Event Reporting: the Tension Between Accessibility

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Event Reporting the Tension Between
Accessibility Confidentiality

• AHRQ IT Portfolio
• 6/9/05

H Kaplan Columbia University InCHOIR Pathology N
YPH
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"To conceive of knowledge as a collection of
information seems to rob the concept of all of
its life... Knowledge resides in the user and not
in the collection."

•  West Churchman, in The Design of Inquiring
  Systems

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NYPH Participating Hospitals

• Milstein Hospital
• Morgan Stanley Childrens Hospital
• Weill Cornell Hospital
• The Allen Pavilion
• Ambulatory Care Network
• Westchester Division of Psychiatric Hospital

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MERS-TH Features

• Standardized reporting form for the entire
  hospital network
• Web system that is accessible to reporters
  through any web browser
• Central database of reports for process
  improvement with on-line query tools
• Automatic routing of reports to all relevant
  hospital personnel

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Push Event report forms are distributed to all
relevant parties in real-time
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Empowering the End User Conjunctive Query by
Field
End user able to build queries without
understanding database design or table
relationships.
3.
2.
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Discovery Form Expanding sections reveal
detailed questions for each event type
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MERS-TH Workflow
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Weekly, monthly and quarterly sets of data may be
downloaded in Excel spreadsheet format
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Interactive Charting Tool
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Tension Between Accessibility and Confidentiality

• Good News re automation
• Reducing the number of paper report forms
• Improved access and availability
• -decrease dead ends
• More timely
• Bad News
• (Still need someone to look at it)
• Increased need to control access
• -HIPPA and medical/legal

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Controlling Information Access

• Organization Tree
• Roles
• Privileges
• Overarching Access Rule Set (derived from
  organization tree)
• Location
• Service line (e.g. cardiac surgery, oncology)
• Types (falls, meds, transfusion, equip, etc.)

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MERS-TH Adapts to Institutional Changes

• Built-in lists of hospitals, services and
  locations can be changed with an on-line
  location tree editor
• Role/location/service-based access control makes
  it easy to reassign user roles.
• Backup users may be specified for each account to
  temporarily assume another users role
• A choice of centralized login mechanisms allows
  centralized institutional password and account
  management

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Ability is the art of getting the credit for all
the home runs somebody else hits -Casey
Stengel, baseball manager

• International Center for Health Outcomes and
  Innovation Research (InCHOIR) CUMC
• A. Gelijns, A. Moskowitz, R. Levitan, N.Egorova,
  G. Greco
• Department of Pathology CUMC
• Barbara Rabin Fastman

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Thank You For Your Attention