Physician Profiling: Overcoming Data Challenges

There are several challenges that need to be overcome when trying to automate the generation of Physician Profiles electronically. In our example, we're going to create a profile to be used to assess performance for ED physicians on Heart Failure Patients. Included in the profile will be various HF measures including Core Measures, LOS, Cost, Charges, and Patient Satisfaction.

Following is a list of challenges that need to be overcome before we can automate the creation and viewing of this profile:

Statit has worked closely with our customers to understand these challenges and has developed the Statit Physician Profile & Review product in response to these issues.

Profile Indicators come from Different Data Sources
Our primary challenge is that the indicators we want to use for the profile come from different data sources (see image below). Of course, the ideal solution is to collect this data and store it into a central warehouse for reporting. Unfortunately, this is a big task and we may not have the resources available to perform this now. Statit Physician Profile & Review solves this immediately by allowing you to point at many different data sources to access the data so you can leave the data elements in their current locations.

Different Identifiers are Typically Used for Physicians
The next big challenge is the fact that data sources are used in different ways to identify the specific physician associated with the encounter. For example, the Core Measure data from our ORYX Provider may be using the Physician License #, the data from our EMR warehouse may be using an internal Physician ID #, and the Survey data may just have the Physician Name associated with the survey questions. To solve this issue, Statit Physician Profile & Review allows you to define Physician Lookup Tables to allow this cross reference. Below, find the Lookup Table used for this profile. Please note that there are different columns that are set up to match how the various data sources have encoded the Physician Info.

Physician Lookup Table Example

Need Consistent Way of Labeling Physicians within a Profile
The use of the Lookup Table also allows the reviewer of a Physician Profile to see all of the physicians presented with the same identifier, regardless of how a specific data source has identified a physician. This is done by specifying which column in the Lookup Table should be used to identify the physicians. For reviewers looking at specific physicians, the identifier is likely going to be the Physician Name. In the sample below, the HF Cost was identified using the PhysicianID, but Statit Physician Profile & Review automatically used the PhysicianName column from the Lookup Table to identify the physicians to the reviewer.

Using Consistent Physician Labels

In addition, you can also set up indicators that may be more public so that others can see how physicians compare, but where the physician identifiers are blinded. This allows users to see how each of the physicians stack up, but they cannot explicitly identify who the physicians are. This can easily be done by adding a new column to the Lookup Table which contains the identifier that will be used in that case.

Managing Peer Groups for Comparisons
For the purpose of comparing physician performance to others, we really want to compare a specific physician's performance to that of their peers. The Specialty column(s) in the Lookup Table can be used to further define different groups of physicians and this information is then used to determine the peer groups. So, when a specific physician's profile is displayed, it will look up the physician's specialty and automatically establish the peer group to be others with the same specialty.

The Specialty fields also provide a way to assign different doctors to different reviewers. Each reviewer that is configured in Statit Physician Profile & Review can be restricted to only access physicians and manage reviews for a specific specialty if desired.

To learn more about Physician Profiling, we invite you to view Dr. Henry Johnson's, Medical Director of MIDAS+, webinar entitled Physician Profile: Impact on Quality. After viewing Dr. Johson's webinar, contact us at (541) 752-4500 or via email at to schedule your personalized demonstration of the new Statit Physician Profile & Review product.