D. Ingersoll1, S. Scott1, D. Yammani2, J. Sabik1, M. Aeder1 2University Hospitals Cleveland Medical Center, Department Of Cancer Informatics, Cleveland, OH, USA 1University Hospitals Cleveland Medical Center, Department Of Surgery, Cleveland, OHIO, USA
Introduction: Although the Electronic Medical Record (EMR) has digitalized all patient interactive data, surgeons are challenged to extract their individual productivity and associated patient outcomes. Individual reports generated by popular EMR programs are mostly standardized and limit options for surgeon outcomes filtering and temporal comparisons, and generally encompass just a 30 day follow-up. A comprehensive dashboard that permits surgeon directed filtering of each performed case with associated complications and financials would be a valuable asset for individual assessment and potential quality improvement. We have created a Dashboard that captures the surgeons’ total volume of work and allows complete 90 day extraction of defined complications, care visits, financials, and outcomes.
Methods: As the majority of surgeons in our multi-hospital system are employed by the system parent organization, all surgical encounters (CPT submissions) are billed by a centralized process. All procedural (surgical and non-surgical) care events within any system entity, inpatient or outpatient, are coded and stored in the warehouse database. Financial remunerations are captured in an associated parallel database. Surgeon UPIN numbers were linked to the medical record number of each treated patient. The Dashboard extracts all associated warehoused data and presents it on a Microsoft Power BI platform. Incidents of system reported complications (infection, deep venous thrombosis, pulmonary embolus), mortality, ED visits, and readmissions were recorded from the index procedure through day 90. The Dashboard displayed complete details of all encounters, code search and graphics.
Results:Following an instructional webinar, each surgeon had full Dashboard access to their own patient data and subsequent encounters. Division chiefs had access to data for each surgeon in their Division. Nearly all surgeons immediately noted transparency in data presentation and the ability to easily modify search and result parameters. Once viewed, some reported the Dashboard prompted consideration for changes in management protocols for specific procedures based on timing of ED visits and readmissions. The initial Dashboard release contained a unique comprehensive taxonomy of all procedures. User feedback has embraced taxonomy modifications and categorization for thousands of operative procedures resulting in meaningful system improvements. Division chief utilization has provided opportunities for financial analysis and proposals for improving quality outcomes.
Conclusion:We have established a surgeon Dashboard with total capture of key outcomes for 90 days following index procedures that provides surgeon directed evaluation of patient care. The transparent presentation of outcomes affords opportunities for data driven practice modifications. Dashboard enhancements have been surgeon driven and directed to improve data accuracy and define further quality improvement opportunities.