Digitalizing quality of care control: a Business Intelligence system for COVID-19 inpatients

Abstract

Abstract Issue As healthcare systems faced the challenge of the COVID-19, the need for fast and automated quality of care control has grown tremendously. Automatization is widely implemented in the form of Clinical Decision Support Systems (CDS), however, developing such software can take several years of trained IT specialists' work. Description of the problem We opted for an analytics and clinical decision support (ACDS) system based on Business Intelligence (BI) software, since it would allow to monitor the necessary clinical data, it was easy to adapt to current tasks and didn't require any special IT-educated specialists to develop and implement. From an individual patient's electronic health record (EHR) was extracted specific clinical data, such as vital signs, laboratory tests and CT scans, respiratory support data; medication prescribed and taken; chronic diseases, etc. Microsoft Power BI software was used to build the ACDS. The ACDS system consisted of three main elements: Flat tables (the data from EHR); Data model, connecting tables; Visualizations (tables and charts) depicting patients' condition, which provided the integration of information, the ability to sort data in necessary order, and intuitive marks, such as color indicators for specific parameter values. Results Named visualizations were integrated in daily work of the heads of units. Out of 1683 patients admitted with COVID-19, 1415 were undergoing treatment after implementation of ACDS system. It was used to correct the treatment course of 568 patients. The following corrections were made: Accuracy of diagnosis (138 cases) and assigned severity (115) Prescribed and delivered medicines (32) Dosage adjustment (25) Transfer to ICU (2) Discharge (412) Lessons Thus, engineering analytical and clinical decision support system based on BI appears to be an advantageous way to automate the control of care quality in challenging and time-pressing circumstances. Key messages In a situation of unprecedented time pressure and resource shortage, the best option for quality of care control might be a simple BI system, rather than a designated CDS software. The practice of COVID-19 analytics system implementation can become a foundation for designing a bigger transparent analytics system that can be adapted to any patient model or clinical entity.

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