5. Product: Informed decisions

Good analytics demands a very different mindset from operational system design. Slade clinical analytics shall be offered as a companion product.

5.1. Theme: Reporting

One of our project goals is to facilitate ‘informed decisions’ in healthcare.

5.1.1. Epic: Clinical analytics

The mix of summaries and reports that a single user sees shall be determined by a mix of access control ( what they are allowed to see ) and opt-in controls ( what they want to see ).

Note

As a:
  • clinical analytics user
I need to perform the following analyses:
  • identification of patients that need care management e.g high risk, chronic disease, frequent flyers, high utilization
  • alerts and listings of notifiable conditions e.g those that should be reported under Kenya IDSR guidelines
  • case mix analyses e.g case mix by physician, case mix by department, workload by surgeon etc
  • volume analyses e.g outpatients by service and department, top N diagnoses, top N procedures
  • length of stay analyses for inpatients
  • clinical study eligibility and recruitment - calling up matching patient records from the registry
  • patient satisfaction analyses - informed by patient surveys
  • drug and device recalls
  • service utilization trends
  • adverse outcomes analysis - mortality reviews, surgical morbidity, adverse drug reactions, medication interactions, allergic reactions, medication errors etc
  • network referral analysis, including network leakage reports for out of network referrals
  • operating room utilization analysis - activity, overruns, delayed cases, rescheduling, cancellations, requests etc
  • monthly, quarterly and annual surgical volume reports
  • surgical supplies utilization
  • surgical equipment maintenance and downtime
  • turnaround times from support services e.g CSSD, blood bank, maintenance
  • drug utlization statistics - by drug, class, physician, service, location, diagnosis etc
  • issuance and usage of controlled substances - by patient, department, date, location etc
  • inpatient, outpatient and emergency department abstracts
  • DRGs - before, during and after inpatient stay
  • case mix analysis based on DRGs
  • retrieve patient demographic data and diagnoses
  • productivity - work completed, time spent
  • birth log
  • death log
  • generate DHIS 2 reports
  • age standardized death rates e.g 0-5 years, 5 - 10 years
  • reporting trends e.g total admissions, bed occupancy over a user define period

5.1.2. Epic: Hospital reporting

This covers administrative-style hospital reporting

Note

As a:
  • hospital administration user
I need to perform the following analyses:

  • workload and utilization e.g by theatres, nursing staff etc

  • end of shift reports

  • statististical reports on casualties, attendance and admission from A&E

  • turnaround times, by point of service

  • daily ( midnight ) ward statistical report: name of the ward, actual vs occupied capacity for each room type, admissions, discharges, transfers in, transfers out, deaths, vacant / available beds, turnover per bed, average length of stay, patient days

  • daily ( midnight ) clinic activity report: clinic name, number of new patients for the day, number of old patients for the day, total number of patients ( new / old / reviews ) seen for the day

  • daily ( midnight ) admissions statistics: analyzed by admitting department, specialty, department, hospital, doctor etc ( in aggregage and listing )

  • running monthly report generated daily: day, total admissions, average length of stay, deaths, percentage bed occupancy, bed turnover interval, total patients seen at A&E, percentage of A&E admissions, cumulative and average statistics

  • monthly morbidity summary sheet from MOH for children under 5 - disease, day of the month, cases reported for each day, cumulative cases for the month to date, total cases reported each day for all diseases, gender of patients, new or existing / old case

  • monthly morbidity summary sheet from MOH for patients over 5 yrs- disease, day of the month, cases reported for each day, cumulative cases for the month to date, total cases reported each day for all diseases, gender of patients, new or existing / old case

  • inpatient statistics: specialty, admissions ( admissions under 5, admissions over 5, paroles, occupied bed days - cash and NHIF, well ), discharges, average length of stay, patient days, turnover per bed, deaths, abscondees, beds - authorized and actual, cots - authorized and actual

  • maternity services statistics - normal deliveries, caesarean deliveries, breech deliveries, assisted vaginal deliveries - vacuum and forceps, born before arrival ( BBA ), maternal deaths, audited maternal deaths, live births, still births, neonatal deaths, low birth weight babies ( under 2500gms ), total new born discharges, date of birth, time of birth, infant mortality, perinatal mortality, immunization schedules and coverage ( in pediatrics ), child growth and malnutrition

  • surgical statistical reports - minor surgeries by type, emergencies by type. cold cases, circimcision, major surgeries by type

  • ICD-10 statistics: injury cases, sports injury among children and adults, general accident statistics, cancer incidence rates, mortality rates, patient survival rates, incidences of vaccine preventable diseases, infectious disease statistics, communicable disease statistics. tropical diseases, non-communicable diseases, child health related diagnoses e.g acute respiratory infections, HIV/AIDS, Asthma, sexually transmitted diseases, other diseases e.g TB, causes of health, causes of infant death, suicide statistics, blindness and deafness, mental health

  • disease control and prevention statistics

  • clinical service visit statistics by department, days on list by unit and treating doctor, elective admissions, actual time of procedure vs planned, cancellations with reason

  • waiting list survey for different time periods or services / procedures

  • services scheduled, cancelled, completed etc by department

  • patints on waiting list

  • days on list by unit and treating doctor

  • elective admissions report

  • nursing reports:
    • KPIs, training, special procedures, patient satisfaction
    • critical patients from wards
    • occupancy report
    • discharge summary report
    • duty rotas and allocation
    • incidents
    • patient complaints
    • discharge against medical advice
    • admissions
    • sick off
    • readmissions within a month
    • readmissions to CCU
    • readmissions after outpatient visit
    • unplanned CCU admission
    • unanticipated cardiac arrests
    • unexpected medical outcomes
    • unexpected surgical outcomes
    • unexpected anaesthetic outcomes
    • unexpected obsteric outcomes
    • maternal deaths
    • fetal deaths
    • neonatal deaths
    • surgical REDOs
    • priority patients e.g VIP, critically ill, long stay, major surgery
    • medication errors
    • near misses
    • self extubations
    • failure to rescue cardiac arrests
    • property loss
    • missed diagnosis
    • declined intervention
    • missed radiological diagnosis
    • laboratory incidences
    • finance indidences
    • ADT incidences e.g insurance fraud
    • security incidences
    • physical medicine incidences
    • food handlers report
    • catering hygiene
    • clinical audits

5.1.3. Epic: Pharmacy reporting

Note

As a:
  • pharmacy adminisrator
I need to perform the following analyses:
  • billing summaries, by patient, date, drugs etc
  • medication summaries, by patient
  • drug usage / utilization
  • goods in transit
  • revenue analysis
  • drug pricing
  • controlled substances
  • statistics: most used drugs, slow moving drugs, workload, stock usage, departmental usage
  • items above maximum stock level