Use and Distribution of Management Reports Roundtable Kathy Davis, Manager, Pathology Informatics Marianne Mara, Programmer Analyst Chris Gaunt, Business Analyst John Blau, Pathology Informatics Fellow

Agenda Meeting the needs of Laboratory Managers and Directors Implementing Management reports Successes with Soft Management reporting tools Challenges with Soft Management reporting tools and alternative solutions Discussion of common data needs at large tertiary care facilities

Management Reports Needs All laboratory sections have their own vision of report requirements Report delivery methods Internal customers External (outreach) customers State/community health reporting requirements Report presentation / content Report frequency Lab managers and directors want the ability to run ad-hoc queries Impact on performance

Implementing Management Reports Limited training in the use of Management Reports due to time constraints for go live readiness Limited resources before going LIVE Cannot restrict user access to folders Identified existing operational reports in legacy system and mapped that report to Soft Reports Gap analysis spreadsheet created for management reports 220 needed reports

Success Stories with Soft Reports

TAT reports for Hem/Onc Clinic The criteria for the input for any day is the ordered test, CBCD, from Received to Verified, for outpatient STATS. 

Data Output Format in Excel Data is manipulated in Excel

Pie Chart for Hem/Onc TAT Output

Fecal Occult Blood Compliance Collect the pending IFOB tests

Fecal Occult Blood Compliance Collect verified IFOB tests

Fecal Occult Blood Compliance Produce graph

Challenges with SoftReports Data fields missing on standard reports Standard reports fail to run or don’t collect expected results Excel spreadsheet formats were missing or cluttered Many reports use lab order date instead of lab result date

Success Stories with SoftReport Designer

Challenges with SoftReport Designer Tables and data elements were not always available in the view of the database, therefore the data elements were not available for queries Needed a data dictionary specific to our installation Lacked a list of SQL functions User import tables missing Poorly designed reports can negatively impact system performance Not able to secure operational reports from custom reports

Canceled Test Report – Exception Report Lacked the ability to print the report by department and order number Laboratories need the following data fields included, some of which were not available in the Exception Report MRN, Order number, order date/time, Test(s) canceled, cancel comments Required excel format with the cancel reason visible

Soft Exception Report - Cancels Soft Exception Report Query for Cancels

Soft Exception Report - Cancels Soft’s Exception Report Output - Cancels

Custom Cancel Report Custom query for cancels

Running the Report Option 1

Running the Report Option 1 - continued

Running the Report Option 2

Running the Report Option 2 – continued

Running the Report Option 2 - continued

Running the Report Option 2 - continued

SoftReportDesigner – Cancel Report Output Custom cancel report output

Generalized Lab TAT Query SELECT DISTINCT GOrd.GP_ORD_ORDNUM AS OrdNum, GOrd.GP_ORD_ORDEREDTESTS AS Test, GOrd.GP_ORD_REGDT, GSPEC.GP_SPE_RECDT AS RecDT, Min(GRpt.GP_REP_SDATE) AS SignoutDT, GSPEC.GP_SPE_COLDT AS CollDT, GOrd.GP_ORD_PATMRN AS MRN, GPt.GP_PAT_LNAME, GPt.GP_PAT_FNAME, GOrd.GP_ORD_ORDEREDSPEC AS Spec, Round((GRpt.GP_REP_SDATE - GSPEC.GP_SPE_RECDT), 4) AS TAT, dbms_lob.substr(gcm.gcm.V_P_GCM_INTERP.GP_INT_REPORTPT, 10000, 1) AS Interp FROM gcm.gcm.V_P_GCM_SPEC GSPEC INNER JOIN gcm.gcm.V_P_GCM_ORDER GOrd ON GSPEC.GP_SPE_ORDNUM = GOrd.GP_ORD_ORDNUM INNER JOIN gcm.gcm.V_S_GCM_TEST ON gcm.gcm.V_S_GCM_TEST.GS_TST_CODE = GOrd.GP_ORD_ORDEREDTESTS INNER JOIN gcm.gcm.V_P_GCM_CLINIC ON gcm.gcm.V_P_GCM_CLINIC.GC_CL_CODE = GOrd.GP_ORD_CLINIC INNER JOIN gcm.gcm.V_P_GCM_REPORT GRpt ON GRpt.GP_REP_ORDNUM = GOrd.GP_ORD_ORDNUM gcm.gcm.V_P_GCM_INTERP ON gcm.gcm.V_P_GCM_INTERP.GP_INT_RECID = GRpt.GP_REP_INTERPID AND gcm.gcm.V_P_GCM_INTERP.GP_INT_ORDNUM = GOrd.GP_ORD_ORDNUM AND gcm.gcm.V_P_GCM_INTERP.GP_INT_TESTID = GRpt.GP_REP_TESTID INNER JOIN gcm.gcm.V_P_GCM_VISIT Visit ON Visit.GP_VIS_MRN = GOrd.GP_ORD_PATMRN gcm.gcm.V_P_GCM_PATIENT GPt ON GPt.GP_PAT_RECID = Visit.GP_VIS_PATID WHERE GOrd.GP_ORD_DEPARTMENT IN ('144', '147') AND TO_CHAR(TRUNC(GSPEC.GP_SPE_RECDT), 'YYYYMMDD') BETWEEN %StartDate% AND %EndDate% GROUP BY GOrd.GP_ORD_ORDNUM, GOrd.GP_ORD_ORDEREDTESTS, GOrd.GP_ORD_REGDT, GSPEC.GP_SPE_RECDT, GSPEC.GP_SPE_COLDT, GOrd.GP_ORD_PATMRN, GPt.GP_PAT_LNAME, GPt.GP_PAT_FNAME, GOrd.GP_ORD_ORDEREDSPEC, Round((GRpt.GP_REP_SDATE - GSPEC.GP_SPE_RECDT), 4), dbms_lob.substr(gcm.gcm.V_P_GCM_INTERP.GP_INT_REPORTPT, 10000, 1), GOrd.GP_ORD_DEPARTMENT, GOrd.GP_ORD_RECID, GOrd.GP_ORD_REQ, GSPEC.GP_SPE_COLLECTED, GOrd.GP_ORD_CLINIC, gcm.gcm.V_S_GCM_TEST.GS_TST_NAME, GOrd.GP_ORD_BILLQUALIFIER, gcm.gcm.V_P_GCM_CLINIC.GC_CL_PTYPE, GRpt.GP_REP_REVNUM HAVING GPt.GP_PAT_LNAME NOT IN ('CDR', 'TEST') AND GOrd.GP_ORD_CLINIC NOT LIKE 'ATLP' AND GRpt.GP_REP_REVNUM = 0 ORDER BY GOrd.GP_ORD_ORDEREDTESTS

Soft Designer Layout for Molecular Diagnostic Laboratory

Soft Designer Report

Molecular Diagnostic Laboratory Tests with TAT or Cancel Reason

SoftReport Designer Queries for AP A query to record the time of Surg Path accessions and who accessioned it to help balance workload for accessioners TAT queries for SurgPath, Autopsy, Cytology, and Flow A query to specifically look at how long slides take to process in histology

Soft Designer SQL

Orders by Pathology Service

Using ODBC

ODBC queries Needed a very fast solution to extract data for quality reporting needs Used ODBC connection to Soft database to extract data quickly Produced the necessary reports quickly as a stop gap measure Working with Soft Reports team and Soft Report Designer to replace the ODBC reporting needs

Benefits of ODBC Can be used by external or homebrew software to directly access data. Oracle’s SQL Developer software lets you browse the contents of tables so you can easily see which columns are blank and which are useful

Drawbacks of ODBC Our ODBC access was for the production server, not the test environment, so a poorly crafted query could have bad consequences No “Wizards” like in the Report Designer; type SQL by hand. Can be a beast to set up, especially if you need to federate a query from a non-Oracle database.

Reports created using ODBC Retrieving HIV test data for the University of Michigan's HIV / AIDS Treatment Program Providing the Cancer Registrars with Pathology reports containing cancer terms Complicated SQL query to help find a missing biopsy Turn-around-time for renal biopsies of a specific type to address clinician complaints of long TAT

ODBC Rapid HIV Report Query and output for HIV report

Discussion Topics Management reports in use Delivery methods for management reports Who writes the reports? Other comments

THANK YOU!