Presented by Nick Baker
General and Community Paediatrician
Executive Clinical Director for Community Based Services, Nelson Marlborough District Health Board.
A Clinical and a Pharmaceutical Events Query Dashboard
1. Nic k Baker
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A Clinical and a Pharmaceutical
Events Query Dashboard
Nelson Marlborough District Health Board
Nick Baker, Community Paediatrician
Donald Hudson, Business and Clinical Intelligence
Graham Parton, Chief Pharmacist
Montage Ltd.
Chip Felton, Principal Consultant, Visualisations
2. Information Needed for
Intelligent Behaviour
• Learning from experience
– modify services to meet needs
– improve effectiveness and outcomes
– enhancing quality and consistency
• Data is stored in many places
– is often inadequate
– collected in incongruent ways
– difficult to link to individual programmes of care
3. What is Clinically Useful?
• Personal health objectives
• right care, right place, right time,
• shared information, teams thrive
• Service level objectives
• audit, trends, effectiveness, planning, staffing
• Population health objectives
– target prevention
• age group, season, practitioners, regions
– evaluate interventions
– surveillance of trends
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Nick Baker
4. First Attempt 1996
• data from each admission stored in Orocare
• 95 fields of data for every admission
• data extracted from oracle based system as a
spreadsheet
• imported directly into Access
• daily downloads possible
• database used to analyse data
• dataset filtered to extract a subset of admissions
• any fields can be used to control to data selected
– standard formats to view data graphs, tables.
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Nick Baker
9. 2013
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proliferating information systems – collaborative?
a large amount of data is collected
the data used for funding and reporting purposes
rarely converted into clinically useful information
lack of checks against clinical reality mean errors
can go unchallenged
• Information visualisation
– “The use of computer-supported, interactive, visual
representations of abstract data to amplify cognition.”
(Card, Mackinlay, Shneiderman, 1999)
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10.
11. 2013 Tableau Reader Based System
From Data to Information
Multiple, Fragmented
Data Sources
Actionable
Information
12.
13. Has New Clinical
Pathway Changed
Prescribing?
• Select Data
• Age group
• Medication
• Very complex queries possible
• Clinician driven hypothesis testing
23. Clinical Uses So Far
• Reality check data
– look at coding, does result make clinical sense
• Answer Quick Queries
• Hospitalisation, pharmaceutical usage
– Emerging trends, identify variation, patterns
• Identify outliers provide focus for discussion
– Hypothesis generation/validation
– Identify at risk groups
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• Target interventions – falls, event management
• Prioritise
• Seasonal and temporal trends for conditions allow
Nick Baker
targeting of community interventions
24. Problems
• rubbish in rubbish out
– constantly refined
– test validity
• need knowledge of limitations
“out of sight out of mind
a blind idiot!”
– enormously powerful tool
– to jump to wrong conclusions and upset people
– best to let clinicians explain information
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25. Conclusions
• The system can
– allow rapid analysis of trends
– answer quick queries
– evaluate interventions
– be used for service planning
– be used to target population health interventions.
– useful addition to standard processes of clinical audit
• Extreme care is needed in using data collected by
non-clinical staff for non-clinical purposes to draw
epidemiological conclusions.
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Nick Baker
26. Conclusion
• Information alone
“blind idiocy”
• Clinical judgement alone
anecdote
• Information + clinical judgement
clarification
• Clinically driven information selection and
visualisation
enlightenment and wisdom?
27. Acknowledgements
• Donald Hudson – Clinical Intelligence
• Graham Parton – Chief Pharmacist
• Chip Felton - Principal Consultant,
Visualisations, Montage Ltd.