LPCA Workshop CONFIDENTIAL This file contains information that is - - PowerPoint PPT Presentation

November 13, 2018

LPCA Workshop

CONFIDENTIAL

This file contains information that is confidential to Azara Healthcare, LLC Do not view, copy, distribute, or disclose without prior consent.

Introductions

• Meet Your Peers and Azara Staff

Introductions

• 1. Find someone in the room you don’t know.
• 2. Introduce yourself and share your:

a. Name and role b. Organization c. One fun fact about yourself

• 3. Be prepared to introduce your new friend to the rest of the room.

a. Their name and role b. Their organization c. One fun fact about them

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Agenda

Introductions Data Hygiene Validation Tools and Problem Solving Custom Registries and Problem

Cohorts Custom Scorecards Targets Custom Dashboards Have you considered?

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9 8 7 6 5 4

How Today Will Work

• Theory followed by hands-on practice.
• We tried to seat you with your team if more than one attending. Those

without DRVS access will be paired with another team to observe.

• For each segment, each organization should work as a team to complete

the exercise together. If time permits, build a second or more.

• We will be walking around the room to assist teams to complete the

exercises as well as recording questions and concerns for follow up.

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Summary

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Make Your Data Work for You

• Strategy
• Focus
• Action Steps

Goals

• Understand the value of data hygiene.
• Create tools to spread data validation beyond the typical team.
• Create matrix and calendar.

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It Takes a Village To Have Good Data

• Data is not just an IT project.
• Ensure the quality of data capture, accuracy, extraction and measure results.
• A cross functional team is critical to strengthening your data integrity.

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Workflows Population Health Needs Template Development Data Validation Feedback on Data Accuracy Labs/Diagnosis/Coding Updates Mapping/Data Dictionaries

Azara’s Approach to Data Hygiene

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Tool Use Measure Matrix Focus on most important measures Validation Calendar Schedule hygiene activities Validation Tools in DRVS Take action: Leverage tools in DRVS to make hygiene activities easier and more sustainable

The Sweet Spot for Your CHC

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Diabetes

A1c BP Control

HTN

BP Control

Obesity

Child and Adult Weight Screening, & Follow up

Cancer Screening

Cervical, Breast, Colon Sweet Spot

Building a Measure Matrix

• Determine your organizational priorities.
• Update Excel Template with CHCs measures.

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Data Hygiene

• Keep your data healthy with regular check-ups.
• Make a plan and stick to it.

Two Pronged Approach to Data Health

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Proactive

• Monitor measure trends with

Measure Analyzer

• Use a Data Validation Calendar

Reactive

• Respond to a complaint about a

specific measure

Data Hygiene Best Practices

• 1. Focus. Identify and prioritize focus measures and performance targets.
• 2. Map existing workflows for key measures. Do not underestimate the power of what

you do not know.

• 3. Standardize best practices that result in usable data.
• 4. Train staff. Use data and analytics to see if staff is documenting in the fields that link to

QI reports. Create an ongoing feedback loop.

• 5. Establish a recurring team meeting that is data and performance focused and continue

to revisit issues. Build a schedule for validating certain measures.

Keeping Your Data Healthy

• Make data hygiene part of your routine.
• Assign responsibility and accountability for these activities.
• Share results and celebrate success.

Daily

Visit Planning Tools

Weekly

Registry & Care Mgmt Reports

Monthly

Quality & Performance Mapping Admin

Annual

UDS Reports & Tables

Reporting Hierarchy in DRVS

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COMPLIANCE

• UDS
• Meaningful Use
• PCMH, etc.

POPULATION MANAGEMENT

• Registries,

Scorecards, Dashboards

• Patient Detail
• Referrals

DAILY CARE DELIVERY

• Visit Planning
• Care

Management Passport

Rx for Integrating Data Hygiene Into Everyday Practice

• Who - One person can’t be responsible- delegate across the organization, but assign to

individuals.

• What Measures - Use your measure matrix as the foundation for a data hygiene

calendar- and group them together when it makes sense (example well child visits and childhood immunizations).

• Which Reports - Know which reports matter most to your organization.
• When - does the organization do data validation?
• Why - what’s the goal? To identify needed care for today.
• Accountability Counts- Make sure someone is checking assignments are complete.

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Data Hygiene Calendar

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Measure Name Targets Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Infant Well Child Visit 15 mos, Childhood Imms and Dental Sealants Colorectal Cancer Screening CAD Lipid Therapy and IVD Aspirin Therapy and Care Coordination DM A1c, Foot, Eye, Nephropathy, LDL Adult and Child Weight Screening and Counseling (UDS) Colorectal Cancer Screening (UDS) Adolescent Well Care and Well Child Visits 3-6 yrs HTN BP Control for DM and HTN and Pneumococcal Imm Breast Cancer Screening Depression Screening and Follow up UDS Measure Review (UDS) Cervical Cancer Screening and Asthma Pharmacological Therapy

”

Data Hygiene Calendar

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Friends don’t let friends do data validation alone

Hygiene Activities Daily Weekly Monthly Q1 Q2 Q3 Q4 Prenatal Trimester of Entry (UDS) Birthweight (UDS) Registries Visit Planning Report Review Key Scorecards / Dashboards Review Mapping Administration

Build Your Data Validation Calendar (15 minutes)

• 1. Retrieve the measure matrix you prepared for homework. Copy the measures that are

strategic for your organization.

• 2. Paste them into the Data Validation Calendar somewhere on the left part of the

spreadsheet next to the calendar cells for reference.

• 3. Consider things like:

⎻ Current performance levels (what needs most work) ⎻ Season ⎻ Timing in relation to UDS ⎻ Awareness months

• 4. Once you’ve chosen measures, consider frequency of hygiene activities.

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Data Validation

• Tips and tricks for assessing data accuracy.
• Friends don’t let friends do data validation alone.

Data Signals for Hygiene

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No Data

Data Signals for Hygiene

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Monitoring Measure Trends

• Look at the data – look for large drops or spikes – ask why.
• Month data shows changes more readily.
• Trailing Year and Calendar Year smooth out the data.

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Track Measure Trends Against Controls

• Create control groups

during PDSA (Plan Do Study Act) cycles

• Track the performance of

the pilot team or location against the control to assess efficacy

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Azara Recommended Process

• Document measure performance baseline.
• Identify areas of focus or concern (calendar).
• Validate patient detail for each measure of concern.
• Correct mapping issues identified.
• Make and train on workflow changes where necessary.
• Compare with baseline to see impact.
• Repeat until goals are achieved.

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To Build Trust Deconstruct the Problem First

• Look at all aspects of the issue.
• Be aware of any assumptions you may have.
• Get specific with examples.
• Look for patterns.

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What Could Be Wrong With My Data?

Data Capture

• Incorrect mapping by Azara or Health Center.

⎻ Not pulling from the correct field in the EHR. ⎻ Missing mapping to standardized vocabulary (e.g., free-text lab results) ⎻ Incorrect “qualifying encounter” definition and encounter service line mappings.

• Change at health center but no communication to Azara.

⎻ Upgrades, new templates ⎻ Non-standardized documentation ⎻ New clinic location ⎻ New immunization codes ⎻ Lab vendor result name change

• Data latency/processing

⎻ Nightly data load, weekly measure processing ⎻ Data extract fails ⎻ Changes in results

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What Could Be Wrong With My Data? |2

Measure or Alert Calculation

• Disagreement regarding interpretation of measure logic.
• Value set variances

⎻ New medications, diagnosis codes, etc., coding requirements by payers updated

• Measure logic error by Azara.
• Alert configured incorrectly or not enabled.
• Measure re-processing (not always needed)

⎻ What are you trying to do?

• See the evidence of the shift X
• Reporting for UDS so that the whole year is impacted Y

⎻ New data source-X ⎻ New requirement - (FIT DNA)-X / Y ⎻ Incorrectly mapped-Y

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Deep Dive Approach to Validation and Tools in DRVS

Break down the details - from definition to mapping.

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Understanding the Measure Definition

• Review the Info Snippet
• Understand what values are in the Value Sets
• Utilize the Measure Investigation Tool (MIT) for how it applies to a patient

Measure Investigation Tool

• Breaks down the Numerator / Denominator / Exclusion
• Understand why in or out of each

Measure Performance Discrepancies

• Looking at the population
• Measure Validation Workbook

Mapping and Data Accuracy

• Mapping Admin (the details on mapping)
• Data Health – Questionable Values Dashboard

Understanding the Measure

• Definitions
• Value Sets

Improving Transparency

Info Snippets Value Sets Measure Investigation Tool (MIT) Center Mappings

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Understand the Measure Definition

• DRVS Measure Info Snippets from a Scorecard.

How are the Numerator, Denominator and Exclusions defined?

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Understand the Measure Definition |2

• DRVS Value Sets from the

Measure Analyzer.

• What are the values that

satisfy the measure?

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Value Set Content

• Check the different types of data that make up the measure.
• Sort by Numerator, Denominator, or Exclusion to find the values you are seeking.

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Value Set Content |2

• A1c Results

⎻ Note the different types of data listed under the “Code System” column – Lab Results, LOINC, ICD-10, Clinical Structured Data.

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Value Set Content |3

• View what is mapped from your EHR.

⎻ Click the “i” icon to display your EHR specific Lab Results names and Clinical Structured Data.

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Data Validation Tools

• Measure Investigation Tool
• Measure Validation Workbook
• Mapping Document and Administration
• Questionable Values Dashboard

Measure Investigation Tool (MIT)

• Designed to investigate why a patient is or is not meeting the criteria of the

components of a measure.

• Identifies the specific criteria as to why a patient is in the numerator, denominator, or

exclusion.

• The MIT is only available for patient-based measures
• Watch for continued improvements as we continue to provide users to view details of

the observations and value sets behind each measure.

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Measure Investigation Tool (MIT) - Access

• Right click on any patient in the Detail List.

⎻ Select ‘Investigate Measure’

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MIT Example #1

• The MIT displays when the patient’s information meet the measure’s criteria.

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MIT Example #1 – Patient Eligibility

• Patient In Measure

⎻ Needs to be >= 18 years old

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MIT Example #1 – Patient In Denominator

• Patient In Denominator

⎻ Has diabetes and a qualifying encounter.

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MIT Example #1 – Patient In Numerator

• Patient In Numerator

⎻ A1c Result < 8 and within 12 months

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MIT Example #1 – Sourcing Data

• Understand Where Data Comes.

⎻ The ”Blue Pills” display the types of data that count for the section.

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MIT Example #2 – Not In Measure

• Patient Not In Measure Criteria.

⎻ Click on the ‘doctor’ icon ⎻ Enter MRN

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MIT Example #2 – Not In Measure

• Patient Not In Measure Criteria.

⎻ Age is 17 years and does not meet specifications.

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Measure Validation Workbook

• Designed to investigate why a patient is or is not meeting the criteria of the

components of a measure.

• Identifies the specific criteria as to why a patient is in the numerator, denominator, or

exclusion.

• Watch for continued improvements as we continue to provide users to view details of

the observations and value sets behind each measure.

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Measure Validation Workbook

• Accessible in DRVS.
• Use for ongoing validation.

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Create a Workbook

• Name workbook.
• Choose measures – standard vs custom.
• Select number of patients to include in the workbook.

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Create a Workbook

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Data Health – Questionable Values Dashboard

• Displays suspicious data coming over from the EHR
• Allows users to efficiently identify data entry errors

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Criteria for suspicious data, i.e. it is unlikely your center has patients who are older than 120 years

Data Health – Questionable Values Dashboard

• Drilling down to patient level detail and the measure analyzer helps pinpoint data

entry errors and trendlines

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Review Mapping Administration

• Review your current EHR to DRVS data mapping.

̶ Review EHR to DRVS mapping for Labs, Structured Clinical Items, Patients Demographics, etc. ̶ Identify all of your EHR data in DRVS that is currently unmapped. ̶ Identify any incorrect mapping.

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Review Mapping Administration

• Understand what is displayed.

⎻ Mapping Summary Table - All DRVS components mapped from your EHR. ⎻ EHR Mapping Details Table - ”Raw” information from your EHR (i.e. Lab Order Name).

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Review Mapping Administration

• Understand the impact of the mapping.

⎻ Modify the Time Period - Look at recent/relevant mappings entering DRVS. ⎻ Distinct count - The unique number of “Source EHR Text” values entering DRVS. ⎻ Count – Frequency of times the value enters DRVS from your EHR.

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Review Mapping Administration

• Identify values that require mappings (i.e. Unmapped).

⎻ Categorize all ”unmapped” values into a category. ⎻ Use Ignore/Archive when values do not match an appropriate category.

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Review Mapping Administration

• Understand DRVS mappings that do not exist.

⎻ Not all DRVS values are mapped and captured from your EHR. ⎻ DRVS Values with 0 Count Tab – Displays structured values not mapped from your system.

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Use Case #1 | Data Hygiene

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• November is National Diabetes Month and your organization’s QI team is working on

the Diabetes A1c > 9 or Untested measure. As part of the team’s regular data hygiene activities, you will:

– Examine overall trendlines to look for spikes and dips in the data – Check patient-level detail to make sure data is coming over correctly from the EHR – Identify data entry errors

#1 Step By Step | Data Hygiene

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• 1. Go the Measure Analyzer for A1c > 9 or Untested by using the search bar in DRVS.
• 2. Click on the measure and open up the Measure Analyzer to look for unusual

spikes/dips/lack of data in the trendline.

• 3. Click on Detail List > right click on a patient name to Investigate Measure.
• 4. Go to the Data Health - Questionable Values Dashboard and check number of

questionable A1c values.

Registry Theory and Training

• Learn how to create custom registries in DRVS.

The Value of Registries

• Stock Registries

⎻ Deployed as a module element to all clients. ⎻ Contain subject-specific patient lists. ⎻ Provide enhancement to stock measures.

• Custom Registries

⎻ Created for one tenant, or single center. ⎻ Contain lists of patients for any need. ⎻ Enhance measures valued by center. ⎻ Stand-alone registries not related to measures.

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The Value of Registries

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• Lists of patients
• Useful for data review
• Allow exploration of a patient group
• Measure reports
• DIY Measure filters
• Exportable patient databases

ARE ARE NOT

Clinical Patient Registries

• Clinical patient registry reports contain a core data columns:

⎻ Patient name, MRN, health center, usual provider, race, ethnicity, language, sex, age, date of birth, payer, phone number, date of last encounter, and date of next appointment.

• Stock clinical registries include:

⎻ Primary Care: Adult Female ⎻ Primary Care: Adult Male ⎻ Primary Care: Adult ⎻ Primary Care: Pediatrics ⎻ Asthma ⎻ Depression ⎻ Diabetes ⎻ HIV ⎻ Hypertension ⎻ Immunizations ⎻ Anticoagulation ⎻ Social Determinants of Health ⎻ Flu- Adult

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Considerations When Building a Registry

• Do the prep work first. Measure twice cut once.
• Write a brief aim statement for the registry:

“Build a report that can track all relevant results, screens, and demographic information for all diabetic patients seen within the last year.”

• When do we consider a new stock registry or updating an existing stock registry?
• Ways to build a custom registry.

⎻ Copy an existing registry and add column(s). ⎻ Create ‘New Registry’

• Evaluate if data elements are available.
• If not currently available in DRVS, there may be additional cost.

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Requirements – Understand What You Need/Want

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Category Question Response Purpose What will you be using the registry for? Users Who will be using the registry? (May be more than one type of user) Frequency How often do you think you will use the registry? (Daily, weekly, monthly, quarterly, once) Priority When do you need the registry? Are there any grants/programs tied to it’s use? Inclusion Criteria What specific criteria gets the patient on the registry? Are there any measure criteria, numerator, denominator or exclusions to follow? Exclusion Criteria Are they any patients you don’t want to show up? Data Elements What information do you want to show up on the registry and in what order?

Designing a Usable Registry - The Details

• General

⎻ Name, description ⎻ Center ⎻ Created by ⎻ Enable

• Inclusion Criteria

⎻ Age, to/from ⎻ Sex At Birth ⎻ Observation(s), and/or

• Exclusion Criteria: Observation(s), and/or
• Data Elements

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Registry Data Elements - By Category

• Static

⎻ Patient level data ⎻ Name, Sex, Gender, DOB, etc. ⎻ Information may only be available on ‘rollover’ on registry view; on export in excel column.

• Dynamic

⎻ Sourced from Observations ⎻ Columns set manually

• Date
• Alphanumeric value(s)
• Numeric value(s)
• Code

⎻ Column settings affect display in registries and measure details

• In general, the column reflects the most recent value in the time period.

⎻ Exception – Medications active in the last 12 months

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Data Elements

• Constantly being updated.

⎻ Demographics ⎻ Diagnosis ⎻ Encounter ⎻ Immunization ⎻ Lab ⎻ Medication Data ⎻ Other

• Data elements are associated modules.

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General

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• Display Name

⎻ Title of registry, shows on left navigation under registry

• Center

⎻ Choose specific center; can only build for one center but shows for all sites

• Description

⎻ Describe the registry so users who are not familiar with it will understand its purpose and key inclusion criteria

• Enabled

⎻ If checked, all users in CHC can view registry; if unchecked, on admin users can see it ⎻ Some registries may have a higher level of security ⎻ Security column on Registry Admin view – shows and restrictions ⎻ Managed through user security

Inclusion/Exclusion Criteria

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• Min/Max Age
• Sex at birth
• Inclusion

Observations

• Inclusion Operator

⎻ And/Or: can only use

• ne
• Exclusion

Observations

⎻ Same list as Inclusion Observations

• Exclusion Operator

⎻ And/Or: can only use

• ne

Registry Administration - Access

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Registry Options

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Registry Builder| General

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Registry Builder| Inclusion Criteria

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Registry Builder| Exclusion Criteria

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Registry Builder| Data Elements

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Data Elements that Appear in Hover-over

• Address 1
• Address 2
• Center Name
• City
• Date of Birth
• Date of Death
• Email Address
• Ethnicity
• Family Size
• Homelessness Status
• Language
• Migrant Status

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• Patient Expired
• Patient Inactive
• Phone Number
• Race
• Sex
• State
• Unscrubbed Ethnicity
• Unscrubbed Language
• Unscrubbed Race
• Usual Provider
• Veteran Status
• Zip Code​

Things to Remember

• Data elements can be moved up and down to change viewing location in the registry.
• Demographic items will appear in the hover-over.
• Include data elements that are associated with the inclusion/exclusion criteria so you

can see why a patient is included.

• Consider use of individual/custom filter settings.
• New clinical data is processed nightly and will show up on a registry the next day

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Use Case #2 | Registries

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Your care management team is working on a new Women’s Rising Risk grant to for women with the following criteria: – Over 18 – Diagnosis of hypertension – Diagnosis of depression – NOT pregnant The team will be conducting outreach to these patients to schedule appointments, during which they would like to close the following gaps in care: – Cervical Cancer Screening – Breast Cancer Screening

#2 Step By Step | Registries

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1. Go to Admin > Report Configuration > Registry Administration. 2. Click New Registry. 3. Create a Display Name, Description, and check/uncheck Enable. This description and name should indicate why the registry was created; for our example, we want to include the Women’s Rising Risk grant name in the title and description. 4. Select Inclusion and Exclusion Criteria:

– Over 18 – Female – Inclusion: Dx of Depression and Hypertension – Exclusion: Active Pregnancy – Remember to select an operator.

5. Choose data elements and order as desired:

– Relevant demographic data that will allow team to conduct outreach such as name, phone number, address, etc – Date of last cervical cancer screening – Date of last breast cancer screening

6. Hit Save. 7. View and run the registry either from the Registry Administration page or by clicking on Registries on the left navigation bar and selecting your registry in the custom section.

Scorecards Theory and Training

• Learn how to create custom scorecards in DRVS.

Scorecard Report

• Provides a quick performance snapshot for a group of measures at an organization.

– Measure – Numerator – Result (%) – Exclusions – Target (%) – Denominator – Performance Indicator – Baseline Performance / Change

Custom Scorecards

• Designed for specific center or PCA needs.
• Core functionality is the same as stock Scorecards

Using a Scorecard

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• 1. Filters
• 2. Info snippet
• 3. Export the measure

detail

• 4. Drill down by clicking
• n the measure name
• 5. Targets
• 6. Measure components

Scorecard Display Options

• Use the additional display options for

different ways to view the measures in a scorecard report.

Display Baseline Performance

• Choose a baseline period to compare to current results.
• Consider setting favorite or editing default filters if you always want the

baseline present.

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Display Groupings in Scorecard Format

• Grouping displays results by selected category for easy comparison e.g.,

providers, location, race, language.

• Includes all measure components.
• Scorecard shows all measures for that specific grouping e.g., provider.

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Display Groupings in Crosstab Format

• Grouping displays results by selected category for easy comparison e.g.,

providers, location, race, language.

• Shows only the measure results.
• Crosstab shows the measure results for each specific grouping e.g.,

provider.

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Display Care Gaps

• Shows each individual patient's compliance with the measures present on

the scorecard and the number of care gaps per patient.

• Displays one patient per row with clinical quality measure gaps identified

in the columns.

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Creating a Custom Scorecard

• Basic Set up

1.Display Name and Description 2.All Centers or single center access 3.Default Period Type 4.Default Provider role

• Usual vs Rendering

Provider 5.Show Exclusions 6.Enable

Creating a Custom Scorecard

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7. Auto search for the measure 8. Choose the desired measure using the magnifying glass 9. Use the three lines to re-order the measures

• Measure Selection

Managing Scorecards

• In the Left Nav, click Admin > Report Configuration > Custom Scorecards.
• You are not able to copy a scorecard.

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View: Open and view the scorecard report. Edit: Make changes to any aspect of the scorecard report Options: Choose Disable to remove the custom scorecard from the left nav menu. Delete: Permanently remove the custom scorecard. As in product

Use Case #3 | Scorecards

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Your CHC is implementing patient visit planning and want to create a scorecard to compare performance before and after the PVP Pilot. The scorecard needs to include the following criteria need to be included for the evaluation of the pilot:

– Three measures Flu immunizations, depression screening and breast cancer screening performance. – Show the performance for the three providers in the pilot. – The pilot started in August 2018.

In addition, you want to be able to view care gaps and easily compare the three providers.

#3 Step by Step | Scorecards

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1. Go to Admin > Custom Scorecards Report > Report Configuration > Custom Scorecards. 2. Name your scorecard and enter a description. 3. Select Month for the default period type- Month 4. Choose a provider role – rendering or usual provider. 5. Select Month as the period type for the second widget. 6. Use the looking glass to choose the measures. 7. Create the scorecard. 8. Choose the provider filter and select 3 providers. 9. Set Baseline period to August 2018.

• 10. Go to the Settings and select set default filters, save filters as default.
• 11. Go to filter icon > display options and check off crosstab and grouping
• 12. Group by provider and save as favorite.
• 13. Go to filter icon > display options and check off care gaps.
• 14. Save as a favorite..

Measure Targets

• Create measure targets in DRVS.

Creating Measure Targets: Target Administration View all measure targets in Report Configuration to:

• Existing targets can be copied or defaulted by

clicking on the gear options( ) for that alert. Measures will use the default target

• To edit an alert, click on the pencil icon ( )
• To delete an alert, clock on the x icon ( )

1 2 3

Creating Measure Targets: Target Administration | 2

• 1. Create Target
• 2. Measure Category
• 3. Measure
• 4. Center
• 5. Name
• 6. Primary Target
• 7. Secondary Target
• 8. Description
• 9. Default
• 10. Create

Note: When creating a target from the Target Administration page, you can select the Measure Category. Separate targets can

• nly be created when a

measure is on multiple scorecards.

Creating Measure Targets: Measure Analyzer

Creating Measure Targets: Measure Analyzer | 2

1.Create Target 2.Measure Category 3.Measure 4.Center 5.Name 6.Primary Target 7.Secondary Target 8.Description 9.Default 10.Create Note: When creating targets from the measure analyzer, the Measure Category and Measure will pre-populate and cannot be changed. The Measure Category is based on the scorecard from which you accessed the measure, either from the search bar or the left navigation.

Use Case #4 | Targets

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Your team has created a PVP scorecard to track performance on key measures. You would like to create a target for your team and add it to your PVP Scorecard. You will start by creating a target for:

– Flu Immunization

#4 Step by Step | Targets

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1. Go to the PVP Scorecard your team created by going to the left navigation and clicking on Reports > Custom Scorecards > [name of your team’s PVP Scorecard]. 2. Select the Flu Immunization measure from the scorecard by clicking on the blue measure link 3. Click on the blue Create Target link from the measure analyzer 4. Name your target 5. Select a primary and secondary target 6. Enter a description 7. Leave Default checked off 8. Click Create 9. Go back to the PVP Scorecard to see your center’s progress toward your new target

Afternoon Break

2:05-2:15pm

Dashboards

• Create a visual narrative with your data.

Make Your Data Matter

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Ask yourself : What is the story you want to tell your viewers? How can we make data impossible to ignore?

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Use Your Data to Tell a Story

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—Dr. Brené Brown, University of Houston

Stories are just data with a soul.

Meaningful Presentation Data presentation (on black stone or white board) matters because the

• nly way we can affect our systems
• f care is to be moved to action by

what the presentation reveals — to action that will make those systems, and the people they serve, better. Katherine S. Rowell

https://mail.google.com/mail/u/0/?tab=ym#inbox/F MfcgxvzLXJjQlhNGndgbZGqpHVFCCpp?projector=1

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Dashboards Basics

• DASHBOARDS

– Show a series of measures in a variety of graphical formats. – Represent your health center as a whole OR can be filtered by various criteria e.g., provider, location, diagnoses, social determinants, demographics. – Display targets or goals established for the chosen measures. – Allow you to drill down into measure analyzer for further ad-hoc exploration and analysis.

What Story Are You Trying to Tell?

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What will you be using the Dashboard for? What time period and is it the same for all widgets? Do you want any filters – demographics, diagnosis, provider, location, team, SDOH Who will be using / viewing the Dashboard? How will the dashboard be used? (Daily, weekly, monthly, quarterly, 1x) Do you have targets for the measures you plan to include?? Example of Callout Box What information do you want to show on dashboard and in what order?

Requirements – Understand What You Need/Want

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Category Question Response

Purpose What will you be using the scorecard/dashboard for? Users Who will be using the scorecard/dashboard? (May be more than one type of user) Frequency How often do you think you will view the scorecard/dashboard? (Daily, weekly, monthly, quarterly, once) Data Elements What information do you want to show up on the scorecard/dashboard and in what order? Filters Do you want to limit the scorecard/dashboard to a particular provider team

• r population within the measure(s) by default, or do you want to allow

users to use filters to adjust the information they see? In the case of dashboards, do you want the same filters to apply across the whole dashboard, or do you want to select individual filters for widgets? Targets Do you have targets for the measures you plan to include? In the case of multiple targets- which target is relevant and why?

Using Dashboards

• A set of stock of dashboards is available for all clients.

– Diabetes (see below) – 2yr Old Immunizations – Cancer Screening – Predominant conditions

• Dashboards also exist for extended modules.

⎻ Risk ⎻ Social Determinants ⎻ Referrals ⎻ Payer Enrollment data – UDS Table 6b – Adult and Pediatric – Data Health – Questionable Values Dashboard – UDS Table 7

Creating an Effective Dashboard

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Add animation to uncover different widgets Add animation to uncover different widgets Add animation to uncover different widgets Add animation to uncover different widgets Add animation to uncover different widgets

Using Dashboards

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• 1. Filters
• 2. Drill down by clicking
• n the Widget Name
• 3. Widget Data View
• 4. Targets
• 5. Hover over to view

details

• 6. Targets
• 7. Percent Change
• 8. Action items – favorite,

export, edit

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Creating a Dashboard| 2 Options

Copy an Existing Dashboard

• Make minor tweaks to current dashboard
• Use same format for another program,

initiative or disease Create a New Dashboard

• Clean slate

Creating a Dashboard*

• Go to Admin > Report Configuration >

Dashboard Administration > Click

*When copying a dashboard, the same general functionality exists

Key Concepts in Dashboards| Periods & Performance

• Use Global Period

– Select if you want all the widgets in the dashboard to have the same period type and period. – Do not select if you want different widgets to have different period types.

• Targets

– Available when set on an individual measure.

• Trend Line

– Multiple trendline view is available when offered groupings.

• Compare to Baseline

– Shows performance as compared to a set baseline period. – Available on widgets that are in table format.

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Key Concepts in Dashboards| Identification of Patients

• Gap

– Shows the number of patients that are not in the numerator.

• To Target

– Shows the number of patients necessary to meet the measure target.

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Widgets| Adding

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Widgets| Adding (continued)

• 1. Name

– Must be unique

• 2. Choose a measure

– Specific to the condition – Basic encounter measure (Face to Face or Primary Care in period)

• 3. Components

– Choose based on your focus

• 4. Grouping

– Filter options – Used for multi-trendline and comparison

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Widgets| Adding (continued)

• 5. Target
• 6. Default View

– Table, pie, bar, column

• 7. Period Type
• 8. Sort By

– Value, result, numerator…

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Settings Gear

• Impacts the Widgets
• Edit Dashboard
• Impacts the entire Dashboard
• Edit Configuration
• Edit Default Filters
• Copy Dashboard

Edit Widget Filters

• Use to set specific filters to a widget.
• Add Filter, Save, Remove All - same as

general dashboard filters.

Edit Default Filters

• Set default filters for the top-level filter bar.
• Available for custom dashboards.

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Layout, PDF Export and Printing

• Go to Action icons to change the

layout, export or print a dashboard.

• Configure the Layout

– Drag and drop or stretch to desired size – The “red line” in edit mode delineates a page break when exporting to PDF. Please be aware of this as you develop your dashboard if the purpose is PDF distribution.

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10 Widget Types

Widget Types

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• Counter

– Displays a single number. You can display any of the following measure components using a counter: numerator, denominator, result, gap (number of patients who do not meet the measure criteria) or to target (number of patients to meet the set target). Counters can help set context for other performance widgets you also plan to include in your dashboard

• Gauge

– Illustrates the result of a performance measure as a percentage in a dial format, with targets (if set). The performance line going around the dial changes colors as the performance reaches targets. This widget gives you a quick sense of current period performance.

Widget Types

• Line Chart

– Demonstrates a measure result as a trend line with reporting periods on the -axis. If targets are set, they are displayed as green (primary) and yellow (secondary) lines. This widget is useful for providing context and understanding performance

• ver time. Indicates the state of the performance- steady,

volatile, trending up, or trending down.

• Measure Family

– Displays multiple measures which share the exact same denominator in a small scorecard format. Scorecard shows the number of patients in the shared denominator, as well as the name, numerator, result as a percentage, gaps, to target and target stoplight indicator for each measure on separate rows. The measure family widget is a powerful tool for showing movement within a patient population, however the widget is

• nly available for a small number of measures within DRVS

with similar denominator.

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Widget Types

• Comparison Table

– Displays the results of a measure grouped by any available grouping option. For example, the table might show the A1c >9

• r Untested measure by age, allowing greater understanding of

factors contributing to the result, and indicators for possible improvement strategies.

• Benchmark

– Displays the selected center, location, provider, etc. performance percentage with targets and stoplight target coloring to indicate if the target was not met, secondary target was met, or primary target was met/surpassed. The second line indicates the average performance for the measure to help users understand how they compare with peers, and what their performance means. Use this widget to quickly gauge which measures need the most focus.

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Widget Types

• Mini Scorecard

– Exhibits a group of measures together in a small scorecard format including the measure name, target stoplight indicator, result, numerator and denominator. A mini scorecard is a quick way to indicate current performance on a group of measures (related to a topic, program or CHC strategic measures for the year), and then use other widgets to display aspects of each

• measure. The Mini Scorecard can also be set up to show

comparative performance to a baseline period.

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Widget Types

• Percent of Total

– Visualizes the performance of one component of a measure by group as a table or pie chart. For example, display the result of the breast cancer screening measure by race. – As a table, this widget shows the count of the measure component and the % of the total that count represents. – As a table, this widget shows the count of the measure component and the % of the total that count represents. – As a pie chart, the widget displays the % of the total the count of the measure component represents as a piece of the pie.

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Widget Types

• Risk Weighting

– Displays a table of all risk factors for a center, and the corresponding weighting of each risk criteria. This widget will

• nly populate data if you are scoped to a single center that

has implemented an Azara risk algorithm.

• Risk Threshold

– Displays the prevalence of each risk factor among the center’s patient population sorted by high, medium, and low risk, with the ‘center determined’ risk thresholds for each risk group. This widget will only populate data when the user is scoped to a single center that has implemented an Azara risk algorithm.

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Use Case #5 | Initial Dashboard Set Up

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• 1. Create a brand new dashboard where you can compare both trailing year and

monthly data.

• 2. Create dashboard for only Colon Cancer Screening.

#5 Step by Step | Initial Dashboard Set Up #1

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• 1. Go to Admin > Report Configuration > Dashboard Administration.
• 2. Name your dashboard and enter a description. Select Enabled or leave unchecked.
• 3. Uncheck global period type.
• 4. Add a trendline widget with a measure you would like to compare trailing year and

monthly performance.

• 5. Select Trailing Year for the period type for your first widget.
• 6. Add another trendline widget using the same measure.
• 7. Select Month as the period type for the second widget.

#5 Step by Step | Initial Dashboard Set Up #2

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• 1. Go the Cancer Screening stock dashboard.
• 2. Click on the Gear Icon in the upper right-hand corner.
• 3. Select Copy Dashboard.
• 4. Name your new dashboard “Colon Cancer Screening Dashboard” and enter details.
• 5. Delete the widgets on the dashboard that do not correspond to colon cancer

screening.

Use Case #5 | Diabetes Dashboard

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You are the QI Coordinator and you have been asked to put together the Diabetes Improvement Plan for HRSA. You want to show C-suite leadership how you are monitoring the Center’s performance on diabetes. Create a Dashboard that shows the following:

1. The number of patients at your CHC with diabetes. 2. The prevalence of patients with diabetes within your population. 3. Patients with an A1c >9 now 4. Patients with an A1c >9 with Food Insecurity.

After your initial meeting the CMO asks for the following, what is the best way to do this?

• 1. How does the rate of untested A1c compare to A1c > 9?

#5 Step by Step | Diabetes Dashboard

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1. Go to Admin > Report Configuration > Dashboard Administration and click New Dashboard. 2. Create a name and description for your dashboard to indicate its purpose; in this case, you could name your dashboard HRSA Diabetes Improvement Plan. 3. Uncheck Global Period Type. 4. Add a Counter widget using any diabetes measure and select the Denominator measure component to show the total number of patients with diabetes. Select the Period Type appropriate for the data you wish to see. 5. Add Percent of Total widget using the Patients with Face to Face Encounters measure and selecting

• Numerator. Group By Patient Diagnosis. Select the Period Type appropriate for the data you wish to

see. 6. Add another Counter widget using the A1c > 9 measure and selecting the Numerator measure

• component. Select Month period type and filter to the most recent month.

7. Add another Counter widget configured in the same way as the one above. Add an SDOH filter and filter on Food. 8. Add a Measure Family widget using the Diabetics by A1c Scorecard.

Use Case #5 | Build Your Own Dashboard (40 minutes)

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• 1. Write brief aim statement.
• 2. Consider your requirements (compliance, grant, contract, pilot).
• 3. Follow the steps to build your custom dashboard.
• 4. Ask your coach for help if needed.

Dashboard Summary

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• Define the story you want to tell.
• Create a sketch.
• Build and refine the data in CPCI.
• Choose the right layout
• Share it
• Use it - Who, what, why, where and when
• Improve!

Have You Considered? (50 mins)

• 1. Count off by numbers 1-8.
• 2. Go to the table designated for your number.
• 3. Then each person will have 3 mins to state a problem they are having, and

get suggestions from the group to solve it.

• Person cannot respond. No “Yeah buts…”
• One other person at the table will write down the suggestions.
• Then the next person goes.
• You might bring up something related to data or DRVS, or you might

bring up something operational. Anything is welcome.

• 4. Once turns are complete, we will do a brief report back.

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Contact Info

Emily Holzman Client Success Specialist Emily.Holzman@azarahealthcare.com LuAnn Kimker Director of Clinical Innovation Luann.Kimker@azarahealthcare.com Jenn Pigott Implementation Specialist Jenn.Pigott@azarahealthcare.com