Health system analytics departments have been put to the test during the pandemic. Philadelphia-based Jefferson Health’s enterprise business intelligence group created a COVID reporting SWAT team to meet evolving clinical, operations, research and regulatory reporting requirements.
Speaking during a Nov. 5 Jefferson College of Population Health webinar, Brian Glynn, director of enterprise business intelligence at 14-hospital Jefferson, said that since the initial COVID kickoff meeting on March 9, his team has had to shift its approach as the needs of internal customers evolved.
Glynn said the overall enterprise analytics group at Jefferson has 50 to 60 employees, with the business intelligence team having around 25 members. One thing that complicated the effort at Jefferson is that several of its hospitals in two of its regional divisions were in the planning process for switching over to Epic, the EHR that the health system is standardizing on. But their current EHRs did not have similar reporting capabilities. “That raised the level of complexity. We were in disparate environments, with two of our divisions on Epic, and two that were not,” Glynn said.
The initial activities of the COVID reporting swat team revolved around what new data capture and reporting features had to be built into the EHR. That included screening where patients had traveled overseas recently and new lab orders around COVID. “We worked with Epic on new work flows on the fly,” he said. “We could be agile in Epic, but we still struggled in our two northern division not yet on Epic.”
The SWAT team also had to build dashboards to describe in real time the patient population in-house and the resources in the ambulatory setting as they pivoted to telehealth, including resources for testing patients for COVID.
As new needs for metrics arose around PPE, bed occupancy, surge planning, and ventilator capacity, the team worked to identify the operational “owners” of the metrics to help validate output and then met with the teams building new EHR tools to make changes there. For some data points, they were able to shift from manually gathering data for COVID reports to automating its collection in the enterprise data warehouse.
In addition, they participated in daily meetings with the incident command center team to better understand new data needs. “We needed to develop that tight alignment with the incident command center,” Glynn said.
The SWAT team also developed a series of Qlik visualization apps to allow operational leaders to do deep dives on key performance indicators around COVID. There were dashboards developed around PPE supplies, ICU figures, inpatient discharges, supply chain,
“It is a robust application that provides operation leaders with insight on how to manage day to day operations,” Glynn said. “We went from snapshots in time to trending and anticipating what is going to happen next.”
Besides clinical and operational leaders, a research working group was established because researchers wanted rapid access to COVID data to develop registries and study potential treatment options and the demographic trends impacting local patient populations. “At Jefferson there is a nice level of collaboration between clinical and operational and research needs,” Glynn said. They developed a data mart for the COVID patient population, pulling data from multiple systems into the data warehouse. So far, 33 research projects have been approved by the research working group, and 18 of those have been approved by the internal review board.
Glynn noted that regulatory reporting can be a challenge, and Jefferson needed to report COVID-related data to the federal government, as well as state and local public health agencies in Pennsylvania and New Jersey. When the White House made a sudden shift and required data be sent to the Department of Health & Human Services rather than the Centers for Disease Control, “that pivot was tough, and required a lot of technical work to make it happen. The HHS metrics did not align with how we were defining things.”
One outcome of the pandemic is that the analytics team has become more agile. For one thing, it pulled off all these changes while working remotely on Zoom calls and Microsoft Teams meetings. It has gotten used to responding very rapidly to new data requests. It has put together robust processes around the path forward. There is now an incident command center analytics steering committee to approve new data requests. “This is sensitive information,” Glynn said. “We are transparent, but we need to have a laser focus on what you are doing with the information and why and make sure we are aligned from a metric definition perspective.”
