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 Understanding Patient and Program Reports and Graphs
Solution
Orion Outcomes has many different reports.  These reports have been developed over the years based on feedback from customers like you.  We are always adding new reports.  The large number of reports might seem overwhelming so we have put together this article to help you make sense and understand the purpose of a few key reports.
 
Patient Reports
 
Outcomes Summary
This report can be provided to the patient and/or their physician as a progress report and marketing tool. The report provides a summary of individual patient change over a selected time period and includes only the outcomes you select from the list provided. The report includes patient name, background information (sex, date of birth, diagnosis, physician and insurance provider), and program involvement (number of sessions completed and participation in maintenance program). The outcomes listed in the first column are grouped according to outcome domain (behavioral, clinical, economic, and health) with the second column identifying the units of measure. (i.e. 1-5 indicates a scale of 1 to 5, NBS means norm based scoring). The third and fourth column contains the patient’s score for each outcome tested on the date indicated. Column five calculates the patient percentage of change for each measured outcomes over the selected time period. The notes section includes any patient notes you have entered in Orion Outcomes.
 
Risk Profile Report Card
This patient risk report card is and excellent tool that can be provided to each patient after every evaluation period. It provides a health risk appraisal for cardiovascular disease. Relative risk for each risk factor (smoking, weight, activity, blood pressure, cholesterol, diet, depression and diabetes) is rated as high, moderate, or low with a numeric overall risk rating in the center box. The report card includes the patient name and evaluation date along with a risk profile reference table. The reference table can be found in the AACVPR Guidelines for Cardiac Rehabilitation.
 
Risk Profile Summary
This report is an excellent tool to show risk factor (smoking, weight, activity, blood pressure, cholesterol, diet, depression and diabetes) change between each evaluation period. The evaluation period is listed down the first column of the table. Only those evaluations that have been completed are included. Each risk factor is identified across the top of the table. The boxes in the table correspond to the evaluation and the risk and include the level of risk (high, moderate, or low) and the measured risk. This report can be provided to the patient to encourage risk factor reduction over time.
 
Program Reports
 
Average Patient Profile
This report provides you with an outcome profile for the average patient in your program. There are many ways to build this report. To start, you select the time period and the outcomes to display on the report. The report can be filtered endless ways to look at subgroups of your patients. The report defaults to using only data from patients who have completed evaluations at the selected periods. This is the recommended method for using this report. Using this report in comparison to the Patient Outcomes Summary will help you and the patients determine if their progress is above or below the average patient in the program. The outcomes listed in the first column are grouped according to outcome domain (behavioral, clinical, economic, and health) with the second column identifying the units of measure. (i.e. 1-5 indicates a scale of 1 to 5, NBS means norm based scoring). The next three columns are included on the beginning of the selected time period and the last three are grouped under the end of the selected time period. The number under the small “n” indicates the number of patients tested at both evaluation periods. These numbers should be the same unless you selected to look at all patient and not just patients who had completed both evaluation periods. The number under “mean” is the average value of the measured outcome in absolute units of measure (second column). StDev is the calculated standard deviation which is a measure of variability. The variability should be reasonably close for both evaluation periods or there may be a data entry error.
 
Change Summary
The change Summary Report is used to provide a comprehensive statistical analysis of your program outcomes. As always you can select the time period to analyze, what outcomes to include on the report and you may filter the report to analyze specific samples of your patient population. In addition the statistical values desired in the report can be selected. The count, minimum, maximum, mean, standard deviation and the significance level are sufficient for most programs. If you have a strong background in statistics you may find the standard error, sample variance, skewness, kurtosis, range, median, sum, t-value and p-value helpful and important. For a complete understanding of the use and value of these measures please consult a statistician.
 
The outcomes listed in the first column are grouped according to outcome domain with the second column identifying the units of measure directly below the outcome. The count is the same as “n” or the number of patients evaluated. Significance level is an important measure that should be understood. The default probability for level of significance is .05. If the box in this column is check it indicates that one is 95 percent confident that the measured values from the selected time periods are different from the first evaluation to the second evaluation. The change is said to be statistically significant.
 
Continuous Quality Improvement
Outcome measurement builds the foundation for the process to improve quality of care or improve program performance. The continuous quality improvement report provides data for selected time periods at specific intervals (monthly, quarterly, yearly). This report is best used with all time periods and quarterly data analysis. Several options exist for including basic statistical measures (count, mean, minimum, maximum), selecting the outcomes to be reported, and filtering the patient population. This report is best used in combination with the Trend Analysis Graph. Basically, this report provides the quarter by quarter analysis of change for all patients who completed the selected end evaluation during the specific interval. The mean change for each specific interval in time provides more of a quality assurance (QA) report to help demonstrate absolute measured outcome performance for the specific interval. You may see the mean change vary greatly from interval to interval depending on the number of patients tested. Specific interval variation does not necessarily demonstrate improved or declining performance for the measured outcome. For and indication of performance over time, use the Trend Analysis Graph.
 
Demographic Statistics
This report provides important information on the patients participating in the program. Generally, one looks at the demographics of all patients but it is easy to look only at patients for a specific time period. The report contains information on the number of patients, average age and age distribution, sex, average number of sessions completed for graduates and dropouts, dropout rate, percentage of patients involved in maintenance programs, percentages of patients classified as high, moderate and low risk through risk stratification, number of patients by hometown, referrals by physician, insurance carriers, evaluation completion, and patients by primary diagnosis. This report is used to provide a snapshot of your patient population. Insurance Provider Summary This report provides the number of patients covered by and particular insurance provider. The report can be built to provide either primary or secondary insurance providers.
 
Outcomes Goals
The results of this report should drive the continuous quality improvement process. This report identifies the percentage of patients who meet the treatment outcomes goals of cardiac rehabilitation as identified by the AACVPR Guidelines for Cardiac Rehabilitation. The report includes the percentage of patients who are non-smokers for greater than 6 months, on Beta-blockers and ACE inhibitors post myocardial infarction, with LDL less than 100, who exercise daily, with Body Mass Index less than 25, on antiplatelets or anticoagulants, and have hemoglobin A1c less than 7 percent.
 
Patient List
The patient list report provides and alphabetical listing of all patients with their address, phone number and birth date. The report can be created for a specific time period.
 
Physician Summary
This report provides the number of patients referred by each physician. The report can be built to provide either referring or primary care physician.
 
Program Profile
The profile report is the specific information related to how your program is delivered. This information is used to identify similar programs in the benchmarking process. The report includes contact information, program type, staffing, program length, components and education topics. To edit this information go to activities on the menu, select edit and program profile.
 
Risk Profile Change Summary (Cardiac Only)
As programs move from exercise based to risk based intervention programs the information found in the risk profile change summary is essential to the CQI process. This report provides a quantitative analysis of risk factor change over a ten year evaluation period. Positive number demonstrates an increased risk over the previous evaluation period while a negative number is consistent with decreasing risk. Once again this report can be created for a specific time period and filtered to meet specific sample conditions. However, the report provides the best information when used over a longer period of time.
 
Risk Profile Summary (Cardiac Only)
Demonstrating long term risk reduction is essential to the future viability of cardiac rehabilitation in a demanding health care climate. This report identifies the percentage of patients who are low, moderate or high risk at each evaluation period for each risk factor. Generally speaking, if the risk based intervention program is effective one will see the percentage of patients with low risk increase at each subsequent evaluation period after the pre program evaluation or a shift or movement of patients towards low risk. As always “n” is the number of patients who have completed outcomes testing for the evaluation period.
 
Graphs
 
Patient Health Status Profile
This report which can be shared with the patient provides an outstanding description and graphical representation of each patients SF-36v2 scores. The report is very useful in one on one discussion of test results with the patient.
 
Program Change Summary Graph
Many clinicians prefer to view outcome changes in graphical form. Keep in mind that a graphical representation may appear better or worst due to issues of scale and presentation. The change summary graph can be developed by selecting any outcome to graph for a specific time period and between two evaluation periods. The data can be filtered to meet specific sample conditions.
 
Change Trend Analysis Graph
This graph is the most useful visual tool used in the CQI process. The Change Trend Analysis Graph demonstrates the program performance trend over time for any selected outcome. Once again, the data can be analyzed for a selected evaluation period and filtered according to specific conditions. The clinician must determine if the outcome selected should have positive or negative change. For example if the outcome should have positive change between evaluation periods (6MDW) , then a program that improves performance over time will have a trend line with a positive or upward slope. Negative slopes should be seen in outcomes measures that decrease between evaluation periods (LDL). When the slope is opposite of the expected direction of change the program should act, through the CQI process, to reverse this trend.


Article Details
Article ID: 9
Created On: 19 Mar 2004 08:39 AM MST

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