One-on-One with NewYork Presbyterian CIO Aurelia Boyer, Part I

AB: The data that NYP has been uploading to Amalga includes text-based exam reports of different types (cardiac catheterizations, EKGs, Echocardiograms for example), Eclipsys CIS data (discharge medication lists, discharge notes both nursing and physician, chest tube drainage for example), and other departmental systems (operating room, blood bank, laboratory for example). Amalga provides functionality beyond being able to view this data to provide care to a patient — we have other systems optimized for that function. Amalga extends analytic capabilities to the data and, most powerfully, it allows us to pick out data elements for analytics that were previously stored only as part of a final report for storing and viewing.

A specific example is to find through Amalga all the patients who had an ejection fraction of less than 35 percent (a finding in a cardiac catheterization report which is not stored as a separate data element in a results reporting system the way a single laboratory value is stored) and who had a QRS interval over 1.1 msec (which requires calculating the different lengths of the EKG wave components reflected in an EKG report). We can now search the database to retrieve the patients that meet both criteria. This is not possible with a database developed for results reporting, or most data warehouses where the text-based result is stored as a single element. The ability extends beyond finding the data element; it also allows the calculation of the values that are relevant to the analytic in a single step. This was not possible with our current data repositories.

AG: What is the traditional method for inquires like that? Does it filter up to the CMO and then somehow get over to IT in terms of a request for specific medical data or a specific measure? Is there a formal process?

AB: The formal process around most of that would be through the IRB method here because, generally, if you’re asking a question like that, you’re doing it for a research purpose. Then, the other way we send requests for data is through the quality department, and so we have a physician that’s the chief quality officer, and so that would be the other formal mechanism of how a request like that would come to us.

AG: So Amalga helps extract the right data?

AB: Quite honestly, Amalga has been faster for us than our homegrown repositories were. I don’t want to say it’s always there, but in this case we had done a lot of work around cardiology, and so it was there. Now, we’re going to move through other areas, but, once again, we’re pretty far through some of the basic clinical data. Obviously, we may not have every neuro piece of data or other things, and so that data flow really is a formal research process for the most part.

AG: Let’s talk a little bit more about www.mynyp.org. When patients log in, are they in the HealthVault application?

Part II Coming Soon