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.
Johnstone
Peter A S
PA
Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322, USA. peter@radonc.emory.org
Crenshaw
Tim
T
Cassels
Diane G
DG
Fox
Timothy H
TH
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