Clinical Inquiry and Reporting Tools

Connect Care is, at its core, about inquiry. We participate in inquiry when asking questions about what we do, perform investigation when answering questions systematically, and promote improvement when iteratively using answers to do better.

The clinical information system (CIS) offers diverse tools for clinicians, improvement advocates and researchers. These help understand how the CIS is used and how health processes and outcomes change for CIS stakeholders. 

Information Sharing

The Clinical Information Sharing Approach (CISA) and its matching Information Sharing Compact help to harmonize information sharing legislation, regulation, professionalism, ethics and policy.

Inquiry Support Tools

Different CIS inquiry support tools serve different question types and answering strategies. Some help stimulate curiosity, others help generate hypotheses and still others help investigators to test hypotheses. All are available to all users, but with role-dependent exposure of identifiable health data.

Reporting Workbench ("My Reports") - can be used to generate real-time clinical, operational, quality and research reports in a variety of formats, with support for drilling down to supporting data and taking action with clinical and administrative decision-supports. These work best for smaller data retrievals and sub-populations. Clinicians and managers can facilitate chronic disease surveillance, find patients meriting proactive interventions and track clinical and system performance.

Crystal Reports - present more standardized analyses in attractive, easy to interpret, formats that serve performance optimization, quality assurance and other improvement purposes.

Slicer Dicer - facilitates interaction with graphical representations of population health data so that patterns of health risks, processes and outcomes can be better visualized, hypotheses generated, and quality improvement tracked.

Dashboards (Radar) - summarize and visualize data of various types, again with self-service data exploration tools and the ability to drill down to more detailed data.

All reporting tools can be expressed in different formats for embedding in clinical and managerial workflows.

Reporting Maturity

Different types of data are have greater precision or accuracy as CIS implementation progresses through adoption, stabilization and optimization. CIS usage data may be trustworthy early on whereas outcomes data requires more time, and meaningful CIS use, to attain validity. AHS has adopted processes for multi-disciplinary review of data sources and for readiness-badging of the associated reports.

In general, we encourage seeking reporting proficiency many months post-launch. The products of inquiry support tools are unlikely to be fully validated until at least 6 months of quality content accrues. Visual cues highlight inquiry supports that are endorsed by Connect Care oversight.

Data Quality

Data reporting and visualization tools can support a wide range of inquiry activities. However, the ability of the Connect Care clinical information system to enable clinically meaningful inquiry depends upon the information behaviors of Connect Care users. If Minimum Use Norms are not followed, then the structured data needed to classify patients (e.g., health problems, comorbidities, medications and key clinical indicators) will be missing and reports will be misleading. The first step to informatics-informed inquiry is promotion of consistent capture of quality data.

Reporting Certification

Ensuring that Connect Care in-system dashboards, metrics and reports work as expected is a continuing improvement activity. Many measures (e.g., lab utilization, minimum use norms compliance, etc.) are sensitive to changing denominators during CIS implementation and transitions. Accordingly, it is important to know which measures have been tweaked sufficiently to be trustworthy. A Connect Care report certification process provides easy-to-recognize visual quality markers.

Once a given dashboard or report is certified, a ribbon icon appears on dashboard thumbnails, with blue signifying certified Dashboards, purple signifying certified Reporting Workbench reports and orange signifying certified Crystal reports. Measures, reports and visualizations that are not certified should be used with caution.

Reporting Training

Inquiry support tools are available to all clinicians. Prescribers, including physicians, can use Connect Care to facilitate personal practice audits, device and drug safety checks, clinical performance improvement and other improvement activities. 

Different levels of formal, ad hoc and embedded training are provided to help clinicians "tool-up" for inquiry when the time is right.

Resources