoring 26

27 E mail Automatic Compliance Monitoring E mail Automatic Compliance Monitoring 27

28 E mail Automatic Compliance Monitoring E mail Automatic Compliance Monitoring 28

29 E mail Automatic Compliance Monitoring Instant Message Chat Logs 29

30 Instant Message Chat Logs Internet Logs 30

31 Internet Logs Internet Logs Exported 31

32 Internet Logs Exported and Filtered Network Logs LDAP Example 32

33 Network Logs LDAP Example Consolidated System Monitoring Helps find the needle in the haystack Collects data from various audit sources Normalizes the data Predefined or ad hoc reports alerts 33

34 Direct System Monitoring Placing software on a computer that will record data for analytics on all activity. Agent secretly loaded on target PC Very invasive Records every keystroke and screen shot Allows playback much like a DVR Useful when you have good reason to believe you will find evidence of adverse activities 34

35 Direct System Monitoring QUESTIONS? Brantley Synco, Director, Internal Audit and Compliance, Baptist Health System / brantley.synco@bhsala.com Jim Donaldson, Director of Compliance/Privacy and Security Officer, Baptist Health Care Corporation / jdonaldson@bhcpns.org 35