Red Brick Systems has been invited to submit customer success case studies for consideration for the annual ComputerWorld Smithsonian awards. These are generally viewed as "the Oscars for IT", being judged by analysts and experts in the IT field. The black-tie awards ceremony is to be held in Washington DC. Medical specialist Tufts is one of the companies shortlisted for the award. This is a technical backgrounder on what Tufts has accomplished with Red Brick. Tufts Health Plan continuously strives to improve the care and services delivered to members and Tufts views IT as enabling the delivery of quality health care, service and value. To reduce dependence on IS for ad hoc reporting while improving the ability of end-users to quickly access and analysed information, Tufts deployed a data warehouse (in 1993) consisting primarily of claims data. Since its initial implementation, Tufts has continuously broadened the scope of information contained in the data warehouse and expanded the number of business areas serviced. Currently, the data warehouse supports over 250 users and comprises over 80 GB. The data warehouse consists of 164 tables containing claims, membership, provider, pharmacy and employer information (very complex schema and approaching an enterprise data warehouse application. Tufts started out with a few subject areas and built this into an enterprise data warehouse over time by addition application areas). Many functional areas both internal and external use the Tufts data warehouse for day-to-day activities. The department responsible for producing the Health Employer Data Information Set (HEDIS) required by the National Committee for Quality Assurance (NCQA) uses the data warehouse to report on HEDIS indicators. Another department, responsible for supporting Tufts hospitals and physician groups, queries the data warehouse to respond to questions regarding the services provided by hospitals and physicians. The information derived from the data warehouse allows the medical community to monitor how care is being delivered and to make improvements. Marketing and sales access and report on information, allowing employer groups to monitor the quality of care and customer service being provided its employees. To improve the quality of care members receive, the Clinical Measurement and Improvement team access and analyse information in the data warehouse to identify members who have missed routine, preventative care such as mammograms, pap tests and eye exams. In addition to supporting quality improvement efforts, the data warehouse supports Tufts Quality Programmes by identifying potential candidates for programs such as Tufts Health Plan`s Breathe Easy Asthma Programme, Taking Charge Diabetes Programme and Healthy Birthday Programme. The Tufts data warehouse contains the necessary patient care data to support these crucial quality improvement initiatives and clinical programmes. The Tufts data warehouse allows management and staff to easily and quickly access information needed to monitor performance, measure efficacy of care and identify improvement opportunities. The following illustrates the benefits provided to Tufts members as a result of use of data warehousing and decision support technology: Breathe Easy, Tufts Health Plan`s Asthma Programme is designed to help improve the quality of care and member satisfaction for asthma patients. Using the data warehouse, Tufts Health Plan identifies members who have asthma-related inpatient, emergency room and pharmacy-related claims within a six-month period. The primary care physician is consulted to determine if the member is appropriate for the program. The programme seeks to educate members to help them better manage their disease, increase their functional status, help primary care physicians educate members about asthma management and reduce asthma-related emergency room visits and inpatient admissions. Initial results show a 38% decrease in asthma related emergency admissions, thereby improving the quality of life for asthma patients. Tufts Mammography Screening Improvement Project: This focuses on improving the mammography screening rate for women between the ages of 52 and 69. The project team relied heavily on information contained in the data warehouse to identify members overdue for mammography screening. Mammograms are the most effective procedure for screening for early detection of breast cancer. Early detection is the key to effective treatment and maximum survival rates. The Clinical Quality Measurement and Improvement team ascertained from the data warehouse which members had not obtained a mammogram in the past year. With this information, letters were mailed and phone calls were made to members reminding them of the need to make an appointment to receive this necessary preventative care. In addition, mailings were sent to primary care physicians listing their members who were overdue for mammography screening. Member feedback regarding this outreach effort has been overwhelmingly positive. Since 1993, the percent of members receiving mammography screening has increased from 71,5% to 76,2%. This percentage increase translates to 3 000 more women receiving this crucial screening. The Diabetic Eye Exam Screening Project: This was initiated as a result of information obtained from the Tufts data warehouse. Analysis indicated that the diabetic eye exam rate for Tufts` senior population was lower than optimal. Once identified as an intervention opportunity, the Quality Improvement team using the warehouse identified members who have a diagnosis of diabetes and were due for an eye exam. Blindness and eye disease are prevalent side effects of diabetes and regular eye screening leads to preventative treatment. Letters addressing the importance of obtaining an eye exam to screen for damage to the retina of the eye were mailed. The primary care physicians for these identified members were sent a letter outlining the diabetic eye exam screening initiative. Initial feedback has been positive and by the end of the first quarter of 1998 the results of this improvement initiative will be available for analysis. As with all technology, the Tufts data warehouse is not standing still. Immediate plans for the data warehouse include the deployment of a Web-based decision support and online analytical processing tool that will deliver an executive information system to senior management, disseminate information automatically to employer groups, and provide physicians and medical groups with direct access to information regarding their patients.
Share
Editorial contacts