1. An introduction to Essentris GDR Intended for Clinicians or anyone who wants to identify and develop an Essentris GDR report specification

2. An introduction to Essentris GDR – Report Specification? An Essentris GDR report specification is a document which can be used by a data analyst to create the logical design of a report using SQL Language or other database reporting tools

3. An introduction to Essentris GDR – Data Deliverables Once the logical design of the report is complete, any number of various kinds of data deliverables (excel, pdf, html, printouts) can be made

4. An introduction to Essentris GDR - overview These slides are designed to meet two objectives Provide a listing of the kinds of data we can use in a GDR Report Provide a framework and vocabulary you can use to create report specifications to give to your data analyst

5. Essentris GDR fundamentals: everything centers on the PATID column Internally generated encounter number Unique across installations Column that joins a single patient’s data NOT visible in Essentris Column that is almost never shown in Reports

6. Essentris GDR fundamentals: CCI’s DATABASE ITEMS Clinicomp maintains a list of some 13,000 DATABASE items which may used on Essentris Screens and so may be used in Reporting We can report on any data from any Essentris screen Data is typically organized one table per concept - ie: a heart rate table, a chief complaint table, a restraint type table…

7. Essentris GDR fundamentals: CCI’s NOTE TABLES The GDR has a separate table for each of the NOTES in use at your site. We can report on the creation time, last store time, and any data stored on any NOTE Data is typically organized one table per note and further organized by the TAG number, ie: the label “case type” might be found next to a text box with the identifier TAG number = 2. Our spec doc will say: case type = tag 2

8. Essentris GDR fundamentals: Determining the main list (Driving List) Best Practices involves identifying a main or “driving list” (DL) DL is verifiable, simple, and is the answer to the question: “Who should be on the report?” The DL is the left side of all joins in the WHERE clause (a technical point)

9. 4 Slides on SQL language: Everyone’s First SQL lesson In Structured Query Language (SQL) we: SELECT A comma separated list of COLUMNS FROM A comma separated list of TABLES WHERE Two COLUMNS are equal (joins) or Some fact about a COLUMN is true

10. 4 Slides on SQL language: the SELECT clause Comma separated list of columns Regular English: the columns of data which need to show in the report

11. 4 Slides on SQL language: the FROM clause Comma separated list of TABLES Practical English: Essentris data sources, usually identified by FULLNAME or Note TAG String, or else is documented in the GDR manual

12. 4 Slides on SQL language: the WHERE clause Two columns are equal (joins) or Some fact about a column is true UNIT.data like ‘ICU’ or NAME.data not like ‘%TEST%’ or GLUCOSE.data > 120 or MedName in (‘ASPIRIN’,’MOTRIN’,…)

13. SQL Language summary: Your data analyst needs to know which TABLES to use and which COLUMNS to show in the report

14. Essentris Data Sources: Start with Essentris We already know our way around Essentris Identify Essentris Data Sources found on different screens: Admit Notes Timed Notes Vitals Flowsheets Order Entry and Meds/Treatments/I&O Flowsheets Admission/Discharge/Transfer Data

15. Essentris Data Sources: Admit Notes User defined template document Only one copy stored on the patient record Has labels, checkboxes and text fields In EDIT mode, right-click checkboxes and text fields, select “describe item”, then double click the Label “Item Edit History” Text fields can be of two types DATABASE: Reference the DBI FULLNAME NOTE: Reference the TAG String (ex: !207.ABC^5.10)

16. Essentris Data Sources: Notes, Describe NOTE Item

17. Essentris Data Sources: Describe NOTE Item Report Column: “Case Type” Tag !200.PER^6.2

18. Essentris Data Sources: Notes, Describe DATABASE Item

19. Essentris Data Sources: Describe DATABASE Item Column = “Allergies” Fullname = “Allergies.adm”

20. Admit Notes tangent: Consider One Essentris DATABASE Items As many as 13,600+ DATABASE Item TABLES in the GDR Some hold one value per patient stay Name, fmp/ssn, rank, Some get charted many times during the patient stay HR, tempC, painscore, vent setting Need the FULLNAME for Report Spec

21. Essentris Data Sources: DATABASE Items Columns you may want in your report: DATA The charted value stored in this item KEY The observation time for the stored DATA LOG TIME The date and time that a person gave their username/password to store the DATA

22. Essentris Data Sources: 3 DBI example (Patient Details) FULLNAMES: NAME, MRN, DOB

23. Essentris Data Sources: 3 DBI example (Patient Details) Example Spec might be: Report to show Name, FMP/SSN, Birthdate for all active patients. Column: “Patient Name” Fullname: “NAME” Column: “FMP/SSN” Fullname: “FMP/SSN” Column: “Birthdate” Fullname: “DOB”

24. Essentris Data Sources: 3 DBI example (Patient Details)

25. Essentris Data Sources: 3 NOTE items example Put your cursor into the cell. Right-click and select “Describe Item”. Double click the ‘Edit History” Label to find the TAG. Reference the TAG string for the Text Prompt (ex: !200.PER^6.2)

27. Essentris Data Sources: 3 NOTE items example Example Spec might be: Report to show Delay Code, Case Type, Datetime of Univ Protocol from the Peri-Operative Note for all patients. Column: “Delay Code” TAG: !200.PER^6.497 Column: “Case Type” TAG: !200.PER^6.2 Column: “DT Univ Protocol” TAG: !200.PER^6.484

28. Essentris Data Sources: 3 NOTE items example

29. Essentris Data Sources: Parameter Flowsheets (Vitals)

30. Time driven values Database items DBIs have a “many to one” relationship to patient Most reports require we find a single value to report: MIN/MAX(data or key), the value closest to a point in time, a single LIST of values, etc Turn chronological DBI charting into Start and Stop times for treatment intervals: vent use, restraints, etc

31. Essentris Data Sources: Parameter Flowsheets (Vitals) Right-click, select “Describe Item” to find the site-defined FULLNAME FULLNAME is the unique identifier for the data TABLE in the GDR

32. Essentris Data Sources: Flowsheet Describe Item

33. Essentris Data Sources: Parameter Flowsheets (Vitals) Example spec might be: Show any patient who has had a fever (temp > 100) Column: “first fever time” FULLNAME: “TempF(DegF)”

34. Essentris Data Sources: Parameter Flowsheets (Vitals)

35. Example spec might be: Show the first fever time for any patient who has had a fever (temp > 100) Column: “first fever time” FULLNAME: “TempF(DegF)”

36. Essentris Data Sources: Parameter Flowsheets (Vitals)

37. Essentris Data Sources: Order Data Facts about Orders which can be included in a report are those which are found on two different Order-based screens: Order Entry Orders Flowsheet

38. Essentris Data Sources: Order Entry Screen Details Order Time, Start Time, Stop Time, Verbal Order, MD Name, Order Name, Orderset Name, Order Category, Comment, ENT,SIGN, C/S, ACK, Verify A_ORDERENTRY table has columns for all these facts about the Order found on the Order Entry Screen

39. Essentris Data Sources: Meds Flowsheet Details These tables contain data you see displayed on the Med Orders Flowsheet: MEDS_FLOW_ANNOTATION_2231 MEDS_FLOW_COMMENT_2267 MEDS_FLOW_DEFINITION_2225 MEDS_FLOW_DELIVERY_2230 MEDS_FLOW_DOSE_2229 MEDS_FLOW_FREQUENCY_2226 MEDS_FLOW_LABEL_COMMENT_2227 MEDS_FLOW_REMARKS_2925 MEDS_FLOW_ROUTE_2228

40. Essentris Data Sources: ADT Data Admission/Discharge/Transfer data

41. Essentris Data Sources: A_ADTHISTORY HL7 interface or Staff will add records to the ADTHISTORY table indicating patient location (UNIT, BED)

42. Essentris Data Sources: A_UNITHISTORY Uses logic based on A_ADTHISTORY table to figure out the Enter Times and Exit Times per patient per unit

43. Essentris Data Sources: A_UNITBEDHISTORY Uses logic based on A_ADTHISTORY table to figure out the Enter Times and Exit Times per patient per unit per bed

44. Essentris Data Sources: A_PATIENTLIST Uses logic based on A_ADTHISTORY table to show one representative record per patient. Includes data like: name, mrn, hospno, MD, admtime In Practice: A_PATIENTLIST = the patient records that are loaded into the GDR

45. Essentris Data Sources: A_PATCOMMON Based on a script which runs per 10 mins on the ncrontab scheduler, This table list all the active patients in Essentris

46. Essentris Data Sources: A_ARCHLIST Based on a script which runs from the Essentris Server Scheduler @1 AM Lists all the archive records on the Essentris Server filesystem