Meaningful Use Norms Dashboard
Meaningful Use Norms identify a set of information behaviours that can promote improved quality, safety and efficiency of care. They apply to all clinicians, individually or in teams, who see patients where Connect Care is the record of care. Minimum Use Norms compliance is a necessary but not sufficient condition for Meaningful Use Norms adoption. The meaningful norms, together with practical tips and links to workflows, appear in:
Feedback about trends in norms compliance can help clinicians identify potential workflow challenges while also helping to find ways to improve health processes and outcomes through informational interventions. The Connect Care Clinical Improvement Support Committee oversees the development of appropriate metrics and their assembly in Connect Care dashboards for feedback at individual and grouped levels. This section describes common elements and functions of all meaning use feedback dashboards.
Finding Norms Dashboards
Meaningful use metrics are gathered and displayed using "dashboards", available through the "My Dashboards" Hyperspace activity. This is, by default, one of the main start-up activities appearing among the tabs showing at the top of Hyperspace after login. The activity can also be launched from the Epic menu or by using global search and jumping to "My Dashboards". Within the My Dashboards activity, select the down-arrow to the right of the currently displaying dashboard name, then use the search tool that appears with the keyword "norms" in order to find and open/run a meaningful use norms dashboard.
Meaningful Use Norms Feedback for Individuals
Meaningful use norms feedback metrics are made available to all Connect Care clinicians for individual feedback. The associated dashboard does not display group comparators, benchmarks with other organizations, or upper and lower bounds for acceptable compliance. These layers may be provided after more experience is gained with the metrics and optimal definitions of comparator groups are devised.
Minimum Use Norms Feedback for Groups
Other dashboards provide access to anonymized group data and are provided to Connect Care and clinical oversight groups responsible for clinical information system training and use.
NOTE: Meaningful Use Metrics are new to Connect Care. The initial intent is to discover possible anomalies in the data. Iterative improvement will occur at a pace driven by user feedback. Later, groups can build consensus about compliance goals and organizational benchmarks.
Norms Categories and Links
Norms dashboards are divided into sections separating data for inpatient, outpatient and other contexts of care. One or more component boxes are found within a section, each focusing on a different norm. Clicking on a section title brings up additional information about the norm, why it matters and what can be done to improve compliance with the norm. Clicking on any information icon (i) likewise gives access to more detailed information about the provenance of the displayed metric.
Measures of Connect Care behaviours that may correlate with meaningful use are selected for presentation in the dashboard. These are usually expressed as a ratio (percentage) of patient encounters (e.g., admissions, outpatient visits) associated with the current user (e.g., as attending prescriber) where an indicator of possible norms compliance is detected (e.g., discharge summary contains LACE readmission risk notification).
Note the information icon (i) that appears when hovering over a metric row. Hovering over this icon activates a pop-up description of the metric, together with a link to a more detailed definition that includes details about how the metric was validated and what might limit its interpretation.
Meaningful use metrics are displayed in tabular format (row of monthly averages) by default. Graphical displays can be substituted by clicking the rightmost three-vertical-dot icon and then selecting "Show Graph" from the pop-up menu. Reverting to a tabular display uses the same menu.
Individual metrics may have one or more data points (e.g., measures for a series of months). Some data points may appear to be outliers or otherwise not reflecting a user's sense of personal compliance with that minimum use norm. A number of actions can be taken to dig deeper into the data behind a metric, and so understand why the measure and the target behaviour may be out of sync:
Data points usually display as percentages. Hovering over a data point activates a small pop-up display of the ratio informing the percentage. By this means, one can quickly recognize when small denominators (e.g., only a few patients seen in a particular metric period) make the percentage very sensitive to small changes in numerators.
Data Pick List
Hovering over a data point exposes a small down-arrow icon that can be selected to reveal a pop-up menu of options for additional actions that can be taken with the data point. The most useful of these will be an option entitled "View ___ Details"; selecting this option will cause a report to be run that will list all the information events that informed the metric. By this means, for example, one can drill down to individual charts, encounters and actions (e.g., orders) to better understand how a data point came to display as shown in the dashboard. This action is most useful when a data point seems off-kilter. There is usually an explanation discerned from the supporting data.
Many factors can reflect how well minimum use compliance metrics reflect actual prescriber behaviours. Associated calculations have been carefully reviewed and revised to better suit Alberta Health Services work patterns. However, review by a broader range of prescribers in a wide range of clinical contexts will reveal anomalies not previously considered. Please use the "Feedback" link at the bottom right of the dashboard - this will activate an online survey where problems can be reported and suggestions recorded.