A Diabetes Outpatient Visit An Informatics View

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A Diabetes Outpatient VisitAn Informatics View

• Paul Knudson, MD
• Associate Professor of Medicine
• Division of Endocrinology
• Office of Clinical Informatics
• Medical College of Wisconsin

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Purpose of Data Management

• Improve quality of patient care, by providing
• Trend data for a particular patient
• Trend data for a particular provider
• Group data for a group of providers and
  organizations.
• Health delivery quality transparency to public
  and payors.
• Business uses pay-for-performance
• Research new discoveries that impact patient
  care.

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Nature of Data Capture

• Discrete Data
• Captured in the electronic health record database
  so as to be retrievable for reports, indexed in
  the database.
• Non-discrete Data
• Not indexed in the database therefore, requires
  great effort to extract for the documentation.

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Epic
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Definitions

• EpicCare a database built using Caché called
  Chronicles. Also includes tools to input and
  report on data.
• Caché a brand of database software using the M
  language.
• M language also called MUMPS, a database
  language designed specifically for capturing
  medical records data in a rapid, transactional
  way. Allows for real-time data entry across a
  large enterprise.
• Workbench real-time reporting tool to get data
  out of Caché database. Not for extensive
  manipulation of the data.
• Clarity Epic relational database management
  tool. Information from Caché is transferred to
  Clarity, usually on a daily basis, not real-time.
  
• Data Warehouse Relational, scalable, robust
  data repository. The data is not real-time. The
  data comes from multiple sources, not just Epic.

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Within Epic

• Some data is discrete, stored in the Caché
  database in a way that can be abstracted and used
  for reporting. For example,
• Laboratory data
• Diagnostic lists
• Some data is stored as text, which is not
  discrete and very difficult to report on

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Once in Clarity

• Reporting on
• Provider trends
• Group trends
• Quality benchmarking
• Send to data warehouse

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Goals of Visit

• Collect and Review Clinical Data
• Provide Quality Care
• Document data to support clinical needs, quality
  (reporting) needs, and billing needs
• Be efficient

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Diabetes Mellitus VisitVisit Navigator
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Diabetes Mellitus VisitVital labs snapshot
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Diabetes Mellitus VisitBest Practice Alerts
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Diabetes Mellitus VisitSmartText
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Diabetes Mellitus VisitSmartText
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Diabetes Mellitus Visit SmartText
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Diabetes Mellitus VisitQuestionnaire
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Diabetes Mellitus Visit
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Future Development

• Epic SmartForms
• More flexible to capture discrete data
• Might be integrated into the clinician work-flow