An introduction to Essentris GDR

Intended for Clinicians or anyone who wants to identify and develop an Essentris GDR report specification

An introduction to Essentris GDR – Report Specification?

An Essentris GDR report specification is a document which can be used by a data analyst to create the logical design of a report using SQL Language or other database reporting tools

An introduction to Essentris GDR – Data Deliverables

Once the logical design of the report is complete, any number of various kinds of data deliverables (excel, pdf, html, printouts) can be made

An introduction to Essentris GDR - overview

These slides are designed to meet two objectives• Provide a listing of the kinds of data we can

use in a GDR Report

• Provide a framework and vocabulary you can use to create report specifications to give to your data analyst

Essentris GDR fundamentals: everything centers on the PATID column

Internally generated encounter number Unique across installations Column that joins a single patient’s data NOT visible in Essentris Column that is almost never shown in

Reports

Essentris GDR fundamentals: CCI’s DATABASE ITEMS

Clinicomp maintains a list of some 13,000 DATABASE items which may used on Essentris Screens and so may be used in Reporting

We can report on any data from any Essentris screen

Data is typically organized one table per concept - ie: a heart rate table, a chief complaint table, a restraint type table…

Essentris GDR fundamentals: CCI’s NOTE TABLES

The GDR has a separate table for each of the NOTES in use at your site.

We can report on the creation time, last store time, and any data stored on any NOTE

Data is typically organized one table per note and further organized by the TAG number, ie: the label “case type” might be found next to a text box with the identifier TAG number = 2.• Our spec doc will say: case type = tag 2

Essentris GDR fundamentals: Determining the main list (Driving List)

Best Practices involves identifying a main or “driving list” (DL)• DL is verifiable, simple, and is the

answer to the question: “Who should be on the report?”

• The DL is the left side of all joins in the WHERE clause (a technical point)

4 Slides on SQL language: Everyone’s First SQL lesson

In Structured Query Language (SQL) we:•SELECT A comma separated list of COLUMNSFROM A comma separated list of TABLESWHERE Two COLUMNS are equal (joins) or Some fact about a COLUMN is true

4 Slides on SQL language:the SELECT clause

Comma separated list of columns• Regular English: the columns of data which need

to show in the report

4 Slides on SQL language: the FROM clause

Comma separated list of TABLES• Practical English: Essentris data sources,

usually identified by FULLNAME or Note TAG String, or else is documented in the GDR manual

4 Slides on SQL language: the WHERE clause

Two columns are equal (joins)

or Some fact about a column is true

• UNIT.data like ‘ICU’ or

• NAME.data not like ‘%TEST%’ or

• GLUCOSE.data > 120 or

• MedName in (‘ASPIRIN’,’MOTRIN’,…)

SQL Language summary:

Your data analyst needs to know which TABLES to use and which COLUMNS to show in the report

Essentris Data Sources:Start with Essentris

We already know our way around Essentris Identify Essentris Data Sources found on

different screens:• Admit Notes

• Timed Notes

• Vitals Flowsheets

• Order Entry and Meds/Treatments/I&O Flowsheets

• Admission/Discharge/Transfer Data

Essentris Data Sources: Admit Notes

User defined template document Only one copy stored on the patient record Has labels, checkboxes and text fields

• In EDIT mode, right-click checkboxes and text fields, select “describe item”, then double click the Label “Item Edit History”

• Text fields can be of two types• DATABASE:

• Reference the DBI FULLNAME

• NOTE:• Reference the TAG String (ex: !207.ABC^5.10)

Essentris Data Sources:Notes, Describe NOTE Item

Essentris Data Sources:Describe NOTE Item

Report Column: “Case Type” • Tag !200.PER^6.2

Essentris Data Sources:Notes, Describe DATABASE Item

Essentris Data Sources:Describe DATABASE Item

Column = “Allergies”• Fullname = “Allergies.adm”

Admit Notes tangent: Consider One Essentris DATABASE Items

As many as 13,600+ DATABASE Item TABLES in the GDR

Some hold one value per patient stay• Name, fmp/ssn, rank,

Some get charted many times during the patient stay• HR, tempC, painscore, vent setting

Need the FULLNAME for Report Spec

Essentris Data Sources:DATABASE Items

Columns you may want in your report:• DATA

• The charted value stored in this item

• KEY• The observation time for the stored DATA

• LOG TIME• The date and time that a person gave their

username/password to store the DATA

Essentris Data Sources:3 DBI example (Patient Details)

FULLNAMES: NAME, MRN, DOB

Essentris Data Sources:3 DBI example (Patient Details)

Example Spec might be:

Report to show Name, FMP/SSN, Birthdate for all active patients.

Column: “Patient Name”

Fullname: “NAME”

Column: “FMP/SSN”

Fullname: “FMP/SSN”

Column: “Birthdate”

Fullname: “DOB”

Essentris Data Sources:3 DBI example (Patient Details)

Essentris Data Sources:3 NOTE items example

Put your cursor into the cell. Right-click and select “Describe Item”. Double click the ‘Edit History” Label to find the TAG.

Reference the TAG string for the Text Prompt (ex: !200.PER^6.2)

Essentris Data Sources:3 NOTE items example

Example Spec might be:Report to show Delay Code, Case Type, Datetime of Univ Protocol from the Peri-Operative Note for all patients.

Column: “Delay Code” TAG: !200.PER^6.497Column: “Case Type” TAG: !200.PER^6.2Column: “DT Univ Protocol” TAG: !200.PER^6.484

Essentris Data Sources:3 NOTE items example

Essentris Data Sources:Parameter Flowsheets (Vitals)

Essentris Data Sources:Parameter Flowsheets (Vitals)

Time driven values Database items DBIs have a “many to one” relationship to

patient• Most reports require we find a single value to report:

• MIN/MAX(data or key), the value closest to a point in time, a single LIST of values, etc

• Turn chronological DBI charting into Start and Stop times for treatment intervals: vent use, restraints, etc

Essentris Data Sources:Parameter Flowsheets (Vitals)

Right-click, select “Describe Item” to find the site-defined FULLNAME

FULLNAME is the unique identifier for the data TABLE in the GDR

Essentris Data Sources:Flowsheet Describe Item

Essentris Data Sources:Parameter Flowsheets (Vitals)

Example spec might be:

Show any patient who has had a fever (temp > 100)

Column: “first fever time”

FULLNAME: “TempF(DegF)”

Essentris Data Sources:Parameter Flowsheets (Vitals)

Essentris Data Sources:Parameter Flowsheets (Vitals)

Example spec might be:

Show the first fever time for any patient who has had a fever (temp > 100)

Column: “first fever time”

FULLNAME: “TempF(DegF)”

Essentris Data Sources:Parameter Flowsheets (Vitals)

Essentris Data Sources:Order Data

Facts about Orders which can be included in a report are those which are found on two different Order-based screens:• Order Entry

• Orders Flowsheet

Essentris Data Sources:Order Entry Screen Details

Order Time, Start Time, Stop Time, Verbal Order, MD Name, Order Name, Orderset Name, Order Category, Comment, ENT,SIGN, C/S, ACK, Verify • A_ORDERENTRY table has columns for all

these facts about the Order found on the Order Entry Screen

Essentris Data Sources:Meds Flowsheet Details

These tables contain data you see displayed on the Med Orders Flowsheet:• MEDS_FLOW_ANNOTATION_2231

MEDS_FLOW_COMMENT_2267MEDS_FLOW_DEFINITION_2225MEDS_FLOW_DELIVERY_2230MEDS_FLOW_DOSE_2229MEDS_FLOW_FREQUENCY_2226MEDS_FLOW_LABEL_COMMENT_2227MEDS_FLOW_REMARKS_2925MEDS_FLOW_ROUTE_2228

Essentris Data Sources:ADT Data

Admission/Discharge/Transfer data

Essentris Data Sources:A_ADTHISTORY

HL7 interface or Staff will add records to the ADTHISTORY table indicating patient location (UNIT, BED)

Essentris Data Sources:A_UNITHISTORY

Uses logic based on A_ADTHISTORY table to figure out the Enter Times and Exit Times per patient per unit

Essentris Data Sources:A_UNITBEDHISTORY

Uses logic based on A_ADTHISTORY table to figure out the Enter Times and Exit Times per patient per unit per bed

Essentris Data Sources:A_PATIENTLIST

Uses logic based on A_ADTHISTORY table to show one representative record per patient. Includes data like: name, mrn, hospno, MD, admtime

In Practice: A_PATIENTLIST = the patient records that are loaded into the GDR

Essentris Data Sources:A_PATCOMMON

Based on a script which runs per 10 mins on the ncrontab scheduler, This table list all the active patients in Essentris

Essentris Data Sources:A_ARCHLIST

Based on a script which runs from the Essentris Server Scheduler @1 AM

Lists all the archive records on the Essentris Server filesystem