Automated data mining of a proprietary database system for physician quality improvement.
OBJECTIVE
Physician practice quality improvement is a subject of intense national debate. This report describes using a software data acquisition program to mine an existing, commonly used proprietary radiation oncology database to assess physician performance.


METHODS
Between 2003 and 2004, a manual analysis was performed of electronic portal image (EPI) review records. Custom software was recently developed to mine the record-and-verify database and the review process of EPI at our institution. In late 2006, a report was developed that allowed for immediate review of physician completeness and speed of EPI review for any prescribed period.


RESULTS
The software extracted >46,000 EPIs between 2003 and 2007, providing EPI review status and time to review by each physician. Between 2003 and 2007, the department EPI review improved from 77% to 97% (range, 85.4-100%), with a decrease in the mean time to review from 4.2 days to 2.4 days. The initial intervention in 2003 to 2004 was moderately successful in changing the EPI review patterns; it was not repeated because of the time required to perform it. However, the implementation in 2006 of the automated review tool yielded a profound change in practice. Using the software, the automated chart review required approximately 1.5 h for mining and extracting the data for the 4-year period.


CONCLUSIONS
This study quantified the EPI review process as it evolved during a 4-year period at our institution and found that automation of data retrieval and review simplified and facilitated physician quality improvement.
Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA. peter@radonc.emory.org
Peter A S
PA
Johnstone
Tim
T
Crenshaw
Diane G
DG
Cassels
Timothy H
TH
Fox
D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods* / Q000592:standards; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000592:standards; D018787:Radiation Oncology / Q000592:standards / Q000706:statistics & numerical data*; D011873:Radiology Information Systems / Q000592:standards / Q000706:statistics & numerical data*; D012984:Software; D013997:Time Factors