Medical Student Cleveland Clinic Lerner College of Medicine Cleveland, Ohio
Introduction: The time and cost of data collection via chart review of the electronic medical record (EMR) is a research barrier. The ability to extract patient outcomes in real-time would expedite data extraction and promote timely dissemination of research findings. This study describes the development of a dashboard conjoining EMR and finance data and its feasibility in evaluating outcomes in a pediatric otolaryngology practice.
Methods: The dashboard design creates a common language crosswalk between surgeries via the EMR, financial data, and the national Vizient database. First, all Otolaryngology procedures billed over two years via ICD-10 diagnosis for inpatient or CPT codes for outpatient procedures were categorized into Procedure Groups. These Procedure Groups constitute the common language that link all data sources. For example, 16 ICD-10 and CPT codes map to the Procedure Group “Neck Dissection”. The joined dataset was inputted into a Tableau workbook supporting dynamic filtering and custom real-time analysis.
Results: The dashboard includes 84 Procedure Groups within Otolaryngology. Examples for pediatrics include choanal atresia repair, Sistrunk procedure, supraglottoplasty, and cleft lip repair. User friendly dynamic filtering via Procedure Group, surgery date range, age group, insurance type, hospital site, surgeon, and discharge status are all options. Outcomes include length of stay, telephone callbacks, postoperative hemorrhage, 24-hour and 30-day reoperations, 24-hour and 30-day return to Emergency Department, 30-day readmission/observation rates, and mortality. National comparisons can be analyzed via embedded Vizient data (e.g. “postoperative tonsillectomy hemorrhage rates).
Conclusion: The hybrid finance/EMR dashboard creates a crosswalk between data sources and shows utility for use in evaluating patient outcomes via real-time data analysis and dynamic filtering. This novel dashboard design allows for real-time, efficient, and immediate quality improvement and surgical outcomes research. Future directions include expanding the capability of the dashboard to extract granular data such as quality-of-life measures, surgery-specific outcomes, and to perform intra- and inter-institutional comparisons.