Reporting on Steroids: Alternatives to Cognos Impromptu

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 risk

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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 Date Chief Complaint Status Primary Dx Secondary Dx Order Date Result ED MD Disposition MD

123456789 12345678 TEST, PATIENT 4802 10TH AVENUE BROOKLYN, NY 11219 7185551212 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)

123456789 12345678 TEST, PATIENT 4802 10TH AVENUE BROOKLYN, NY 11219 7185551212 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)

123456789 12345678 TEST, PATIENT 4802 10TH AVENUE BROOKLYN, NY 11219 7185551212 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)

123456789 12345678 TEST, PATIENT 4802 10TH AVENUE BROOKLYN, NY 11219 7185551212 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)

123456789 12345678 TEST, PATIENT 4802 10TH AVENUE BROOKLYN, NY 11219 7185551212 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)

123456789 12345678 TEST, PATIENT 4802 10TH AVENUE BROOKLYN, NY 11219 7185551212 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)

123456789 12345678 TEST, PATIENT 4802 10TH AVENUE BROOKLYN, NY 11219 7185551212 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 LinesAcct # MR # Patient Name Admission Date Bed Location Procedure Date Procedure Note

123456789 12345678 TEST, PATIENT 2011-05-01 11:15:29.597 Telemetry - 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, PATIENT 2011-05-01 12:09:00.000 MICU 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, PATIENT 2011-05-01 21:03:24.313 Urology 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, PATIENT 2011-05-02 08:57:00.000 SICU 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, PATIENT 2011-05-02 10:14:43.070 CICU 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, PATIENT 2011-05-04 08:23:33.910 MICU 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, PATIENT 2011-05-04 15:32:07.740 CICU ^ 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 10:00AM Urine Culture - URINE RANDOM Jul 6 2011 10:34AM NO GROWTH 1 DAY

(ET: 22 HOURS) Final

123456789 12345678 TEST, PATIENT 11m/F Jul 6 2011 12:22PM Urine 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 1:14PM Blood 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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Managing Incomplete Board

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Managing Incomplete Board

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Questions?• Kenneth N. Sable, MD, FACEP

[email protected]

• Corey M. Weiner, [email protected]

• Emil Soleyman-Zomalan, [email protected]

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mailto:[email protected]



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Reporting on Steroids: Alternatives to Cognos Impromptu

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