Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Development of a quality of care dashboard in breast cancer using EHR data (#168)

Candice Donnelly 1 2 , Shima Ghassem pour 1 , Kirsten Jackson 1 2 , Nirmala Pathmanathan 3 , Elisabeth Elder 3 , Farid Meybodi 3 , Anna Janssen 1 2 , Paul Harnett 2 4 , Tim Shaw 1 2
  1. Faculty of Health Sciences, University of Sydney, Camperdown, NSW, Australia
  2. Sydney West Translational Cancer Research Centre, Westmead, NSW, Australia
  3. Westmead Breast Cancer Institute, Western Sydney LHD, Westmead, NSW, Australia
  4. Crown Princess Mary Cancer Centre, Western Sydney Local Health District, Westmead

Background

Breast cancer care is complex and resource intensive. Whilst clinical guidelines are well established, the causes of variation in breast cancer care remain uncertain. Care delivery may vary dependent on service attributes. Therefore, readily available quality measurement and feedback is essential to monitor care and guide improvement.

 

Aims

This project aims to empower clinicians in monitoring evidenced based care using a dashboard applied to electronic health record (EHR) data within the Westmead Breast Cancer Institute (BCI). The study objectives include;

  1. Test the feasibility of applying quality measures to a breast cancer dataset of consolidated EHR data.
  2. Develop an analytics tool (interactive dashboard) to visualise the quality measures.

 

Methods

The dashboard was co-designed to ensure clinical relevance and optimise opportunities for translation into practice. A clinical working group was engaged in fortnightly consultations to identify content for quality measurement and presentation on the dashboard. In collaboration with the Western Sydney LHD analytics team, EHR data sources were mapped and extracted into a breast cancer consolidated dataset. The interactive dashboard was built to visualise quality measurement results. The dashboard underwent iterative feedback sessions to create a final dashboard for service implementation.

 

Results

A set of 24 quality measures on the timeliness and appropriateness of care, and patient outcomes were identified and refined. Four heterogenous EHR data sources are auto-extracted daily and populate the consolidated breast cancer dataset. A prototype dashboard, built in R Shiny Dashboard was translated into the NSW Health Qlik Dashboard application. The final dashboard successfully analyses and presents the 24 quality measures. The dashboard's use and impact on quality monitoring and improvement will be evaluated over 2019-20.

 

Conclusion

This project highlights meaningful use of EHR data to provide timely, relevant and reliable information on quality of care and offers great promise to drive improvements in cancer care delivery.