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开发一个源自电子健康记录的健康公平仪表板,以改善学习者对数据和指标的获取。

Developing an electronic health record-derived health equity dashboard to improve learner access to data and metrics.

作者信息

Tsuchida Ryan E, Haggins Adrianne N, Perry Marcia, Chen Chiu-Mei, Medlin Richard P, Meurer William J, Burkhardt John, Fung Christopher M

机构信息

Department of Emergency Medicine University of Michigan Ann Arbor Michigan USA.

出版信息

AEM Educ Train. 2021 Sep 29;5(Suppl 1):S116-S120. doi: 10.1002/aet2.10682. eCollection 2021 Sep.

Abstract

OBJECTIVES

It is essential to engage learners in efforts aimed at dismantling racism and other contributors to health care disparities. Barriers to their involvement include limited access to data. The objective of our study was to create a data dashboard using an existing quality improvement (QI) infrastructure and provide resident access to data to facilitate exploratory analysis on disparities in emergency department (ED) patient care.

METHODS

Focusing on patient populations that have previously been shown in the literature to suffer significant disparities in the ED, we extracted outcomes across a variety of metrics already collected as part of routine ED operations. Using data visualization software, we developed an interactive dashboard for visual exploratory analyses.

RESULTS

We designed a dashboard for our resident learners with views that are flexible and allow user selected filters to view clinical outcomes by patient age, treatment area, and chief complaint. Learners were also allowed to select grouping and outcomes of interest to investigate questions and form new hypotheses of their choosing. Available dashboard views included summary counts view to assess ED visits over time by selectable group, a rooming and triage acuity view, time-to-event survival curve view, histogram and box plot views for continuous variables, a view to assess outcome variables by time of day of ED arrival, customizable contingency table views, and correspondence analysis.

CONCLUSIONS

Utilizing an existing QI infrastructure, we developed a dashboard that provides a new perspective into commonly collected ED operations data to allow for the exploration of disparities in ED care that is accessible to learners. Future directions include using these data to refine hypotheses on ED disparities, understand root causes, develop interventions, and measure their impact.

摘要

目的

让学习者参与旨在消除种族主义和其他导致医疗保健差距因素的工作至关重要。他们参与的障碍包括获取数据的机会有限。我们研究的目的是使用现有的质量改进(QI)基础设施创建一个数据仪表板,并为住院医师提供数据访问权限,以促进对急诊科(ED)患者护理差异的探索性分析。

方法

我们聚焦于文献中先前显示在急诊科存在显著差异的患者群体,提取了作为急诊科日常运营一部分已经收集的各种指标的结果。使用数据可视化软件,我们开发了一个用于可视化探索性分析的交互式仪表板。

结果

我们为住院医师学习者设计了一个仪表板,其视图灵活,允许用户选择过滤器,以按患者年龄、治疗区域和主要诉求查看临床结果。学习者还可以选择感兴趣的分组和结果来调查问题并形成他们自己选择的新假设。可用的仪表板视图包括按可选组评估随时间的急诊就诊次数的汇总计数视图、病房安排和分诊 acuity 视图、事件发生时间生存曲线视图、连续变量的直方图和箱线图视图、按急诊到达时间评估结果变量的视图、可定制的列联表视图以及对应分析。

结论

利用现有的 QI 基础设施,我们开发了一个仪表板,为常见收集的急诊科运营数据提供了新的视角,以便学习者能够探索急诊科护理中的差异。未来的方向包括使用这些数据完善关于急诊科差异的假设、理解根本原因、制定干预措施并衡量其影响。

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