scholarly journals Leveraging the NSSP R Studio Server to Automate QA Monitoring and Reporting

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Peter J Rock ◽  
Michael D Singleton
Keyword(s):  
Data Quality ◽  
Information Exchange ◽  
Syndromic Surveillance ◽  
Health Information Exchange ◽  
Opioid Overdose ◽  
Diagnosis Codes ◽  
Key Stakeholders ◽  
Facility Level ◽  
Key Indicators

Objective: The aim of this project was to develop a nimble system to both monitor and report on the quality of Kentucky emergency department syndromic surveillance (SyS) data at system-wide and facility levels.Introduction: In 2016, the CDC funded 12 states, under the Enhanced State Opioid Overdose Surveillance (ESOOS) program, to utilize SyS to increase timeliness of state data on drug overdose events. In order to operationalize the objectives of the grant, there was a need to assess and monitor the quality of Kentucky’s SyS data, with limited resources. We leveraged the NSSP’s R Studio Server to automate quality assurance (QA) monitoring and reporting to meet these objectives.Methods: Using the R Server, we pulled data from the process messages table, aggregating messages to single patient encounters. In addition to compiling the code on a powerful remote server, the server can access the process table messages relatively quickly. We developed an R Markdown report to produce a report that includes a variety of system- and facility-level metrics that highlight key indicators of system performance and data flows. By using R, we were able to create an auto-generating QA report that runs weekly and e-mails for analyst review. Quality metrics included: % completeness of chief complaint and discharge diagnosis codes (overall and by facility)[Fig 1 & Fig 2]; visit trend by day of visit (with interactive spark lines)[Fig 2]; maximum date of message created, date message arrived at NSSP server, date of visit, and total messages[Fig 3]; message arrived trend (interactive sparklines)[Fig 3]; volume and type of error messages failing to process[Fig 4]; message volume by ADT type[Fig 5]; and volume of patient class by type by day[not shown]. Our SyS analyst reviews the report and delivers it to stakeholders with general comments about ongoing and newly emerging data quality concerns.Results: The report has proven to be beneficial in ongoing QA monitoring. The report is shared weekly with key stakeholders at the Kentucky Department for Public Health, Kentucky Health Information Exchange, NSSP, and regional ESSENCE users. Findings are reviewed at monthly SyS stakeholder meetings. The report has identified numerous errors, dead feeds, and other systems changes in near real-time; leading to corrective action and general data quality enhancement. Weekly monitoring of QA has improved data feed stability and communication of identified issue with key stakeholders.Conclusions: The R Studio Server provides a nimble platform to develop, refine, and automate a QA reporting system that can lead to improved SyS data quality. In Kentucky, in addition to improving overall data quality, these weekly reports and subsequent communication have help built relationships among key stakeholders and elevated the importance of syndromic surveillance data locally. Continual monitoring of data is critical to ensure quality and therefor the validity of the data.

scholarly journals Does Health Information Exchange Reduce Unnecessary Neuroimaging and Improve Quality of Headache Care in the Emergency Department?

2012 ◽  
Vol 28 (2) ◽  
pp. 176-183 ◽  
Author(s):  
James E. Bailey ◽  
Jim Y. Wan ◽  
Lisa M. Mabry ◽  
Stephen H. Landy ◽  
Rebecca A. Pope ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Improve Quality ◽  
Headache Care

scholarly journals Validation of Emergency Department and Outpatient Data Using ILI syndrome classifiers

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Jenna Iberg Johnson ◽  
Komal Brown
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
New Orleans ◽  
Information Exchange ◽  
Syndromic Surveillance ◽  
Health Information Exchange ◽  
International Classification Of Diseases ◽  
Outpatient Clinics ◽  
Classification Of Diseases

The goal of this analysis is to compare the results of influenza-like-illness (ILI) text and International Classification of Diseases (ICD) code classifiers applied to the Louisiana Office of Public Health (OPH) syndromic surveillance data reported by New Orleans area emergency departments and the Greater New Orleans Health Information Exchange (GNOHIE) data reported by New Orleans area outpatient clinics. This study adds to the evidence supporting the emerging use of outpatient data for syndromic surveillance.

scholarly journals Technical Challenges of Syndromic Surveillance System Deployment in a Health Information Exchange

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Julio C. Silva ◽  
Charles Cox ◽  
Dino P. Rumoro ◽  
Shital C. Shah ◽  
Marilyn M. Hallock ◽  
...  
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Health Information Exchange ◽  
Scaling Up ◽  
Lessons Learned ◽  
Technical Process ◽  
Syndromic Surveillance System ◽  
Collaborative Initiative

This session describes the technical process, challenges, and lessons learned in scaling up from a local to regional syndromic surveillance system using the MetroChicago Health Information Exchange (HIE) and GUARDIAN collaborative initiative.

scholarly journals Findings from the 2021 Yearbook Section on Health Information Management

2021 ◽  
Vol 30 (01) ◽  
pp. 084-090
Author(s):  
Meryl Bloomrosen ◽  
Eta S. Berner ◽  
Keyword(s):  
Data Quality ◽  
Health Information ◽  
Information Management ◽  
Information Exchange ◽  
Health Informatics ◽  
Health Information Exchange ◽  
Health Information Management ◽  
Bibliographic Databases ◽  
Public Health Informatics ◽  
Health Records

Objectives: To summarize the recent literature and research and present a selection of the best papers published in 2020 in the field of Health Information Management (HIM) and Health Informatics. Methods: A systematic review of the literature for the IMIA Yearbook HIM section was performed by the two section editors with the help of a medical librarian. We searched bibliographic databases for HIM-related papers using both MeSH headings and keywords in titles and abstracts. A shortlist of the fifteen best candidate papers was first selected by section editors before being peer-reviewed by independent external reviewers. Results: The three major themes of Health Information Exchange (transmitting, sharing, and accessing patient health-related data and information) (HIE), Data Quality, and Privacy and Security make up 80% of the fifteen papers, with individual papers on personal health records, information governance and the professionalism of the HIM field. Conclusions: Traditional HIM concerns about HIM practice and workforce as well as issues about the data in electronic health records (EHRs) including data quality, coding, health information exchange among entities within the healthcare systems and privacy and confidentiality continue to be a large part of the HIM research literature. Although there was little research applying these themes to pandemic concerns, HIM professionals have the expertise to make ccontributions to public health informatics research and this research would benefit from their involvement.

Evaluating the Quality and Usefulness of Data Breach Information Systems

2013 ◽  
pp. 225-240
Author(s):  
Benjamin Ngugi ◽  
Jafar Mana ◽  
Lydia Segal
Keyword(s):  
Information Systems ◽  
Data Quality ◽  
Quality Data ◽  
Quality Of Data ◽  
Law Enforcement Agencies ◽  
Data Breach ◽  
Security Breaches ◽  
Key Stakeholders ◽  
The U.S

As the nation confronts a growing tide of security breaches, the importance of having quality data breach information systems becomes paramount. Yet too little attention is paid to evaluating these systems. This article draws on data quality scholarship to develop a yardstick that assesses the quality of data breach notification systems in the U.S. at both the state and national levels from the perspective of key stakeholders, who include law enforcement agencies, consumers, shareholders, investors, researchers, and businesses that sell security products. Findings reveal major shortcomings that reduce the value of data breach information to these stakeholders. The study concludes with detailed recommendations for reform.

scholarly journals Identifying homelessness using health information exchange data

2015 ◽  
Vol 22 (3) ◽  
pp. 682-687 ◽  
Author(s):  
John Zech ◽  
Gregg Husk ◽  
Thomas Moore ◽  
Gilad J Kuperman ◽  
Jason S Shapiro
Keyword(s):  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Housing Status ◽  
Number Of Patients ◽  
Address Data ◽  
Patients Experience ◽  
Exchange Data

Abstract Background Homeless patients experience poor health outcomes and consume a disproportionate amount of health care resources compared with domiciled patients. There is increasing interest in the federal government in providing care coordination for homeless patients, which will require a systematic way of identifying these individuals. Objective We analyzed address data from Healthix, a New York City–based health information exchange, to identify patterns that could indicate homelessness. Methods Patients were categorized as likely to be homeless if they registered with the address of a hospital, homeless shelter, place of worship, or an address containing a keyword synonymous with “homelessness.” Results We identified 78 460 out of 7 854 927 Healthix patients (1%) as likely to have been homeless over the study period of September 30, 2008 to July 19, 2013. We found that registration practices for these patients varied widely across sites. Conclusions The use of health information exchange data enabled us to identify a large number of patients likely to be homeless and to observe the wide variation in registration practices for homeless patients within and across sites. Consideration of these results may suggest a way to improve the quality of record matching for homeless patients. Validation of these results is necessary to confirm the homeless status of identified individuals. Ultimately, creating a standardized and structured field to record a patient’s housing status may be a preferable approach.

Health Information Exchange for Improving the Efficiency and Quality of Healthcare Delivery

2011 ◽  
pp. 352-374 ◽  
Author(s):  
Jing Shi ◽  
Sudhindra Upadhyaya ◽  
Ergin Erdem
Keyword(s):  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Critical Role ◽  
Healthcare Delivery ◽  
Cost Effective ◽  
Quality Of Healthcare ◽  
Future Research ◽  
The Right

In healthcare industry, providers, patients, and all other stakeholders must have the right information at the right time for achieving efficient and cost effective services. Exchange of information between the heterogeneous system entities plays a critical role. Health information exchange (HIE) is not only a process of transmitting data, but also a platform for streamlining operations to improve healthcare delivery in a secure manner. In this chapter, we present a comprehensive view of electronic health record (EHR) systems and HIE by presenting their architecture, benefits, challenges, and other related issues. While providing information on the current state of EHR/HIE applications, we also discuss advanced issues and secondary uses of HIE implementations, and shed some light on the future research in this area by highlighting the challenges and potentials.

Assessing Statewide All-Cause Future One-Year Mortality: Prospective Study With Implications for Quality of Life, Resource Utilization, and Medical Futility (Preprint)

2018 ◽  
Author(s):  
Yanting Guo ◽  
Gang Zheng ◽  
Tianyun Fu ◽  
Shiying Hao ◽  
Chengyin Ye ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
High Risk ◽  
Information Exchange ◽  
Elderly Population ◽  
Validation Cohort ◽  
Health Information Exchange ◽  
Risk Group ◽  
Futile Treatment

BACKGROUND For many elderly patients, a disproportionate amount of health care resources and expenditures is spent during the last year of life, despite the discomfort and reduced quality of life associated with many aggressive medical approaches. However, few prognostic tools have focused on predicting all-cause 1-year mortality among elderly patients at a statewide level, an issue that has implications for improving quality of life while distributing scarce resources fairly. OBJECTIVE Using data from a statewide elderly population (aged ≥65 years), we sought to prospectively validate an algorithm to identify patients at risk for dying in the next year for the purpose of minimizing decision uncertainty, improving quality of life, and reducing futile treatment. METHODS Analysis was performed using electronic medical records from the Health Information Exchange in the state of Maine, which covered records of nearly 95% of the statewide population. The model was developed from 125,896 patients aged at least 65 years who were discharged from any care facility in the Health Information Exchange network from September 5, 2013, to September 4, 2015. Validation was conducted using 153,199 patients with same inclusion and exclusion criteria from September 5, 2014, to September 4, 2016. Patients were stratified into risk groups. The association between all-cause 1-year mortality and risk factors was screened by chi-squared test and manually reviewed by 2 clinicians. We calculated risk scores for individual patients using a gradient tree-based boost algorithm, which measured the probability of mortality within the next year based on the preceding 1-year clinical profile. RESULTS The development sample included 125,896 patients (72,572 women, 57.64%; mean 74.2 [SD 7.7] years). The final validation cohort included 153,199 patients (88,177 women, 57.56%; mean 74.3 [SD 7.8] years). The c-statistic for discrimination was 0.96 (95% CI 0.93-0.98) in the development group and 0.91 (95% CI 0.90-0.94) in the validation cohort. The mortality was 0.99% in the low-risk group, 16.75% in the intermediate-risk group, and 72.12% in the high-risk group. A total of 99 independent risk factors (n=99) for mortality were identified (reported as odds ratios; 95% CI). Age was on the top of list (1.41; 1.06-1.48); congestive heart failure (20.90; 15.41-28.08) and different tumor sites were also recognized as driving risk factors, such as cancer of the ovaries (14.42; 2.24-53.04), colon (14.07; 10.08-19.08), and stomach (13.64; 3.26-86.57). Disparities were also found in patients’ social determinants like respiratory hazard index (1.24; 0.92-1.40) and unemployment rate (1.18; 0.98-1.24). Among high-risk patients who expired in our dataset, cerebrovascular accident, amputation, and type 1 diabetes were the top 3 diseases in terms of average cost in the last year of life. CONCLUSIONS Our study prospectively validated an accurate 1-year risk prediction model and stratification for the elderly population (≥65 years) at risk of mortality with statewide electronic medical record datasets. It should be a valuable adjunct for helping patients to make better quality-of-life choices and alerting care givers to target high-risk elderly for appropriate care and discussions, thus cutting back on futile treatment.

scholarly journals Barriers and facilitators to a health information exchange system for general practitioners

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
N S Centemero ◽  
B Rechel
Keyword(s):  
Clinical Practice ◽  
Health Information ◽  
General Practitioners ◽  
Information Exchange ◽  
Medical Information ◽  
Health Information Exchange ◽  
Barriers And Facilitators ◽  
Local Health ◽  
Care Providers

Abstract Background Health information exchange (HIE) systems, that are computer-based tools used by healthcare providers for secure access to share patient's medical information electronically, seem to help reduce the use of specific resources and improve the quality of care. This highlights the importance of this issue in the Public Health sector. This research goal is to identify barriers and facilitators perceived by general practitioners (GPs) when using an HIE system in a Southern Switzerland area. Methods we performed a qualitative study using semi-structured interviews, interviewed 10 GPs, randomly selected among some 500 HIE system local users and analysed interview transcripts using thematic content analysis with an abductive approach (a mix of deductive and inductive approaches). Results findings showed the following key facilitators: a) perception of dealing with a secure system; b) possibility of delegating management to secretaries and healthcare assistants; c) technical support and training; d) high quality of the information exchange; e) positive impact on clinical practice; and f) regional context. However, major challenges persist, and GPs reported the following main barriers to using an HIE system: a) frequent lack of all patient information needed; b) no effective workflow improvements; c) lack of some technical features. Conclusions We propose four recommendations based on findings: 1. Future initiatives should focus on developing HIE systems giving GPs access to all possible patient medical information; 2. Crucial data privacy and security issues should never be overlooked; 3. Technical and workflow improvements should particularly consider the socio-technical nature of HIE systems; 4. Much attention needs to be paid to the importance of relationships between health care providers and between these and local health institutions when implementing HIE systems. Key messages This study filled a research gap as it is the first that tackles HIE system barriers and facilitators in Ticino. When information sharing for clinical practice focuses on improving the quality and costs of healthcare, GP's trust in HIE system security is crucial.

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