Digital Dashboards & Business Intelligence: Defined at Last

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The RADIANCE dashboard uses open-source software to extract CT dose data and help estimate radiation exposure. Image courtesy of the Hospital of the University of Pennsylvania.

Business intelligence. Digital dashboards. While the terms are often bandied about, radiologists and imaging stakeholders are striving toward more precise definitions and applications to help their practices gain maximum efficiencies. In search of a consensus, we asked leaders in the field to understand current applications and future potential.

"[B]efore outcome data can protect patients, drive payment, sanction providers, inform the public or spur improvement, the healthcare industry must determine acceptable levels of validity and reliability and develop a mechanism to collect these data," wrote Peter J. Pronovost, a professor of anesthesiology and critical care medicine, surgery, and health policy and management at the Johns Hopkins University, in Baltimore, in the April edition of Health Affairs.

Such mechanisms hinge on standardized language and metrics. In radiology, leaders are revving their engines to standardize imaging management reports. Bradley J. Erickson, MD, PhD, from the department of radiology at the Mayo Clinic in Rochester, Minn., and chair of the TRIP (Transforming the Radiology Interpreting Process) Committee within the Society for Imaging Informatics in Medicine (SIIM), says that one of the more recent efforts for the TRIP Committee is to develop agreed-upon terms of nomenclature of processes for imaging department workflow.

According to Erickson, the project has identified 100 different names of points in the workflow of an imaging department. "Once we agree on what certain terms mean, we can have ways to electronically capture those events and then display them on a tool such as a digital dashboard," says Erickson. "If you want to compare effectiveness across departments then we need to agree on what different terms mean in a workflow."

Everyone wants to know their turn-around time but those times can be measured in different ways resulting in overcooked, good-looking data, says Erickson. Another useful metric in need of standardization is room utilization. Does the end user consider an imaging room being used for 24 hours a day or when the doors to a hospital open? The discussion to standardize these metrics to forward quality care is needed, says Erickson.

Erickson and colleagues, who plan to demonstrate the concept and gather feedback at the SIIM meeting in June, have created a database with anatomical examinations of various times and identified key metrics and those events present in the database.

"Standardizing the definition of clinical information will be an important advance in dashboarding tools," Erickson explains.

Internal development

Just because digital dashboard tools haven't hit the streets in waves doesn't mean a hospital should ignore the option to develop its own solution. For instance, Woojim Kim, MD, assistant professor of radiology and associate director of imaging informatics at the Hospital of the University of Pennsylvania (UPenn) in Philadelphia, created a Google-esque web-based search engine application and analytics dashboard for the University of Pennsylvania Hospital's RIS in 2009. Containing report text and metadata on more than 13 million reports dating back to 1988, radiologists can easily search and data mine imaging reports.

"Most institutions have been, in terms of radiology reports, digital for a long time and are sitting on a mountain of data," says Kim. It used to take hours to days to request all exams relating to a condition such as pneumonia, he notes. It's now accomplished with the click of a radiologist's mouse, typically in less than a second.

Rounded out with interactive demographics and graphics, a radiologist can access individual report results and a bird's eye view of search results.  The metadata can be broken down to display summaries like gender distribution, study years and ordering physicians.  Because the application is not tied to a specific vendor, the information is presented in a uniform and consistent manner regardless of the source, and the application can tap into other specialties in medicine like pathology.

For administrators, the dashboard provides a high-level tool to understand the state of the hospital. For example, Kim notes that turn-around times at the Hospital of UPenn have decreased since the dashboard was deployed. "The dashboard