The Centers for Medicare & Medicaid Services (CMS) establishes priorities for the end-stage renal disease (ESRD) Network contractors annually in the Statement of Work section of each Network’s contract with the agency; these priorities support CMS and Department of Health and Human Services (HHS) national quality improvement goals and priorities.
Tasked with promoting best practices in vascular access management, the Information Management and Quality Improvement Teams at the IPRO ESRD Network Program worked collaboratively with Health Informatics to utilize Tableau Server, a cloud-based data visualization tool. Empowered with the freedom to explore national Fistula First Catheter Last (FFCL) data sets – without limiting them to pre-defined queries, wizards, or chart types – in conjunction with other national ESRD data sets, the IPRO ESRD Network Program was able to create a set of standardized reports (shown below) that led to enhanced business intelligence and innumerable data discoveries.
For example, in IPRO ESRD Network of the South Atlantic (NW6 – GA, NC, SC), the density map was previewed at the Vascular Surgeon Workgroup to graphically display the highest rates of long term catheters (LTC); upon in-depth review, the members suggested using the Tableau Server data to strategically target locations with high LTC rates that corresponded to vascular access surgeon residents whose services could be called upon to perform vein mapping in the field. This data view was able to supplement the group’s mission and provide the basis for potential collaborations previously untapped at the Network level.
Coupled with the peace of mind that both the underlying data and corresponding analytics are governed, secure, and accurate, the IPRO ESRD Network Program has credited Tableau Server for providing much-needed insight into the Networks’ Quality Improvement Activity (QIA) intervention deployment and subsequent tracking. At this point in time, the Information Management Team at the IPRO ESRD Network Program and Health Informatics have consolidated FFCL data fragmented across 64 (and growing) datasets into a single 2-million row dataset, capable of comparing and trending one-and-a-half (1.5) years of vascular access counts and rates across ESRD Networks, batch submitting organizations, facilities, and de-identified patient demographics. The result is increased functionality and reduced data manipulation effort as each standard dashboard and its underlying reports are applicable to all four (4) Networks in the IPRO ESRD Program.
The hybrid Network/Health Informatics team is currently working on the reporting functionality of data extracted from the Patient Contact Utility, a CMS-approved local database that captures patient grievances, in an effort to provide analysis of grievance trends and patterns. The ease of data sharing, robust integration, simplicity of scalability, and excellent reliability are all testaments to the comprehensive roll-out and implementation at the ESRD Networks guided by IPRO Health Informatics.