Bryson Blakelock, Data Analyst, and Sonja Stirling, Director, Finance and Data Analytics, Muskoka Algonquin Healthcare.
Health System News recently spoke with the members of the Data and Analytics Team at Muskoka Algonquin Healthcare (MAHC) about their experience using Integrated Decision Support (IDS) since subscribing 11 months ago, and how it's benefiting their organization.
IDS is Ontario's most mature and widely used collaborative solution for integrating health services utilization data across health providers, empowering its growing subscriber community with insight-rich, time-saving tools and reports designed by and for Ontario's health care analysts and decision-makers. IDS equips providers and regional health teams with a longitudinal line of sight into patients' care journeys, to enable planning, population health management, program evaluation and quality improvement, and operational benchmarking.
Read more about our recent interview with Bryson Blakelock, Data Analyst, and Sonja Stirling, Director, Finance and Data Analytics, MAHC.
Why did you decide to subscribe to IDS? What were you hoping to gain?
S. Stirling: Right now, Muskoka Algonquin Healthcare has a small team of two data analysts, and when I moved into this position about a year ago, we didn't have many tools to analyze patient-level data. At the time, we were using spreadsheets to produce and share utilization reports – a manual process that was labour-intensive. These were static reports, so if there were any corrections to the data, our reporting would be out of sync. There were many instances that monthly or quarterly finalized data would have to be regenerated and transferred into spreadsheets to account for the changes in the initial data reported. With IDS, we're now using live data, and corrections are automatically integrated and reflected in the reports. This has saved our small and busy team a lot of time.
Over the years, we've struggled to access consistent data – a single true source. With IDS, we can be confident in the data we are utilizing, which is extremely important when submitting this information to the Ministry of Health and our management team for decision making. We also wanted to tie this together with the ability to benchmark with peer hospitals, again, to assist our management team and our finance team, when making decisions on budgeting for future years.
IDS also helps us provide our teams with information that can help tell the story of what's happening, which is critical for making decisions about certain programs. This has been especially important for management and our board in understanding the patient journey.
How's your team/organization using IDS? What are some things you're doing now that you weren't doing before?
B. Blakelock: Building on what Sonja said, we're in the middle of a major capital redevelopment project for our two sites, Bracebridge and Huntsvillle, and we've been getting many data requests related to this, to help inform both our communities and our decisions for the future. As there are many aspects involved with such a large project, we want to make sure that decisions made are informed by accurate, complete data.
IDS has given us the ability to access coded patient data to help inform decisions, and ultimately, projections for the future state. This would not have been an easy task prior to joining the IDS community.
As an example, we can look at which sites patients go to, for what service, and whether they're residents or visitors to Muskoka. We can see patient volumes year-over-year to understand if they're increasing, identifying specific needs like emergency department (ED) visits or programs such as chemotherapy and dialysis. This also allows us to inform our team engaged in forecasting utilization rates so we can better prepare to care for the volume of patients we may expect to see in the coming years.
S. Stirling: One of the big things that so many hospitals are looking to do right now is benchmarking across peer groups – both on the financial side and operational side, such as hours worked, number of patients going through a specific program, etc. It was important for our budgeting process this year. We look forward to seeing even more organizations join IDS to enhance this benchmarking capability.
Currently, we're moving to an integrated stroke unit and our physicians are asking for a lot of information, such as who got to the hospital in three-and-a-half hours, who got tPA, 30-day outcomes following treatment, and that sort of thing. You can't find this through MIS Trial Balance data [Ministry of Health's Management Information Systems], only through what's submitted through NACRS [the Canadian Institute for Information's – CIHI - National Ambulatory Care Reporting System], DAD [CIHI's Discharge Abstract Database], and specific charts. IDS allows us to access most of this information and we have confidence that it is valid, accurate information, coming from our coded data.
We have a research coordinator who's working on a project investigating which patients have qualified for a tPA – so you need to have arrived at the hospital within three-and-a-half hours of a stroke occurring to be eligible for a tPA. IDS narrows this down because you can see the triage time and date and the tPA administration time. They're also trying to identify, of those who receive a tPA, how many passed away within 30 days. They want to understand if a tPA is helping, to determine what's resulting in the best outcomes for patients. To accomplish this, manual chart reviews are required as not all hospitals are currently on IDS, limiting the full patient journey view. Having the entire province in the IDS community could ensure the full patient journey is more readily available.
Another project is looking at unattached patients, those who don't have a family physician, to find out whether they're coming to the hospital, being readmitted, or if they've found a clinic. A new clinic was established recently, and these data will help to inform if this is leading to reduced ED visits or readmissions in the community. This helps to provide a sense of one of the biggest issues in patient care – are you using the ED because you're not attached to a primary care provider? It's a real challenge in this area because there aren't a lot of family physicians. We're trying to get a true picture of what the impact of this is. This also helps to demonstrate the need to physicians who may be considering Muskoka, and how they can benefit patients.
Do you also use IDS for your day-to-day responsibilities?
S. Stirling: Everything that Ontario Health requires us to report on, we're able to get out of IDS directly, with one or two exceptions. So, we can provide our stroke unit with a scorecard with all the measurables that we must report against. It's the same for the pay-for-results program, which we get specific funding for. We need to be able to access the data monthly to report on whether we're improving on wait times in the emergency department, time to initial physician assessment, and time to an in-patient bed after a decision to admit is made.
B. Blakelock: There are a lot of things we're providing all of the managers so that they can improve their [patient care] areas or focus intentionally on aspects that may need improvement. For example, our Manager, ICU, District Stroke Coordinator and our regional partners were interested in seeing different stroke metrics to hopefully improve patient outcomes. I recently created a dashboard for the stroke program that's close to completion. I was able to pull a lot of data from the Stroke Distinction dashboard IDS created while also getting assistance from IDS for other metrics. While this is still in its infancy it's exciting to see how this data will be used.
What are the top three things you appreciate most about IDS?
B. Blakelock: When we reach out for assistance or clarity, there's usually a 24-to-48-hour turnaround. All the data are coded, so we know that everything is as it should be, and it's also nice to have all the data in one place.
S. Stirling: Also being able to look at other hospitals for benchmarking. We did this when we were trying to figure out how many patients were coming from other areas. IDS breaks it all down for you beautifully and it's very easy to use.
You can also look at other IDS user reports when you're stuck on how to get something. If it's a published report in the user community and we think it can be useful for us, we can copy and utilize that. It's a real sharing community.
There's another aspect I've really made use of and that's the data definitions in IDS. I'm in finance so I don't know coded data. When I'm looking something up, I'll go to the data definitions to clarify what I need. There are nuances between different data sets and data items that we may be unclear about.
How are you hoping to use IDS in the future?
S. Stirling: We're creating new dashboards. We've chatted with managers in different areas to be able to target specific things they're looking for which will help them make their decisions. For example, with obstetrics, the previous dashboard only had inpatient information. But obstetrics patients use a lot of outpatient services like stress tests. The new dashboard will pull this information in as well and will be much more helpful for managers to understand how these patients are using services.
We've also customized a pre-programmed inpatient scorecard within IDS, with the specific information our managers need.
Eventually, we'll also be adding rehabilitation data which is part of supporting our stroke unit.
If your organization had no challenges/barriers (such as cost, time, etc.), how would you ideally leverage IDS to benefit your organization or improve the patient care journey?
S. Stirling: I think there is a lot of untapped opportunity within IDS. We go looking for what we know, but we don't know what we don't know. We still have a lot of learning to do and have barely scratched the surface.