Mod. 4 Health Data Analytics Flashcards
Organizations must protect records against _______, _______, ________ and _______.
Loss
Defacement
Tampering
Unauthorized use
Effective confidentiality policies should have specified confidentiality policies for
- release of information
- removal of medical records
- protection of PHI
What does HIPAA stand for?
Health Information Portability and Accountability Act
What are the four goals of electronic health records?
- Guide clinical practice
- Interconnect clinicians
- Personalize care
- Improve population health
What are some groups that may access PHI without written authorization?
- governing body
- senior leadership
- healthcare personnel involved with the patient’s care at the time
- Quality improvement, risk management and utilization management
- Health information management
What are some information security methods?
- Separate portion of records (such as psych)
- Restricted access to computer files
- Adequate back up plan and firewalls
- Requirement of signed forms for release of information
How is data defined?
Abstract representations of things, facts, concepts and instructions that are stored in defined format
How is information defined?
Obtained when data are translated into results and statements that are useful for decision making
What is RA(S)CI?
Responsible, Accountable/Approve, Supportive, Consulted, Informed
When do you use RA(S)CI?
Identify roles and responsibilities during an organizational change process
What role is “responsible” in RA(S)CI and what’s expected of them?
The Doer
Actively participate and contribute to best of ability; person/people working on the activity
What role is “Accountable/Approve” in RA(S)CI and what’s expected of them?
The Buck stops here
Person ultimately accountable for results; position with yes/no authority
What role is “supportive” in RA(S)CI and what’s expected of them?
The Helper
People to support responsible person, not always used; helping out at direction of responsible people
What role is “consulted” in RA(S)CI and what’s expected of them?
In the loop
People with particular expertise to contribute to specific questions, involved prior to decision or action
What role is “informed” in RA(S)CI and what’s expected of them?
Tell me after
People affected by activity/decision and need to be kept informed but do not participate; need to know
What are the benefits of RA(S)CI?
- Determines ownership
- Promotes teamwork by clarifying roles
- Increases efficiency
- Improves communication
- reduces misunderstanding
What does a clinical information system do?
Support direct care processes (lab/radiology, results, etc.)
What does an administrative (non-clinical) information system do?
Aid day-to-day operations (billing, financial, HR)
What does a decision information system do?
Deal with strategic planning functions (case/effect)
What is a health information system?
A health information system (HIS) refers to a system designed to manage healthcare data
What are some examples of administrative financial information systems?
- Payroll
- Accounts payable
- Patient accounting
What are some examples of administrative human resource information systems?
- employee records
- labor analysis
- turnover
What are some examples of administrative office information systems?
- Word processing
- scheduling
- spreadsheets
What are some uses for decision information systems?
- strategic planning and marketing
- performance evaluation
- clinical pathways
- identifying positive and negative outcomes
- includes risk (count) and severity-adjusted (measurement) data
What is a chart-based (EHR-based) analysis system?
Nursing or medical record analysts review records/EHRs
What is the disadvantage to a chart-based analysis system?
higher cost/smaller sample size
What is a code based analysis system?
Based on retrospective administrative data and uses clinical data spanning entire stay
What are the advantages of code based analysis?
lower cost and larger sample size
What questions quality professionals should ask when evaluating information management systems?
- Does it capture/store and retrieve clinical and financial information from a variety of sources?
- Does it interface with other information systems?
- Does it allow for establishment of trigger/threshold measures?
- Does it allow for critical alerts?
- Does it support accreditation and regulatory requirements?
What are the two types of data?
- Categorical (count)
- Continuous (measured)
What are the two types of categorical data?
nominal and ordinal
What are the two types of continuous data?
interval and ratio
What is nominal categorical data?
- (count, discrete, qualitative) considered attributes data with no quantitative value
- Binary data (two possible values)
What are examples of nominal categorical data?
- Surgical patients (pre-operative/post-operative)
- Patient education (attended video session/did not attend video session)
What is ordinal categorical data?
Characteristics (nominal data) are put into categories and ranked ordered. Categories are not arbitrary
What are examples of ordinal categorical data?
Nursing staff rank (nurse level 1, 2, 3)
Education (AA, BS, MS, PhD)
Attitude toward research (Likert scale) (1. Strongly agree…5. Strongly disagree)
What is continuous data?
Continuous or “measured” data are assigned scales that theoretically have no gaps (i.e., variables data)
What is interval continuous data?
The distances between each point is equal and there is no true zero
What is an example of interval continuous data?
Values on a thermometer
What is ratio continuous data?
The distances between each point is equal and there IS a true zero
What is an example of ratio continuous data?
height and weight
Which of the two types of data is least powerful statistically and why does it matter in practical terms?
Categorical
When comparing patient outcomes after process change, fewer data points (and subjects) are needed if data in continuous form are collected
What is an example of why categorical data is less powerful statistically?
Blood pressure: can categorize subjects as either hypertensive or non-hypertensive or recording the measured levels of systolic and diastolic pressure. The latter is more powerful and allows more flexibility in analysis
Continuous data is usually reported as?
Mean, median, min., max. percentiles
What is Functional Independence Measure (FIM)?
measures the level of a patient’s disability (lower score (i.e., 1) equals needs more assistance for daily living)
What does it mean to compare data sources?
Examine processes and results against a reference point either internally or externally with competitors and other organizations providing similar services
What does it mean to benchmark data sources?
Examine processes and results that represent best practices for similar activities inside or outside the healthcare industry
What is the goal of benchmarking?
To identify how to improve the outcomes (not identify the difference between organizations). Enables organizations to set target or goal for process improvement
Benchmarking involves asking the right questions. What are some questions you should ask?
- What is the best practice?
- What are we doing? How are we doing it?
- How well are we doing it?
- What are the measurement results?
- Why are we looking for improvement?
What are the first two steps in interpreting data and using information?
Plan and Organize
- Anticipate barriers, identify responsibilities and lay groundwork for multidisciplinary collaboration
- develop data dictionary
After planning and organization, what are the next steps in interpreting data and using information?
Pilot data collection; verify and correct
- Begin limited data collection as pilot
- identify data limitations and errors
- modify data collection plan as needed
- collect data
After piloting and collecting the data, what is the next step in interpreting and using data?
Analyze and Present findings
- look at trends
- how is the data likely to be interpreted?
- who should receive the data?
- for what purpose?
After analyzing and presenting findings, what are the next steps in interpreting and using data?
Study and Develop Recommendations
- Perform variation analysis
- review additional data
- conduct retrospective medical reviews
- perform process analysis
After studying and developing recommendations, what is the next step in interpreting and using data?
Take action
- empower teams to make decisions and implement changes
- educate and train staff
- report findings
After taking action, what is the next step in interpreting and using data?
Monitor performance
- have proposed changes been implemented?
- how could compliance be enhanced?
- what effect are changes having on patient outcomes?
After monitoring performance, what is the next step in interpreting and using data?
Communicate results
Population (N) is ________
total aggregate or group
Sample (n) is ___________
a portion of the population
What does sampling accomplish?
Provides a logical way of making statements about a larger group and allows quality professionals to make statements from the sample to the population depending on the type of sampling used
What is probability sampling and an example?
Can generalize findings. E.g., sending a survey to every 5th patients in the list
What is nonprobability sampling and an exmaple?
Cannot generalize findings. E.g., surveying the first 5 patients who show up every week
What are the three probability sampling types?
- Simple random sampling
- systematic sampling
- stratified sampling
What is simple random sampling?
Each individual in the population has an equal chance to be chosen (e.g., drawing names out of a hat)
What is systematic sampling?
After random selection of 1st case, draw every nth case (e.g., every 5th patient)
What is stratified sampling?
The population is divided into groups, each member has an equal probability (e.g., patients with a specific disease)
What are the five types of nonprobability sampling?
- Snowball sampling
- Convenience sampling
- Expert sampling
- Quota sampling
- Purposive sampling
What is snowball sampling?
Subjects suggest other subjects (sub-type of convenience sampling)
E.g., cancer patients in a clinic who identify other cancer patients they know
What is convenience sampling?
Any available group of subjects is used (lack of randomization) E.g., information about participants who took one instructor's CPHQ class but not all classes taught
What is purposive sampling?
A particular group is subjectively selected based on criteria
E.g., nursing group represents cross section of women
What is expert sampling?
Experts in a given area are selected due to their access information
E.g., survey department managers about staff satisfaction
What is quota sampling?
A judgement is made about the most representative sample
E.g., 15 charts per month/5% or 30-which ever is greater
With the exception of case studies, _______ samples yield a more valid and accurate study and are representative of the population.
larger
As the actual difference between groups gets smaller, the size of the sample required gets _______.
bigger
Continuous data requires a ______ sample size than categorical data.
smaller
Regardless of the shape of the original population distribution, as sample size increases, the shape of sampling distribution becomes a normal ____ ____
bell curve