TABLEAU TUTORIAL: A Quick Look at Meaningful Use EHR Adoption by Eligible Providers

I asked my class to answer a few questions about electronic health record (EHR) adoption in Virginia as a first warm up exercise in Tableau.  The data is from the CMS website with additional provider information added. For this exercise I only used Virginia MU Stage 1 data to keep the file size small, but this would also be fun to do with all of the national data.

If you are not familiar with MU data, it is sort of a EHR use report card for office based doctors, dentists, midwives, etc.  “Report card” is a little misleading, it is actually self-reported EHR utilization scores that providers send to the government to receive incentive money and avoid penalties.  Here is a codebook for the data I am using.

Each row of the data has provider information, the year, a 1,2, or 3 indicating if this is the first or third time they submitted, core measure scores, and menu item scores.  Core measure scores are usually a percentage, and are things like “percentage of patients with medication orders entered using CPOE” (CM1), and “percentage of patients with medication list maintained electronically” (CM5).

Open the MU PUF data in Tableau

MU_data_ready_to_go

Meaningful Use Public Use File in Tableau

Tableau will take its best guess at what data elements should be Dimensions and what data are Measures.  I moved (by dragging) all of the measure data into the Measures panel and hid most of it by right clicking anything that wasn’t what I was interested in and selecting “Hide”. (See picture to the right)

 

View Average Core Measures ( of Utilization) Per Year

Drag MU core measures over and dont forget to change aggregate function to AVG

Drag MU core measures over and dont forget to change aggregate function to AVG

To see a simple bar chart of average Core Measure scores, drag Attestation Success Date to Column tray and one or more CM scores to the rows tray. Once you drag them over, dont forget to change the aggregate function from SUM() to AVG().  Since all f the data measures have similar names, you might even want to rename them (by right clicking).  For example, I’m going to rename “CM1 Percentage” to CPOE and “CM4 Percentage” to ePrescribing.

Now you should have a chart with the averages per year for all core measures.  If you want to view a specific practice and compare to the state average, you have at least two options. (there us a third popular solution to this that involves duplicating your data set, but I wont describe that one here)

MU_CM1_CM4
Option 1 to compare one practice to the state average is to just make multiple charts and use the filter

The easiest way is to duplicate your worksheet, and then use the filter pane to show only the practice(s) you want included.  This way you have multiple charts, each showing a different practice (or one showing the state average). This is fine, but visually comparing two charts is tough, and it would be nicer if you could see the practice data with the state average right there in the same chart.

Option 2 to compare one practice to the state average is to create a Calculated Field that shows the practice you are interested in.
Create a calculated field

Create a calculated field

If you can do formulas in excel, then you can do calculated fields in Tableau.  If you are a little weird-ed out at first, just keep practicing. They get easier the more you do them and they are awesome for making very powerful, tricked out analyses.

This one is not very tricked out, it is simply a filter.  I click on measure CPOE (used to be called ‘CM1 percentage’) select create–>Calculated Field.

Give it a name that makes sense and add code similar to the following:

IF [PP Prac Name]= "Virginia Women's Center"
THEN [CPOE]
END

 

example code for the calculated field

example code for the calculated field

Now you have a measure that will show CPOE use for only one clinic that you can display right next to the average CPOE use of all clinics.

Drag ‘Attestation Success date’ to the columns,and  ‘CPOE’ and ‘VWC CPOE ‘ to the rows and you can see them side by side.  Try the dual combination or dual lines chart types.

Dual Combination chart with one clinic next to average of all

Dual Combination chart with one clinic next to average of all

jon.

Dr. Jonathan P. DeShazo is an expert on health information technology, clinical data, and consumer informatics. He is currently an Assistant Professor in the Department of Health Adminstration and serves as Scientific Director of the Biomedical Informatics Core at Virginia Commonwealth University.

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