As a platform that aggregates clinical, financial, operational and other data, the edw is becoming the single source of truth for the organization, supplying the data for an array of analytics applications. To drive stronger sepsis surveillance and other quality improvements, mission implemented an advanced sepsis analytics application. High-level and granular views into sepsis care. From the general sepsis metrics tab (see figure 1 care teams have an at-a-glance view of all major sepsis care metrics, including number of sepsis patients, mortality rate and sepsis los. Sepsis care team staff can also drill down and filter by severity, patient demographics, 3-hour bundle treatment elements, sepsis order set usage, and sepsis alerts. Comparative analysis is another new capability, such as comparing sepsis mortality by age group or a co-existing conditions. Figure 1: Sample sepsis general metrics visualization.
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Replacing manual processes key to reducing sepsis mortality rate. Optimal sepsis treatment is comprised of time-bound critical elements of care that, when strictly followed, can reverse this fast- acting condition. To track compliance with these bundle elements for optimal sepsis care in the past, mission had used a manual process that was largely unsustainable and did not provide the level of detail necessary to identify key areas of opportunity and make further sustained improvements. A care team coordinator spent roughly 15 hours a week reviewing charts, confirming sepsis diagnoses and tracking overall bundle compliance and individual compliance with each element of care—which included fluid resuscitation; lactate measurement; antibiotic administration within 3 hours; and two blood cultures drawn prior. Despite this time-intensive process, missions care team had little insight into what might drive compliance challenges with individual bundle elements, as such detail was too cumbersome to manually uncover. Because survival of sepsis is highly dependent on an early diagnosis, certainty that the ehr alert system was correctly flagging at-risk patients was another necessity. Yet it was difficult to decipher just how effectively the alert system carried out this critical task. As there are multiple ways to measure and code for the conditions varying degrees of severity, mission needed an effective way to combine icd and drg codes to accurately define and track the sepsis patient cohort. Improving data quality would considerably mitigate with all of the above issues and provide missions sepsis care teams with the much- needed insight into performance improvement opportunities. Advanced analytics for sepsis surveillance and bundle compliance tracking. Mission already had the foundation in place to support access to such data: a late-binding enterprise data warehouse platform (EDW).
Accordingly, missions sepsis care team has implemented a number of best practices to safeguard patients from sepsis and quickly treat those who are diagnosed. Mission had previously implemented effective evidence-based practices for Foley catheter removal, central venous catheters and peripherally inserted central catheter lines as well as measures to prevent hospital-acquired pneumonia and ventilator associated pneumonia, which often precede sepsis.6 An algorithm imbedded within Missions electronic health record (EHR). To treat patients with the condition, the team utilizes 3 and 6-hour bundle treatment regimens derived from the surviving Sepsis Campaign. With such concerted efforts in place, missions sepsis mortality rates have consistently outperformed the national average. However, mission wanted to reduce these rates and los even further. It also wanted to be prepared to readily meet future cms reporting requirements. Both objectives called for a more systematic method of tracking and improving sepsis bundle compliance.the
The cost is also a burden on the. Severe sepsis is the single most expensive condition to treat in the hospital, on average, costing over 20 billion every year.3 A major factor driving these expenditures is that the average length of hospital stay (LOS) for sepsis patients is 75 percent longer than stays. The centers for Medicare and Medicaid Services (CMS) has also stepped. The national quality forums Early management Bundle for severe sepsis and Septic Shock was scheduled to become a cms sepsis measure that would take effect on January 1, 20 reporting. The measure has been revised and reissued, and hospitals are set to begin collecting data for this measure on October 1, 2015. Hospitals like mission health are actively engaged in reducing sepsis mortality rates. The sixth-largest health system in North Carolina, mission is on a continuous quest to implement quality improvements that enable every patient to achieve desired outcomes without harm, without waste, and with the best experience for the patient and family.
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Securing UWs data is of prime importance. The data management Committee works to ensure data assets are secure while making data available to all who need. From our patented data security model to its inclusive membership across uw, our governance enviromental program is key to creating a single source of institutional data to support University decision-making. Learn more about governance. My folder" Add, download, five years ago, the only way wed see improvement opportunities for sepsis care was at formal meetings or if cases were proactively brought to my attention.
With the sepsis analytics, now we have all this insightful information. At any time we can drill down to the most meaningful metrics at the patient and provider level. I expect significant improvements in sepsis care to be made with this new access to data. Scott Ramming, md ed physician, the human and financial burden of sepsis. Sepsis acts swiftly and aggressively. Many sepsis patients ultimately progress to developing severe sepsis, and mortality rates are extremely high—between 20 and 50 percent.1 With severe sepsis striking more than 1 million Americans annually,2 the numbers are unacceptably high.
Operational and Technical metadata capture across data movement that helps rte very transparent and cost effective. Solutions can be hosted on public or private clouds with quick implementation cycles. Total Cost of Ownership for these applications are 20 of traditional dw applications. Our solutions provide unprecedented abilities to gain new insights into over all data assets. The Universitys Enterprise data warehouse (EDW) integrates data from many sources across the University into a central repository. The edw stores current and historical data that are used to support operational reporting and strategic analysis.
The goal of the edw program is to support better, faster, data-informed decision making. Hundreds of reporting and analysis tools foster better, faster, data-informed decision-making. Data models, enterprise Information, Integration analytics (eiia) data models help you understand high level university business process relationships and low level data relationships. Pictures do tell a thousand words. Learn more about, edw data models. Definitions metadata, while a picture paints a thousand words, data consumers cannot live on pictures alone. Descriptions allow us to speak a common language and provide context. Learn more about metadata.
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The solution will cost effectively and intuitively assist peims coordinators sanitize, code, and report their data saving thousands of dollars and countless hours / year. Problem Statement, most of the organizations which deployed edw solutions over past 2 decades have acquired large volumes of data with only good a fraction of that data being consumed. Same hardware is used for loading data and reporting creating performance constraints. Traditional edw solutions have become stale in absorbing unstructured data and in providing predictive insights. Key features and Benefits, seamless, repeatable services for ingesting cold, warm data into data reservoir on Hadoop. Provisioning data services to move data to/from any db and presentation layers. Robust access layer and entitlements from Hadoop as well as consumption layer.
that identifies the issues with the data in the extract. Users can print the on-screen report, filter it by error type, or download the complete report as a csv file. Then users fix the data in their local information systems and repeat the process as often as needed. This process is tedious, manual, and monotonous. Errors are not aggregated by row. Coordinators cannot edit the errors directly in the validation tool. The corrected file must be re-validated and the process repeated. The way forward: Kinetech is currently partnering with select districts and sis providers to build a bridge (direct integration) between their sis, our peims saas solution, and the texas Education Agencys (TEA) Education Data warehouse (EDW).
Peims reporting and is required quarterly with 2018 dates being : Fall (Collection 1 midyear (Collection 2 summer (Collection 3 Extended year (Collection 4 each district has dedicated resources to manage these quarterly reports. If every district had one full time employee working on these reports, they likely have many more, then the annual cost would be (on the lowside) 42,000,000 per annum (35k salary *1200 Districts). This does not include the cost of Student Information Systems (SIS) or other it resources used to support this process. Challenge: There are several challenges that must be addressed to tackle this problem. Specifically, strict standards from the tea must be adhered to such as the the texas Education Data Standards (teds). In addition, the system must adhere to the xml framework defined by the state to upload records to the Education Data warehouse (EDW). Furthermore, existing student information systems (SIS) present problems in collection, reporting, and quality. Finally, districts must adhere to legal requirements and cutoff dates to ensure they receive the maximum amount of funding for properly reporting on their constituency. Current Process: The current process adhered to by most school districts is as follows: Users create a teds-compliant extract from their local information system and save it locally.
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Executive summary: Kinetech is looking for select school districts to help solve the multi-million dollar challenge created by teas peims requirements. This article outlines the current problem, challenge, process and our peims solution. Read more if you are study looking to streamline your peims reportings and receive the maximum funding for your district / campus. Problem: peims reporting costs Texas schools between 40 and 100 Million dollars per annum. At last count there are over 1200 school districts in the State of Texas serving over 5 Million students. To comply with the texas Education Agency (TEA) each district and as a result each campus, must submit student demographic, attendance, and other information to the public Education Information Management System (peims). This is commonly called.