Minimum Use Norms Dashboard
Connect Care minimum use norms identify a set of practices that all clinicians need to adhere to in order to preserve the integrity of patients' digital health records while not unduly burdening other Connect Care users. The norms, together with practical tips and metrics, appear in:
Feedback about trends in norms compliance can help clinicians identify potential workflow challenges and consider options for optimizing both the user's experience and the quality of the health record. 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 minimum use feedback dashboards.
Finding Norms Dashboards
Minimum use metrics are gathered and displayed using "dashboards", available through the "My Dashboards" Hyperspace activity. This is available by default as one of the main start-up activities 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 minimum use norms dashboard.
Minimum Use Norms Feedback for Prescribers
Minimum use norms feedback metrics are made available to all Connect Care prescribers 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: Minimum use norms dashboards will evolve iteratively. The initial intent is to discover possible anomalies in the data not already addressed. Subsequent versions add anonymized group comparators as well as compliance goals and organizational benchmarks.
Norms Categories and Links
Norms feedback 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 minimum use 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 uses that may relate to the minimum use norms 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., adverse reactions reviewed at admission).
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.
Minimum 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 the user's sense of compliance with that minimum use norm. A number of actions can be taken to dig deeper into the data behind a metric point, and so understand why the measure and the measured 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.