Transcript A GDR Introduction for Clinicians

An introduction to Essentris
GDR
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Intended for Clinicians or anyone who
wants to identify and develop an
Essentris GDR report specification
An introduction to Essentris
GDR – Report Specification?
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An Essentris GDR report specification is
a document which can be used by a data
analyst to create the logical design of a
report using SQL Language or other
database reporting tools
An introduction to Essentris
GDR – Data Deliverables
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Once the logical design of the report is
complete, any number of various kinds
of data deliverables (excel, pdf, html,
printouts) can be made
An introduction to Essentris
GDR - overview
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These slides are designed to meet two
objectives
• Provide a listing of the kinds of data we can
•
use in a GDR Report
Provide a framework and vocabulary you can
use to create report specifications to give to
your data analyst
Essentris GDR fundamentals:
everything centers on the PATID
column
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Internally generated encounter number
Unique across installations
Column that joins a single patient’s data
NOT visible in Essentris
Column that is almost never shown in
Reports
Essentris GDR fundamentals:
CCI’s DATABASE ITEMS
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Clinicomp maintains a list of some 13,000
DATABASE items which may used on
Essentris Screens and so may be used in
Reporting
We can report on any data from any Essentris
screen
Data is typically organized one table per
concept - ie: a heart rate table, a chief
complaint table, a restraint type table…
Essentris GDR fundamentals:
CCI’s NOTE TABLES
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The GDR has a separate table for each of the
NOTES in use at your site.
We can report on the creation time, last store
time, and any data stored on any NOTE
Data is typically organized one table per note
and further organized by the TAG number, ie:
the label “case type” might be found next to a
text box with the identifier TAG number = 2.
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Our spec doc will say: case type = tag 2
Essentris GDR fundamentals:
Determining the main list (Driving List)
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Best Practices involves identifying a
main or “driving list” (DL)
• DL is verifiable, simple, and is the
answer to the question: “Who should be
on the report?”
• The DL is the left side of all joins in the
WHERE clause (a technical point)
4 Slides on SQL language:
Everyone’s First SQL lesson
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In Structured Query Language
(SQL) we:
• SELECT
A comma separated list of COLUMNS
FROM
A comma separated list of TABLES
WHERE
Two COLUMNS are equal (joins)
or
Some fact about a COLUMN is true
4 Slides on SQL language:
the SELECT clause
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Comma separated list of columns
• Regular English: the columns of data which need
to show in the report
4 Slides on SQL language:
the FROM clause
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Comma separated list of TABLES
• Practical English: Essentris data sources,
usually identified by FULLNAME or Note TAG
String, or else is documented in the GDR
manual
4 Slides on SQL language:
the WHERE clause
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Two columns are equal (joins)
or
Some fact about a column is true
• UNIT.data like ‘ICU’ or
• NAME.data not like ‘%TEST%’ or
• GLUCOSE.data > 120 or
• MedName in (‘ASPIRIN’,’MOTRIN’,…)
SQL Language summary:
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Your data analyst needs to know which
TABLES to use and which COLUMNS to
show in the report
Essentris Data Sources:
Start with Essentris
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We already know our way around Essentris
Identify Essentris Data Sources found on
different screens:
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Admit Notes
Timed Notes
Vitals Flowsheets
Order Entry and Meds/Treatments/I&O Flowsheets
Admission/Discharge/Transfer Data
Essentris Data Sources:
Admit Notes
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User defined template document
Only one copy stored on the patient record
Has labels, checkboxes and text fields
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In EDIT mode, right-click checkboxes and text fields,
select “describe item”, then double click the Label
“Item Edit History”
Text fields can be of two types
• DATABASE:
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Reference the DBI FULLNAME
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Reference the TAG String (ex: !207.ABC^5.10)
• NOTE:
Essentris Data Sources:
Notes, Describe NOTE Item
Essentris Data Sources:
Describe NOTE Item
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Report Column: “Case Type”
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Tag !200.PER^6.2
Essentris Data Sources:
Notes, Describe DATABASE Item
Essentris Data Sources:
Describe DATABASE Item
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Column = “Allergies”
• Fullname = “Allergies.adm”
Admit Notes tangent: Consider
One Essentris DATABASE Items
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As many as 13,600+ DATABASE Item
TABLES in the GDR
Some hold one value per patient stay
• Name, fmp/ssn, rank,
Some get charted many times during the
patient stay
• HR, tempC, painscore, vent setting
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Need the FULLNAME for Report Spec
Essentris Data Sources:
DATABASE Items
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Columns you may want in your report:
• DATA
• The charted value stored in this item
• KEY
• The observation time for the stored DATA
• LOG TIME
• The date and time that a person gave their
username/password to store the DATA
Essentris Data Sources:
3 DBI example (Patient Details)
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FULLNAMES: NAME, MRN, DOB
Essentris Data Sources:
3 DBI example (Patient Details)
Example Spec might be:
Report to show Name, FMP/SSN,
Birthdate for all active patients.
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Column: “Patient Name”
Fullname: “NAME”
Column: “FMP/SSN”
Fullname: “FMP/SSN”
Column: “Birthdate”
Fullname: “DOB”
Essentris Data Sources:
3 DBI example (Patient Details)
Essentris Data Sources:
3 NOTE items example
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Put your cursor into the cell. Right-click
and select “Describe Item”. Double click
the ‘Edit History” Label to find the TAG.
Reference the TAG string for the Text
Prompt (ex: !200.PER^6.2)
Essentris Data Sources:
3 NOTE items example
 Example Spec might be:
Report to show Delay Code, Case Type,
Datetime of Univ Protocol from the
Peri-Operative Note for all patients.
Column:
TAG:
Column:
TAG:
Column:
TAG:
“Delay Code”
!200.PER^6.497
“Case Type”
!200.PER^6.2
“DT Univ Protocol”
!200.PER^6.484
Essentris Data Sources:
3 NOTE items example
Essentris Data Sources:
Parameter Flowsheets (Vitals)
Essentris Data Sources:
Parameter Flowsheets (Vitals)
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Time driven values
Database items
DBIs have a “many to one” relationship to
patient
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Most reports require we find a single value to report:
• MIN/MAX(data or key), the value closest to a point
in time, a single LIST of values, etc
• Turn chronological DBI charting into Start and Stop
times for treatment intervals: vent use, restraints,
etc
Essentris Data Sources:
Parameter Flowsheets (Vitals)
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Right-click, select “Describe Item” to find
the site-defined FULLNAME
FULLNAME is the unique identifier for
the data TABLE in the GDR
Essentris Data Sources:
Flowsheet Describe Item
Essentris Data Sources:
Parameter Flowsheets (Vitals)
Example spec might be:
Show any patient who has had a fever
(temp > 100)
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Column: “first fever time”
FULLNAME: “TempF(DegF)”
Essentris Data Sources:
Parameter Flowsheets (Vitals)
Essentris Data Sources:
Parameter Flowsheets (Vitals)
Example spec might be:
Show the first fever time for any patient
who has had a fever (temp > 100)
Column: “first fever time”
FULLNAME: “TempF(DegF)”
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Essentris Data Sources:
Parameter Flowsheets (Vitals)
Essentris Data Sources:
Order Data
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Facts about Orders which can be
included in a report are those which are
found on two different Order-based
screens:
• Order Entry
• Orders Flowsheet
Essentris Data Sources:
Order Entry Screen Details
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Order Time, Start Time, Stop Time,
Verbal Order, MD Name, Order Name,
Orderset Name, Order Category,
Comment, ENT,SIGN, C/S, ACK, Verify
• A_ORDERENTRY table has columns for all
these facts about the Order found on the
Order Entry Screen
Essentris Data Sources:
Meds Flowsheet Details
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These tables contain data you see displayed
on the Med Orders Flowsheet:
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MEDS_FLOW_ANNOTATION_2231
MEDS_FLOW_COMMENT_2267
MEDS_FLOW_DEFINITION_2225
MEDS_FLOW_DELIVERY_2230
MEDS_FLOW_DOSE_2229
MEDS_FLOW_FREQUENCY_2226
MEDS_FLOW_LABEL_COMMENT_2227
MEDS_FLOW_REMARKS_2925
MEDS_FLOW_ROUTE_2228
Essentris Data Sources:
ADT Data
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Admission/Discharge/Transfer data
Essentris Data Sources:
A_ADTHISTORY
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HL7 interface or Staff will add records to
the ADTHISTORY table indicating
patient location (UNIT, BED)
Essentris Data Sources:
A_UNITHISTORY
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Uses logic based on A_ADTHISTORY
table to figure out the Enter Times and
Exit Times per patient per unit
Essentris Data Sources:
A_UNITBEDHISTORY
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Uses logic based on A_ADTHISTORY
table to figure out the Enter Times and
Exit Times per patient per unit per bed
Essentris Data Sources:
A_PATIENTLIST
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Uses logic based on A_ADTHISTORY
table to show one representative record
per patient. Includes data like: name,
mrn, hospno, MD, admtime
In Practice: A_PATIENTLIST = the
patient records that are loaded into the
GDR
Essentris Data Sources:
A_PATCOMMON
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Based on a script which runs per 10
mins on the ncrontab scheduler, This
table list all the active patients in
Essentris
Essentris Data Sources:
A_ARCHLIST
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Based on a script which runs from the
Essentris Server Scheduler @1 AM
Lists all the archive records on the
Essentris Server filesystem