1. PECS Reporting 101 and Drill Down Benjamin Fouts MPH OneWorld Community Health Center Omaha, NE Phase 2 Health Disparities Retreat April 12, 2007 Council Bluffs, IA

2. Agenda  What is a “drill down” ??  Two methods to drill down in PECS  Registry Summary Reports  Canned or Custom Reports  Example of a customized drill-down report

3. Drill Down Definition  To examine information at another level.  In information technology, to move from summary information to the detailed data that created it.  Especially in a database, to navigate to a more detailed level or record. http://www.answers.com/topic/drill-down

4. Drill Down  Many Health Disparities Collaborative indicators summarize complex and multi- faceted systems  Drilling down focuses on one or more components of the system to analyze its effect on the whole  You can drill down to progressively more and more detail until you get to the level that gives you the data you need

5. Two Methods to Drill Down in PECS 1. Registry Summary Report  Provides data directly from the Collaborative indicators  Can be run for individual clinics or primary providers  But, there is limited data to choose from and display

6. 1. Registry Summary Report  Report category: Diabetes  Name: “DM Registry Summary Report”  Choose to Preview report  Then, in the report, click on an indicator

7. 1. Registry Summary Report  Choose patients included in or excluded from the indicator  Copy data to your clip- board and paste into Microsoft Excel

8. Two Methods to Examine Data 2. Other Reports a. Reports that came with PECS (red font) b. Customized reports (black font)

9. 2. Other Reports: Components  The fields you query (i.e., the way you select the population you are interested in)

10. 2. Other Reports: Components  The fields you display (i.e., what you are interested in knowing about the population, including fields for further analysis)

11. Example: Diabetic Self Management (SM) Goal Setting A drill down exercise can start when you notice something unusual in one of your Collaborative trend graphs

12. Example: Diabetic SM Goal  Check: reminder works  Check: data clerk person entering goals appropriately  We will decide to “drill down” on provider teams

13. Example: Diabetic SM Goal Registry Summary Report Data  Remember that the graphed indicators correspond to the bolded and italicized data elements on the Registry Summary Report  To understand the patients who are included in the indicator, check the exact definition of the indicator on http://www.healthdisparities.net/

14. Example: Diabetic SM Goal Registry Summary Report Data Documentation of self-management goal setting: “The number of diabetic patients in the clinical information system with documented self-management goals in the last 12 months divided by the total number of diabetic patients in the clinical information system.”

15. Example: Diabetic SM Goal Registry Summary Report Data Click on 12b to get the following fields:

16. Example: Diabetic SM Goal Registry Summary Report Data This patient-specific data may be all you need:  To do a chart review  To see patterns that can tell you something  To take action: get a nurse to call the “excluded” patients and make SM goals

17. Example: Diabetic SM Goal Use Another Report  If the Registry Summary Report data is not specific or detailed enough for your purposes, you will need to use another report  Then, ask yourself, can you use one of the reports that comes with PECS or do you need to create your own?

18. Study Questions For the Example of Diabetic SM Goal Simple hypothesis: There are differences in SM goal setting between the different provider teams

19. Study Questions For the Example of Diabetic SM Goal Q:Study population: who are the patients you want to focus on? A:Diabetic patients with and without a self management goal Q:Display fields: what are the fields you need to display? A:Encounter provider and SM goal date

20. Example: Diabetic SM Goal Keep in Mind…  You might not have a neat and tidy hypothesis  Sometimes drilling down means following leads, refining study questions and getting different kinds of data in order to isolate the problem you are encountering

21. Example: Diabetic SM Goal Check Existing Reports  First, check to see if an existing report meets your needs  If it only comes close, it can be used as the beginning of a custom report

22. Example: Diabetic SM Goal Check Existing Reports  Does this report have the filters we need?  Yes: it has a diabetic patient filter and a self management goal filter

23. Example: Diabetic SM Goal Check Existing Reports Note:  Enter 365 days to get the same patients as the “excluded” patients from the Registry Summary Report  Enter ZERO to get all patients (i.e., those with recent SM goals, old SM goals, and no SM goals)

24. Example: Diabetic SM Goal Check Existing Reports  Does this report have the output (or display) fields we need?  No: it does not display the provider who saw the patient

25. Example: Diabetic SM Goal Create a Custom Report  Choose to edit “List DM Pts no SM Goal Last xx Days”  Enter a different report name  Choose “No statistics”

26. Example: Diabetic SM Goal Create a Custom Report  The filters for this report do not need to be changed  On the Select Columns screen, select the Encounter category, then 1) click on Encounter Provider Name and 2) click Add

27. Example: Diabetic SM Goal Run the New Custom Report  Now we have the new custom report (black font)  Click  On the next screen, leave the default report dates and click  Enter 365 days in the pop up window

28. Example: Diabetic SM Goal Working With the Output Sort the list. In Excel, highlight rows and columns with data and click “Sort…” in the Data drop-down menu

29. Example: Diabetic SM Goal Working With the Output Sort by Encounter Provider

30. Example: Diabetic SM Goal Working With the Output Count the patients for each provider (hint: Excel counts highlighted cells that contain numbers)

31. Example: Diabetic SM Goal Working With the Output Create a table to display the output

32. Example: Diabetic SM Goal Working With the Output Conveniently, we can get the total number of patients for each provider by using the same report, but with a zero in the dialogue box. Count patients the same way.

33. Example: Diabetic SM Goal Working With the Output  Complete the table. Conclusions?  Target performance improvement activities accordingly. Give data and feedback directly to providers or teams

34. Example: Diabetic SM Goal Monthly Monitoring  Once you implement a performance improvement activity, you can then monitor the data monthly  To do this, we need to add Encounter Date to our report

35. Example: Diabetic SM Goal Monthly Monitoring  If we want to see last month’s data, enter March 31 date for “Thru”  Then enter zero to see all patients

36. Example: Diabetic SM Goal Monthly Monitoring In Excel, sort the columns again, but this time sort by encounter provider and then by encounter date

37. Example: Diabetic SM Goal Monthly Monitoring Highlight the rows with an encounter in March for one provider (Do not highlight other dates outside of March or other providers)

38. Example: Diabetic SM Goal Monthly Monitoring Then, with the rows still highlighted, sort by self management goal setting date (“Column D” in the sorting box)

39. Example: Diabetic SM Goal Monthly Monitoring We then count all self management goals made within a year of the March encounter date.

40. Example: Diabetic SM Goal Monthly Monitoring  Of the 17 patients seen in March by the provider, 15 had a self management goal within the past year and 2 did not  Add to a modified table

41. Drill Down Conclusions  Depending on what you are looking for, drill down using data from:  Registry Summary Reports  Reports that come with PECS  Custom reports  To analyze the data, you usually have to import it into Excel, then sort it by particular fields and count the results

42. Drill Down Conclusions  Questions? Benjamin Fouts MPH OneWorld Community Health Center Omaha, NE bfouts@oneworldomaha.org