visualizing healthcare: you have the data, but can you see the story?

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Data Visualization

The power of seeing.

Unexplained variation in

healthcare delivery in the U.S.

Cancer Patients Receiving Chemotherapy Treatment During Last Two Weeks of Life In the U.S.

The Research

Colin Ware

I SEE

I UNDERSTAND

Pre-Attentive Processing

& Human Cognition

Count the Fives

See the Fives

• Gestalt (Pattern) Principles

ProximitySimilarityEnclosureClosureContinuityConnection

Continuity: Objects that are aligned together or appear to be a continuation of one another are perceived as a group.

Colors

Fill in the blank:

Approximately 10% of all males and

1% of all females are_____________.

Q1 Q2 Q3 Q4Falls

Patient Falls with Injury 0.46 0.45 0.41Serious Reportable Events 1 0 1 6

Medical Records MD Notes Composite 72% 66% 65% 67%H&P Compliance 100% 96% 94% 95%H&P Updated per Policy 41% 21% 80% 45%

Medication Management-InpatientMedications Secured Properly 88% 83% 78% 83%Patients' Own Meds-Labelling 38% 86% 60% 86%Recording/Reporting Fridge Temp 40% 70% 53% 83%Patient Education on AntiCoag 80% 80% 80% 80%Med Rec-Admission 89% 92% 89% 87%Med Rec-Discharge 98% 98% 98% 97%

Medication Management-OutpatientSites-MESAC Approval of Samples 100% 100% 100%Sites-Correct Use of SIMS for Approved Samples 86% 86% 86%

Pain ManagementPain Assessment/Reassessment NA 97% 98% 98%Severe Pain Management NA 84% 95% 97%

Patient IdentifiersMislabeled Specimens 1058 1110 1177 1143Blood Transfusion RN VerificationSafety Reporting Proxy 0 0 0 0

Patient RightsGrievance Responded (per MGH policy) NA 79% 82% 76%

Restraints Restraint Prevalence NA NA 6.1% 3.2%MD/NP/PA Daily Assessment NA NA NA 33%Ordered per Policy NA 90% 89% 89%Utilization Matches Order NA 88% 80% 37%RN Assessment & Interventions NA 92% 82% 85%

Skin IntegrityPressure Ulcer Prevalence NA NA 2.9% 2.1%CNS Consults (>Stage 2) NA 95% 87%Wound Measured Weekly NA 86% 80%Serious Reportable Events 3 2 1 4

Universal Protocol UP Compliance (Procedural Areas) 96% 99% 94% 92%UP Compliance (Ambulatory Areas) 71% 91% 64% 86%Wrong Site Procedures-SRE 0 2 0 1

Other NPSGsCritical Value Callbacks NA NA 98% 98%

MGH's Worry Box Interventions without OrdersInfection ControlInternal Handoffs

Data TBDData TBDData TBD

Data TBD

Priority AreaCY10

The indiscriminate use of color adds NOTHING

to the viewer’s experience.

Use Color to Show Differences Highlight Important Information

Compared with what?

Basic Statistics Required

MeanMedical Patients Average Length of Stay

(ALOS) Patient Days in Hospital

A 3 B 2 C 1 D 5 E 8 F 9 G 3 H 5 I 2

ALOS 4.2

MedianMedical Patients Median Length of Stay

Patient Days in Hospital A 1 B 2 C 2 D 3 E 3 F 5 G 5 H 8 I 9

Median LOS 3

Correlation

Correlation is NOT Causation

Living in a southern state doesn’t cause diabetes.

BUT it is a good clue about who needs help the most.

None of us are immune…

Data Visualization

Summary Best Practices

Tables

Use a TABLE to: Look up specific values

Compare specific values

Display precise values

Communicate more than one unit of measure

Graphs

Use a GRAPH to:

Show Patterns

Show Trends

Show Exceptions

Reveal relationships between multiple values

At a Glance

I SEE

I UNDERSTAND

Methods of Encoding Data on a Graph

Quantify the Size of the Parts

Income < $25K

Income $25-50K

Income > $50K

0% 10% 20% 30% 40% 50% 60% 70% 80%

Black and White Boston Residents

Who are Overweight or Obese by Income

Income < $25K

Income $25-50K

Income > $50K

40% 50% 60% 70%

Black and White Boston Residents

Who are Overweight or Obese by Income

Atlanta Palo Alto

Annual # Cases 25,000 21,000

Case Mix Index Average Length of Stay 5.5 Days 5.5 Days Average Charge per Case $40,000 $100,000

Median Charge per Case $20,000 $40,000

“Anything you can do with a pie chart you can do

better with a bar chart.”

Data Visualization Club Mantra

Unplanned Hospital Readmissions

QUANTIFYING THE PROBLEM

The U.S. federal government has pegged the cost of readmissions for

Medicare patients (65 and older) alone at

$26 billion annually

$17 billion of it pays for unplanned readmissions

that may not happen if patients get the right care.

The overall readmission rate for those 65 and older in the U.S. is

about

15% annually and in New Zealand for the same

population it’s about

10% annually

Unplanned Hospital Readmissions

SEEING THE OPPORTUNITIES

Hospital Readmissions

Overview

Zoom

Details

I SEE

I UNDERSTAND

See how you’re doing

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visualizing healthcare: you have the data, but can you see the story?

Healthcare