Cognos Web-based Analytic Tool Overview

Transcription

1 Cognos Web-based Analytic Tool Overview Market, Quality and Physician Data Analysis with Drill-thru Feature Mari Tietze, PhD, RN-BC Director, Nursing Research and Informatics DFWHC ERF UB-04 Source of administrative data submitted to the Texas Dept. of State Health Services State data drives what data is collected and used within a regional effort in DFW. DFWHC ERF

2 Decision Flow for Analysis Type Used by Providers to Determine what data might be needed and what is the best source of information. Data needed Yes Market Data Yes Outbound Pt address-focused State Yes THCIC PUDF Outbound No No DI PUDF v1_2 No Inbound Hospital-focused State Yes THCIC PUDF Inbound DI PUDF v1_2 Quality Data Yes PSI rates Yes State No THCIC PSI No No DI PSI * * = Drills-thru to patient-level data THCIC PUDF MRSA Yes IQI Rates & volumes No CMS Abstracted Data Yes State No DI IQI Rates * DI IQI Volume THCIC IQI Rates THCIC IQI Volume CMS Quality Indicators ** MRSA PUDF Specialty Data ** = Data source is CMS/TMF No DI PUDF MRSA AHA Texas 2003 and 2004 With County Census Physician DRG or Procedure DRG DI PUDF v1_2 PHY DRG Procedure DI PUDF PHY WITH CCS Physician Lookup 3 Sample Reports ZIP Code MS-DRG 4 2

3 Hospital XYZ, Primary Market (ZIP Code) by Top Hospital Volumes Hospital XYZ [designated with arrow] and key peer hospitals DFWHC ERF Hospital XYZ, Stroke MS-DRGs [ ] by Top Hospital Volumes Hospital XYZ [designated with arrow] and key peer hospitals DFWHC ERF

4 Outpatient Data Availability Emergency Room Data Ambulatory Surgery Data 7 Outpatient ER Visit Principal Diagnosis Highest Volumes Hospital XYZ DFWHC ERF

5 Outpatient ER Visit Abdominal Pain NYU Categories [n = 1,250] Hospital XYZ DFWHC ERF Outpatient Visit NYU per ZIP Code [n = 1,250] ZIP Code Suppressed Alcohol, Substance Abuse or HIV ICD-9 Codes Hospital XYZ DFWHC ERF

6 Physician Analysis [Attending and Operating] DRG and Procedure 11 Attending Physician Analysis by DRG Volume Hospital XYZ DFWHC ERF

7 Operating Physician Analysis by Principal Procedure Volume Hospital XYZ DFWHC ERF Operating Physician I53390, CCS* Principal Procedure by Volume Hospital XYZ * = Clinical Classification Software by AHRQ which categorizes ICD-9 procedure codes into clinically relevant groups DFWHC ERF

8 Patient Safety and Quality Analysis AHRQ Patient Safety Indicators 15 Hospital XYZ, Death Among Surgical Patient With Complications Risk Adjusted Rate per 1,000 Cases Compared to Peers Could Drill-thru to these records Hospital XYZ [designated with arrow] and key peer hospitals DFWHC ERF

9 Hospital XYZ System, Death among Surgical Inpatients w/complications Observed Rate for per 1,000 Cases DFWHC ERF Hospital XYZ, Drill-thru with Associated Co-morbidities DFWHC ERF

10 Hospital XYZ, Post-op Wound Dehiscence Risk Adjusted Rate per 1,000 Cases Compared to Peers Could Drill-thru to these records Hospital XYZ [designated with arrow] and key peer hospitals DFWHC ERF Patient Safety and Quality Analysis AHRQ Inpatient Quality Indicators 20 10

11 Hospital XYZ, Inpatient Quality Indictors Risk Adjusted Rate for CHF per 100 Cases Compared to Peers Could Drill-thru to these records Hospital XYZ [designated with arrow] and key peer hospitals DFWHC ERF Patient Safety and Quality Analysis CMS Quality Indicators 22 11

12 Comparative CMS Indicator Compliance Rates DFWHC ERF Comparative Compliance Rates for Pneumonia Initial Antibiotic Received within 4 Hours DFWHC ERF

13 Business Intelligence Tool Options Cognos Query Tool 25 Query Tool Main Menu DFWHC ERF

14 POA Initial Focus 1. Serious preventable event, object left in surgery 2. Serious preventable event, air embolism 3. Serious preventable event, blood incompatibility 4. Catheter-associated urinary tract infection 5. Pressure ulcers (decubitus) [707.00, , ] 6. Vascular catheter-associated infection 7. Mediastinitis after cardiac artery bypass graftingsurgical site infection 8. Hospital-acquired injuries (fractures, dislocations, intracranial injury, crushing injury, burn, and other unspecified effects of external causes) DFWHC ERF Query Tool: An Analysis Hospital XYZ Hospital XYZ DFWHC ERF

15 Member Dashboards: System- and Hospital-Level Hip Replacement 29 Hip Replacement Procedure Dashboard for Health Care System XYZ and One Hospital Masked Masked Rate Numerator: Iatrogenic pulmonary embolism and infarction, Other, Venous embolism and thrombosis of deep vessels of distal lower extremity Rate Denominator: Total hip replacement, Partial hip replacement, Total knee replacement DFWHC ERF

16 Hip Replacement Procedure DVT/PE Rates for Health Care System XYZ Overall System Rate 1 Std Dev Mean 1 Std Dev Rate Numerator: Iatrogenic pulmonary embolism and infarction, Other, Venous embolism and thrombosis of deep vessels of distal lower extremity Rate Denominator: Total hip replacement, Partial hip replacement, Total knee replacement DFWHC ERF Hip Replacement Procedure Primary Payer Distribution for Health Care System XYZ Rate Numerator: Iatrogenic pulmonary embolism and infarction, Other, Venous embolism and thrombosis of deep vessels of distal lower extremity Rate Denominator: Total hip replacement, Partial hip replacement, Total knee replacement DFWHC ERF

17 Hip Replacement Procedure Comparison of Average Charges by Revenue Code Type for Health Care System XYZ Rate Numerator: Iatrogenic pulmonary embolism and infarction, Other, Venous embolism and thrombosis of deep vessels of distal lower extremity Rate Denominator: Total hip replacement, Partial hip replacement, Total knee replacement DFWHC ERF Hip Replacement Procedure Operating Physician Case Counts for Health Care System XYZ Physician ID 1 Physician ID 2 Physician ID 3 Physician ID 4 Physician ID 5 Physician ID 6 Physician ID 7 Rate Numerator: Iatrogenic pulmonary embolism and infarction, Other, Venous embolism and thrombosis of deep vessels of distal lower extremity Rate Denominator: Total hip replacement, Partial hip replacement, Total knee replacement DFWHC ERF

18 Regional Enterprise Master Patient Index Hip Replacement Admissions and Readmission Characteristics 35 Readmit Status of Total Hip Replacement with DVT Complication Principal Diagnosis Admitted for total hip replacement procedure First admission in Regional Enterprise Master Patient Index Diagnosis Position 2: Venous embolism and thrombosis of deep vessels of proximal lower extremity V57.89 = Other specified rehabilitation procedure, multiple training or therapy DFWHC ERF

19 Readmit Status of Total Hip Replacement without Complication(s) Less than 30 Days Since Last Admission Total Hip Replacement Not readmitted as of 2008Q3 Not deceased DFWHC ERF