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AMIA Annu Symp Proc. 2006; 2006: 971.
PMCID: PMC1839625

Report Central: Quality Reporting Tool in an Electronic Health Record

Abstract

Quality reporting tools, integrated with ambulatory electronic health records, can help clinicians and administrators understand performance, manage populations, and improve quality. Report Central is a secure web report delivery tool built on Crystal Reports XI™ and ASP.NET technologies. Pilot evaluation of Report Central indicates that clinicians prefer a quality reporting tool that is integrated with our home-grown EHR to support clinical workflow.

Introduction

Providing reports from the electronic health records helps clinicians realize the value of using structured documentation in the EHR. Structured documentation in EHRs provides the essential data to create quality reports that inform clinicians on the care of their patients, ranging from preventative care for diabetes and cancer screening, to quickly and accurately identifying patient populations for prescription recalls. To promote seamless integration into existing workflows, clinical quality reports must have drill-down capabilities that can transform a condition-specific population report into views of individual patient records while supporting efficient workflow. The goal of building a quality reporting delivery tool is to inform care providers about patient care and quality outcomes, as well as increase perceived value of our home-grown EHR.

Background

Partners Healthcare System has developed the Longitudinal Medical Record (LMR), an ambulatory EHR used across the Partners network, which captures a variety of structured clinical data and includes such tools as charting, results management, referral management, and order entry. The Report Central application is a new LMR module that seamlessly integrates into Partners’ clinical systems. Instead of purchasing a commercial business intelligence tool, Partners made the decision to build a custom solution to ensure flexibility and tight integration with LMR for workflow support.

Design and Methodology

Data warehouse

In order to query against patient populations without impacting production systems, there is a need for an aggregated data warehouse. Report Central uses the Quality Data Warehouse, which aggregates data from various sources at Partners. The data warehouse compiles and stores data from multiple sources, such as vital signs, Health Maintenance, medications, and other EHR data, as well as enterprise master patient index, PCP/provider panels, and laboratory results.

Role-based security

Report Central is a web-based application with patient data, and as such it is important to make sure that data presented remain secured at all times. Access to Report Central is centrally managed for every LMR user with role definitions determining which reports a user may see. Report Central uses a session token from LMR and invokes a session service to identify the user. This ensures that the session is valid and makes it secure for intranet access. For the extranet access, in addition to a session token, Report Central also receives a cookie set by lmr.partners.org (server for internet use of LMR), which is used to invoke single sign on. This ensures that the user is recognized for extranet access to LMR.

Technology

Most reports are constructed and viewed using Crystal Reports XI™. Crystal Reports plug-in controls for the .NET environment afforded the flexibility to customize the report portal as well as manage single sign-on security features. Customizing the portal application with C# ASP.NET programming also meant that Report Central could use any developer software for report designs without binding to one tool. In addition, developing Report Central in a .NET environment helped to better integrate the application with existing systems at Partners.

Findings from Implementation

Thirty primary care providers evaluated Report Central during its ten-week pilot implementation. Pilot users evaluated the quality reporting tool on ease of use of the application and the usefulness of its six clinical quality reports. Usage reports indicate that pilot users accessed Report Central to run reports and view previously run reports on a regular basis. Pilot results indicate clinicians found Report Central to be an easy tool to use, with more than three-quarters of the survey respondents preferring to use this new reporting tool to previous methods of receiving reports. In addition, pilot results show that clinicians found the clinical quality reports easy to use and understand, as well as meaningful to patient care and improving outcomes.

Conclusion

Report Central is a web-based reporting tool that seamlessly integrates with LMR patient records. Pilot evaluation results indicate that clinicians prefer a tool developed within LMR that allow them to run quality reports on demand to help assess outcomes for patient care and for improving their documentation into LMR. Clinicians prefer a simple and intuitive reporting tool that produces results without the hassle of waiting on a complex query or the need to learn a program to do so. The result is a customized reporting tool that eliminates the hassle of reauthentication yet respects role-based security for report viewing. Drill-down access to the patient records from reports adds a high-value clinical workflow to the LMR system.


Articles from AMIA Annual Symposium Proceedings are provided here courtesy of American Medical Informatics Association
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