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Beate Danielsen, Health Information SolutionsSoora Wi, Kaiser Permanente
Eileen Walsh, Kaiser Permanente
Need for customized data collection possibly at different sites connected by an intranet or the internet
SAS foundation technologies available including staff resources familiar with those technologies
Need for customized data reports delivered via an intranet or the internet
Need for flexibility in terms of data collected and reports generated
Brief introduction to a custom data collection at Kaiser Permanente – Division of Research
Status and challenges 2 years agoFeatures of re-designed applicationCost / Benefit considerationsOutlook and future goals
Neonatal Minimum Data Set (NMDS) On-line data collection from Kaiser
Permanente’s 6 Level III Neonatal Intensive Care Units 18,000 infants screened annually for
eligibility 3,000 eligible infants annually Up to 800 variables collected per infant
stay Data used for monitoring health
outcomes, participation in QI initiatives, performing research, and more
On-line reporting
Web-based application relying on HTML, JavaScript, JSP/Java/JDBC, Tomcat, Oracle, and SAS
Necessity of exporting Oracle tables into SAS Limited on-line help Limited real-time error checking Lack of on-line reporting Considerable delay between NICU encounter
and its abstraction into the database and additional delays to NICU reports
Need of outside programmer for system changes such as addition of new variables or any type of application maintenance
No support of other constituents
Client PC
Application Server
SAS BaseSAS/IntrNetSAS/Graph
Unix System
Browser sends http request (a completed HTML form)
Web ServerApache
Unix Systembroker.cgi
Data
Web server passes variables in specific format generated
via CGI script
Runs SAS program and sendsresult as HTML / XML
Web server returns HTML and other
generated content such as figures, XML documents, etc. that
it received from application server
Kaiser DORIntranet
Kaiser DOR Intranet
Web-basedSAS data setsDBs fully managed through
applicationData integrity checks built into
application using JavaScript and comprehensive SAS-based error check
User-friendly environment with relevant help screens
Multiple levels of access (e.g., review-only user, abstractor, supervisor, DB reports only)
Database activity reports and other custom reports helpful in the abstraction process
Integration of an expanded data collection on a subset of cases
(continued)
Integrated reporting Ability to populate some of the SAS
DBs from other sources Support DB generation to meet needs
of multiple constituents: national and statewide patient outcome registries, payer-sponsored quality benchmarking programs, and regional/local QI initiatives by KP clinical staff
(continued)
LEGACY SYSTEM
More complicated set up requiring the maintenance of multiple software products
Limited real-time error checking
Relatively inflexible, data collection only with limited flexibility to add/remove data elements
RE-DESIGNED SAS-BASED SYSTEM
Simpler set up requiring SAS only
Real-time error checks Flexible: Data collection, user
management, reporting, support of QI projects built-in
Application built and in production within 6 months
Staff time needed for data entry reduced from 6.0 to 4.0 FTEs
Increased independence of KP staff
Integration of legacy data into re-designed application
Population of database variables through other KP databases particularly the EMR further reducing abstracting time
Continuous improvement of application interface based on user feedback
Expanded reporting
SAS/IntrNet only solutions are difficult to maintain Entirely dependent on the application
designer NMDS implementation makes it easy to find
relevant modules (“gatekeeper” macro) asp.net is a better solution
Only available on Windows-based web servers, therefore not platform independent
Need for ASP programmer
SAS Foundation Technologies combined with basic web techniques provide a powerful tool to institutions vested in SAS to generate completely customized and flexible solutions for data collection and informative reporting.
Beate Danielsen, Health Information [email protected]
Soora Wi, Kaiser [email protected]
Eileen Walsh, Kaiser [email protected]
