SlicerDicer workshop

November 15, 2022

ID9100

To CiteDCA Citation Guide

00:05The pop up window.
00:09But this slicer Dicer guide is 74 pages.
00:12It's very detailed.
00:14It was developed by Jennifer McCann and
00:17Jada team to help us out with regards
00:21to learning about slice or dice.
00:23So it's really a very,
00:25very good resource for you to
00:27look at as you begin your journey
00:29towards using Slicer Dicer.
00:34So the next one I wanted to point
00:36out are these training videos.
00:39These are linked to our learning
00:42management system or the LMS?
00:46So as.
00:50Yale faculty, you do have access to it,
00:53you just need your epic
00:57credentials to log in.
00:58Use your same password to log into epic
01:01to get to the learning management system.
01:04So the link is right here.
01:07I'm using my laptop,
01:08maybe that's the reason why,
01:10but if you're on your desktop,
01:11you should be able to access
01:14the learning management system.
01:15And the rest of the learning
01:17home breaks down a different
01:19learning materials according to
01:21the models or the data models
01:24that are available currently.
01:27For you to use.
01:30So now I turn you over to Emily and she'll
01:34walk you through in terms of, you know,
01:36how do we use Slicer, Dicer in general.
01:44So for for me and for most of you,
01:47there will be 3 primary uses of Slicer
01:49Dicer and all of them are have a lot
01:52of benefit that they can provide to
01:54you both in your research career
01:56and your patient panel management.
01:58So the first one is actually looking at
02:00your particular patient population and
02:02being able to figure out who needs what
02:05or what needs to be done using Slicer Dicer.
02:08I'm just going to give you an example
02:10of what some a couple of things
02:13that I've done and my patience.
02:15For you can be any number of things
02:17depending on your role in the hospital.
02:19So if you you're it's considered
02:20your patient.
02:21If you were an encounter provider,
02:22if you are the member of the
02:24treatment team and really any area
02:26of the patient care setting that
02:28includes the emergency department,
02:30inpatient, admission Care team member,
02:32surgical team member,
02:33whether it was a birth or
02:36pregnancy admission.
02:37And then if you're a member of the
02:39care team in any other capacity,
02:40there is a consultant or a
02:42primary care provider that a
02:44patient in which you've serviced.
02:45As those capacities would be your patient,
02:48what that means is Slicer Dicer is
02:50that you'll be able to see data
02:52about them at the patient level,
02:53so you'll be able to see specific
02:55information including all of their you know,
02:57their name and identifying
02:59information in Slicer Dicer itself.
03:01Which is really useful when you're
03:03trying to manage your own patients
03:05and figuring out who needs what.
03:06So these are just two examples that
03:09I have looked at lately for myself.
03:11So the one on the left hand side
03:13is I was looking to see how many
03:15of my patients that I'm seeing,
03:17I'm admitting and then looking
03:19specifically for some of those
03:22patients to figure out what happened
03:24to them and what their.
03:26More information about their
03:28hospitalization was so in Slicer Dicer,
03:30I was able to look for my patients
03:33in the ER and then divide them
03:35up by disposition whether or not
03:38I admitted or discharged them.
03:40And then if I go to one of the visual
03:42options and look for the table,
03:45what comes up is there identifying
03:47information.
03:47So spreadsheet for each patient with
03:50a number of identifying details and
03:52then I know what their MRI is and
03:54I can go then into the patients.
03:56Start to learn more about what
03:58happened or to address a certain issue.
04:00So for me that's something that's
04:01really useful in the ER,
04:02just finding out what happened to
04:03patients and kind of understanding how
04:05I'm doing and the global level for
04:07the patients I see for a variety of metrics.
04:09An example,
04:10before I was in the ER,
04:11I was a primary care pediatrician
04:13in the primary care center.
04:15And for that I might want to look
04:17globally at my patient population.
04:19So here I looked back at my
04:21primary care patients from 2014 and
04:23look to see of the patients for
04:25whom I'm the primary care provider,
04:27how many of them have had a well visit
04:29this year and how many have not.
04:31So there's not a ton of
04:32them for me at that time.
04:33But there were 115 of my patients
04:35that I had seen in their checkup,
04:37but 17 that had not.
04:39So then if I go to the patient.
04:40Level data I can look and see.
04:43Who those are that haven't had the well
04:46child check and then go into their chart,
04:48try and schedule them from
04:49from for a well child check,
04:51but I can see the individual patients
04:53and then take action based on you know,
04:55information that I've uncovered
04:57in Slicer Dicer.
04:58You don't need anyone's help to do this.
04:59It's something that you can do on
05:01your own in epic without having
05:03to contact anyone or get special
05:05permission from anyone to find
05:06out this level of detail.
05:08So that's,
05:09that's this can be a really powerful tool.
05:11One thing you can also do is share
05:13your patients ability to see your
05:15patients with other providers.
05:16So if you work in you know in a
05:18smaller area where there's only a
05:19handful of providers and you want
05:21to look at patients for your whole
05:22clinic or your whole practice,
05:23you can share all of the patient,
05:25your patients with each other and
05:27therefore like create kind of like a
05:29subpopulation of patients that are
05:30all specific to your your clinic.
05:35The next thing is quality improvement.
05:37So this is the quality improvement
05:38project that we're working in in the
05:40emergency Department for Children
05:41which is looking to see how many
05:43of our behavioral health patients
05:45have this day in our ER often for
05:47long time waiting for evaluation or
05:48a psychiatric bed are receiving.
05:51I am medications ideally we don't
05:53want them to get agitated to the point
05:55that they were require IM injections
05:57and so we're trying to reduce the
05:59number who are getting IM injections.
06:01So using Slicer Dicer I was able
06:04to look at all patients.
06:06Call Ed encounters,
06:07look at anyone who came in with
06:09a psychiatric chief complaint
06:11and then look and see,
06:13divide them by which type of IM
06:15medication they received and then
06:17you can graph this over time.
06:19So you can use this as a run chart
06:20for quality improvement essentially.
06:22And you can see that most of
06:24our patients get nothing,
06:25but there are plenty that do get something.
06:28This is percentage of the overall population,
06:30but you could look at absolute
06:31numbers as well and you can see
06:33that we're giving Thorazine,
06:34I am more commonly.
06:35Than we are a Benadryl and Haldol,
06:37but we're still giving it probably
06:39more than we want to be.
06:40You can set goals also like
06:42this dotted red line,
06:44you know is a sort of arbitrary goal
06:46that I chose for this demonstration.
06:48But you can also set thresholds so that
06:50if it's above a certain threshold or below,
06:53it will sort of be called out on this graph.
06:55So you can set this up as a run chart
06:57for your quality improvement project
06:58and it's something that you can also
07:00share the view with anybody else
07:02who's working on the project and they
07:03should be able to see it as well.
07:04So it's really helpful to be able to track.
07:06This is over.
07:08And the last thing,
07:10something that you guys are probably
07:12exceptionally interested in is
07:13using Slicer Dicer for research.
07:15In general,
07:16Slicer Dicer is best for what we
07:18would call hypothesis generation.
07:20So because you are not able to get
07:23the individual patient level data for
07:25the entire data set that you might
07:27want to be working with in Slicer Dicer,
07:29it would only be for patients that you
07:31yourself have a treating relationship with.
07:33It's not going to be good enough
07:35to sort of analyze that data
07:37for publication in the paper.
07:39So we have in a whole group whose
07:41job it is to get you that really
07:44specific and detailed patient data
07:46that you do want to go on to analyze.
07:49And it's a group called JADAK,
07:51which stands for the Joint
07:53Data Analytics team.
07:54But for those of you who
07:55need a specific data set,
07:57this is the website that you want to go to.
07:59So it's service now.
08:01Dot com you can see it here
08:03and you're welcome to copy that
08:04down and it will take you to
08:05a website that looks like this and
08:07in order to enter your request
08:08for patient level data that will
08:10come to you in spreadsheet form,
08:12for the most part this is the
08:13option that you want to select.
08:14So Jadot research data request.
08:18But a lot of times we don't necessarily
08:20need the patient level detail initially.
08:22We have an idea and we just
08:24want to understand.
08:25Am I in the right ballpark with this
08:28idea and slicer dicer is really
08:31helpful for that specific idea.
08:33So for I haven't,
08:34I had a student come to me recently
08:36wondering if she could work on a
08:38quality improvement project include
08:40improving the time to pain medication
08:42for sickle cell patients in the ER.
08:44But we weren't even sure how many
08:46patients we were seeing in the ER who
08:48were presenting with sickle cell pain crises.
08:50So for slide structure,
08:51the two of us got together and
08:53just trying to figure out what
08:54are our overall numbers.
08:55Are there enough patients in which
08:57we could see an impact and make
08:59this a quality improvement project
09:01worth pursuing or ultimately a
09:03research project worth publishing on.
09:05So for in this example,
09:07we looked at all in Ed encounters and
09:10anybody who came in with a sickle cell
09:13disease diagnosis and then we ruled out,
09:16we took out all patients that had
09:17received antibiotics because we
09:19wanted to make sure they weren't
09:20there for additionally another
09:21complication of sickle cell and
09:22then we just looked at the numbers.
09:24So it's ranges anywhere from 2 to 12.
09:27Per month and the pediatric ER
09:29specifically and we decided together
09:30that was probably enough to pursue
09:32the project and so this kind of thing
09:34comes up a lot, just wondering.
09:37Even for Curiosity's sake,
09:39whether or not trends are changing,
09:41are we seeing more of this in my
09:43clinic or less of that in my clinic?
09:44And then moving on to more specific
09:46research proposals as well.
09:47This is a great place to start.
09:49Just to get an idea of ballpark numbers
09:51is like a few in a feasibility capacity.
09:54So those are the three main areas
09:56that we use Slicer Dicer for,
09:58but there's plenty of others
10:00as well if you guys explore.
10:05They'll hand it back over to
10:07Richie. Thanks, Emily. Hmm.
10:12Alright. So now we get to
10:16actually trying Slicer Dicer.
10:20So what we're going to do today is
10:24basically walk you through how you
10:26use Slicer Dicer and then we're going
10:28to break out into two groups and
10:31we'll be looking at different data
10:33models that are available for you,
10:35as well as run some sample queries
10:38so that you know how it works.
10:40And if there are any specific
10:42questions that you have, we can.
10:44Early answer them there.
10:47So I'm back on my slicer
10:49Dicer learning home screen.
10:51So you ask, how do I access slicer Dicer?
10:55I'm going to teach you two ways.
10:57The first one is via the epic menu,
10:59which is right up here.
11:01I like to use keyboard shortcuts,
11:03so if anybody's interested,
11:05the keyboard shortcut for
11:07this if you're using your PC,
11:09that would be the ALT key.
11:12So I'm just gonna click on that.
11:16What you want to do is look for reports.
11:20And then find Slicer Dicer and you
11:23can certainly click from here once.
11:25If you Slicer Dicer already,
11:27it will live under the recent
11:29area and then if it's there,
11:32what you can do is just pin it so that
11:36it always appear in your epic menu.
11:39You can actually also configure it to
11:42so that it appears up here as well.
11:45The 2nd way to actually get the
11:49Slicer dicer is by using chart search,
11:52which is this icon here.
11:55You click that,
11:57there is a keyboard shortcut for it.
12:00It's control plus space.
12:02What you do need to do now is type in
12:06Slicer Dicer or the 1st 3 letters even.
12:09So now it pulls up a slicer
12:12dicer and I can click on it.
12:15To get me to the slicer dicer.
12:26Data models currently,
12:28depending on your access level,
12:31you may have more or less data
12:34models that you can work on.
12:37If you hover around a data model,
12:39you can see that there's
12:41this information icon here.
12:43You want to click that to
12:44take a look and see what the
12:46description of that data model is.
12:48For the purposes of our demonstration today,
12:51I'm going to use the patient's data model.
12:56I'm clicking on that so this is
12:59your startup Slicer Dicer screen.
13:01For those of you who have never
13:04used Slicer Dicer before,
13:05you will actually be greeted
13:07by a beginner tutorial.
13:09You'll be prompted to take that
13:12beginners tutorial first before you
13:15can actually start doing your queries.
13:18Up here on the right hand side
13:20is an icon for the tutorials.
13:22That beginner tutorial will
13:24also be found here.
13:26There's another tutorial there that
13:28you can also access that also helps
13:31you with additional things you
13:32want to know about Slicer Dicer.
13:34So the screen is divided into 3 areas,
13:38the left hand side.
13:39As you can see here,
13:41there's a bar graph there,
13:43so every time you put in items
13:46within your query.
13:48So the Slicer Dicer automatically
13:51calculates what you've put in and will
13:54give you an actual result right away.
13:57So when I hover here,
13:59you can see that there's a
14:01description of the bar graph,
14:02how it, how I got to this point.
14:05For example,
14:05here it's the number of patients,
14:08this is the number of patients that
14:10have access to which represents the
14:12Yale New Haven Health System Service area.
14:15So if I put it in specific
14:19criteria for my search,
14:20it will also appear here.
14:26So as you can see up here,
14:28this is the name of the graph.
14:30If I click on it, I can actually edit
14:33it and customize it according to what
14:36I want for the graph to be named as.
14:39On the upper right hand corner
14:42here is an information icon.
14:44If I click on it, this will allow me
14:47to actually put in description for
14:50the search or the graph that I have.
14:52The words all time here represents the data,
14:55the data points or the the
14:58time points rather,
14:59for which my graph is based on.
15:03The default time frame that Slicer
15:06Dicer has when you start putting
15:09in criteria will be six months.
15:12At the bottom here in your X axis
15:16you will be able to actually.
15:22Sorry but the zoom bar is
15:26on is obstructing my view.
15:30So this is the ad access label.
15:32You can click on that to create
15:35a different label for the graph.
15:38So the second are the middle
15:41column and the right hand column.
15:45They're kind of related to each other,
15:46so there's five different components.
15:49Here are items here that I can manipulate,
15:52manipulate to help with my search
15:56and to also give me different
15:59visual options for the graph that
16:01I have here on the left hand side.
16:03So if I start putting in items
16:07for my population.
16:08Like here it's in the population side.
16:10Now you can see on the right hand
16:14side that it's set as the base
16:16which is all patients and then
16:19if I start putting in criteria
16:22that criteria will automatically
16:24be placed here on this area here.
16:28So the second portion after I defined
16:31my population will be the slices.
16:33So basically here what what's happening
16:36is just you're grouping the population
16:39into different groups or slices.
16:41And then here on the third item is measures.
16:45So I can apply certain measures
16:47here to define my results,
16:50for example like percentages.
16:51The next one is dates.
16:56So here you can actually set
16:58the dates that you want.
17:00Again as I mentioned the.
17:04Default date range of six months,
17:06but you can certainly change that
17:09according to your preferences and then
17:11the visual options will be here as well.
17:14The next section of our talk will actually
17:16walk you through a different items here
17:18so that we can do it in more detail.
17:21I'd also like to point out on
17:24top here the different icons.
17:27It allows you to undo your search redo,
17:30start over, load a search that
17:34you've saved in the past, like here.
17:41And then you can save your search here also.
17:44This is where you can save your
17:48share your search rather and
17:51also save it at the same time.
17:54And then the settings icon
17:55here allows you to change the
17:58settings for your slicer dicer.
18:00So now I turn you over to Emily and
18:02she'll walk you through some specific
18:05things regarding population and slices.
18:15Give me just a second.
18:16I'll pull up my epic. Hold on.
18:28If there are any questions,
18:30feel free to ask the chat options available.
18:33Also Jen McCann, our clinical
18:36systems analyst will help us
18:38out answer those questions also.
18:50We one question. Go ahead. Yeah,
18:53we have access to our own patients. What
18:55about all of the, if I wanted to
18:58have access to all of the patients
19:00from my section? Do I need to?
19:02How do I go about doing that?
19:07You can share your patient population
19:09with other members of your section
19:12in order to have them share with me,
19:14yes, like in order to really have
19:16everybody within the whole section
19:18share with access to everybody else's,
19:20you each individually have to go in
19:21and share your patient population with
19:22all the other members of the section.
19:24But you definitely could do so.
19:28Alright, sorry for the delay,
19:29kind of have closed on me.
19:34OK.
19:45And I couldn't find the.
19:47I I tried to do it I I was able to
19:49get the the Slicer dicer but the
19:52training dashboard I couldn't get
19:53to that page.
19:57Yeah so you in the dashboards right now.
19:59So if you are looking interested you just
20:01go to the title of the dashboard that
20:04you happen to be on once you click this
20:06little dashboard icon and I think if you
20:09search for Slicer Dicer it should come up.
20:12So there it is, Slicer.
20:13Dicer is all one word,
20:14which sometimes can, but OK.
20:18Is that does that work? Yeah.
20:19Actually, I think I was doing a space.
20:21I think that was the difference.
20:23Epic likes to do everything like one word.
20:25It's sort of a little silly thing
20:27that they do, but OK.
20:30All right.
20:31So for as you're getting
20:32started with Slicer Dicer,
20:34the first thing that you want to do is
20:36kind of define your patient population.
20:38So it will ask you to select a data model.
20:40And you kind of want to think about,
20:42you know your Excel spreadsheet
20:44in your head and ask yourself,
20:46what does each row in your imaginary
20:49Excel spreadsheet represent?
20:50Do you want to know just about
20:52your patients as a whole?
20:53Are you looking at like specific visits?
20:55Like if one patient has had five visits,
20:57do you want each one of those
20:59visits to have a separate line?
21:00Like you really want to know about
21:01what happens within the visit?
21:03And then are you looking just
21:05at particular Med orders or
21:08referrals or a research study?
21:11So that will help you select which data
21:12model you want to go with and that's
21:14how you want to be thinking of it.
21:16Like these data models are sort of
21:18like that line in the spreadsheet.
21:19And you can see I have probably
21:21more than most of you will because
21:23I'm a physician builder.
21:24So there's probably 15 that are
21:26listed here that I have access to,
21:29but Epic actually has more than
21:3150 of these that they have made.
21:33And that's looking at like all different
21:36kinds of aspects of the patients
21:37care and we are in the process of
21:40releasing more and more all the time.
21:42So if there isn't something that you
21:44see that you would like to see now stay
21:47tuned is definitely something that we
21:49are rolling out on an ongoing basis.
21:51For instance,
21:52something things that we don't have yet
21:53but which are coming would be a data
21:55model for inpatient hospitalization
21:56specifically where each line of that
21:58spreadsheet would be a hospitalization.
22:00There's also imaging studies,
22:02anesthesia records.
22:03You stays birth,
22:05outpatient, prescriptions,
22:06pregnancies,
22:07those are all things that we
22:09have in the works and epic is
22:11also developing more that they
22:13haven't actually implemented yet.
22:14So there's going to be something
22:16here for almost anything that
22:18you could think of eventually.
22:20So keep checking back for more.
22:22And for the purposes of demonstration today,
22:24I'm going to go with the patients model
22:26and this is the model that probably
22:29will be most useful to you all.
22:31But the first thing that you want
22:33to do when you are opening or
22:35starting a session is define what
22:37your patient population will be and
22:39the more specific you can be with
22:41that the better your results will be.
22:44So for we were doing a project and
22:46I'll use this kind of as an example
22:48in the ER of looking at how many,
22:51we were wondering how many patients
22:53came in with pelvic pain and then had
22:55a pelvic ultrasound ended up getting
22:57diagnosed with ovarian torsion.
22:59So we can kind of use the.
23:00Sites or dicer to figure that out.
23:02So what our patient population we really
23:05only want adolescents and we want them
23:07to have come in with abdominal pain
23:09and we want them to have had a pelvic
23:12ultrasound and we want them to be female.
23:14We don't care about any
23:16of the other patients.
23:17We might want to know different
23:18things about that population,
23:19like who ended up with a very
23:21intelligent versus who didn't.
23:22But for we don't care about anybody
23:24else in the whole health system except
23:25for that like subset of patients.
23:27The way you want to define that subset
23:29is always using this population tab.
23:31So get as specific as you as you
23:34possibly can within this population tab.
23:36So the first thing that I'll do,
23:38I tend to use browse over here
23:40rather than search for criteria,
23:41but you could do either one and so I'm
23:45looking to narrow my patient population to.
23:48Females who are less than 21.
23:52And so patient demographics is a folder.
23:54There are a lot of folders
23:56you can choose from.
23:57These blue folders aren't really folders,
23:59they're just items in themselves.
24:01So if you pick BPA triggered for instance,
24:04it will just be like a yes or no.
24:05It is the criteria itself,
24:07but all the yellow ones have
24:09items that within each folder.
24:11So for us,
24:12there's a lot of things within
24:14patient demographics and I'll
24:16just choose age in years.
24:18And then if I click up here I'll say
24:2021 and I want it to be less than 21.
24:24And then you can see it narrows all
24:27my all patients who are less than 21
24:29are in my population and everyone
24:31else is now no longer included.
24:33And then I can go back to that
24:35and do the same thing.
24:38For legal sex. So I'm really only
24:44interested in women. Females.
24:52And then it's narrowed further from there.
24:54And then I want to say why?
24:55I really only want to to.
24:58I only really only care about
25:00them if they were seen in my ER.
25:02And so you can look under the encounters
25:04folder has a lot of things about a
25:06particular encounter and so I can
25:07look for patients only that have had
25:09an encounter in the pediatric ER.
25:12So this is the department that
25:13I've selected and I'll click
25:15the pediatric emergency depart.
25:33And say I think, oh, well,
25:34you know, actually see patients
25:36sometimes it's shoreline too.
25:37Let me include that.
25:38You can select as many departments
25:41as you want and then this you
25:43can switch the logic of your
25:45multiple criteria to or or and.
25:48So for instance, say I was interested
25:49only in patients that had started at
25:51Shoreline and went to the pediatric ER,
25:53I could switch this to Anne.
25:56And you can see how many
25:57female adolescents had been to
25:58both emergency departments.
26:06Fewer, but for this purpose,
26:08we'll switch it back to or and
26:09there are a lot of different
26:11criteria to choose from as well,
26:12so we can go back and
26:15look for chief complaint.
26:17Looking for abdominal pain?
26:41OK. And then we also want to look and
26:44see if they've had a public ultrasound.
26:48So once one of the folder here that's
26:50listed procedures is really you want to
26:52think of it as any order that you could put
26:54in that would have a result rather than,
26:57you know, a physical procedure
26:58that you might do on a patient.
27:00So in the procedures bucket
27:02would be any lab order,
27:03any imaging order and it would be
27:05the things that have been completed.
27:07So if it was ordered and cancelled,
27:08it's not going to appear in
27:10this procedures folder. Or.
27:14So I'm going to look for
27:16ultra pelvic ultrasound.
27:31And you can select any that you
27:33think might be relevant and you can
27:35see here this little icon next to
27:37these are linking them together.
27:39So I really only want to see
27:41patients who had a visit with a
27:43pelvic ultrasound at that visit.
27:45And you can link subsequent criteria
27:47to that particular encounter rather
27:49than just to the patient overall,
27:50meaning they have to be synchronous
27:51at the same time.
27:54In order you can also find out if you're
27:57not really sure what these criteria mean.
27:59You can click on the information tab
28:00and it will tell you a little bit more
28:02so it will tell you how they define it.
28:04And then if you're really epic savvy,
28:05you can also click on the
28:07show lineage information.
28:07That will tell you exactly what the sort of.
28:11Areas of the tables on the back end
28:13of epic it pulled from and what
28:15the item is called in Epic itself.
28:17You can sometimes find this
28:19information within EPIC,
28:20but if you really want to know like
28:21how is this information being derived,
28:24this is the way to find it.
28:25And sometimes that can help you when
28:26you're asking Jadot for a data set too.
28:28Saying this is what I found in Slicer Dicer.
28:30These are the tape,
28:31the you know the columns and the
28:32items that were filling my query
28:33and this is what I think I want.
28:37So once you have,
28:39this is my basic patient population and
28:41then you can go on to slice it as well.
28:43So there aren't that many patients here.
28:45I might want to expand my imaging criteria,
28:47but for now this is going to be fine.
28:50So I want to know how many of them
28:52ended up having ovarian torsion versus
28:53not and I want to see both groups.
28:55So that would be the second box.
28:57We've narrowed our patient
28:58population sufficiently and now
28:59we're going to go to the second box,
29:00which is just a slice or basically
29:03dividing that up into groups.
29:04The same folders will appear under slices
29:07as appeared under the patient population.
29:09So you'll get familiar with these
29:11folders and items that you can choose.
29:13And in this case I want to choose diagnosis,
29:15so I'm looking for a diagnosis
29:17of ovarian torsion in particular.
29:34And it's like sometimes you have to be
29:37like specific about what you put in.
29:40Or try different things and be you know,
29:42be a little patient and try as
29:43many things as you can in order
29:45to find what you're looking for.
29:48And so we can look at all of those.
30:06The more things you kind of put in,
30:08it can take a little bit longer.
30:10And so for that we kind of suggest
30:12leaving the dates to a relatively brief
30:14period of time as you're setting up how
30:17you want your visualization to look.
30:19So the past three to six months,
30:20six months is what's defaulted.
30:22You're under the date dates,
30:23and once you feel like you have the
30:25visualization you're looking for and
30:27you can expand all the way to include
30:28whatever dates you might be interested in.
30:31So you can see none of the patients
30:32who had these had pelvic ultrasound in
30:34our ER ended up having ovarian torsion.
30:39And then once you have,
30:40if you have the visualization you want,
30:42you can save it actually so you can save.
30:46This. Session call it whatever
30:48you like and it will.
30:50And then when you go back to load,
30:53if you click load you can just
30:55reload that particular session.
30:56You can see how many I have here.
31:01The other thing that you can do
31:02is share the session with people.
31:03So once you've saved it,
31:04you can share it with any other user.
31:07So if the two of you two people
31:08are working on the same project or
31:09have the same patient population,
31:11you can they everyone doesn't have to do
31:13the visualization again for themselves,
31:14it can be shared with everyone else.
31:16Now I'll hand it back over to Richie.
31:22All right. Thanks, Emily.
31:32I'm just trying to screen share my screen.
31:36So those 3 point whatever 7,000,000
31:39patients. Are available to
31:42you guys because you guys do this, right.
31:45They're not all available to us.
31:46We only have our own patients.
31:49Are available to you.
31:50You just can't find.
31:52You wouldn't be able to
31:53find out who they are.
31:53That makes sense.
31:56So there's like a little icon
31:57under visual options that will
31:59give you that table that I showed
32:01earlier where you can see who the
32:02patient is and any information you
32:04want about them that will only
32:06be available for your patients.
32:07But every other thing,
32:08the graph is you can look
32:09at all the patients.
32:13Yeah, to speak to that as well,
32:15I have a new search here.
32:17So as you can see, the base for
32:19my population is my patience.
32:23So if I do the drop down here,
32:26I have the choice of all patients
32:28versus my patients, right?
32:30So if I click on that,
32:32these are all the different items
32:36that is considered my patient.
32:39So it's either PCP, your anesthesia T
32:43team at attending attributed provider,
32:47you're the encounter provider, etcetera.
32:50There's the information icon here
32:52that allows you to actually look at
32:55the definitions for those specific
32:57items within the my patients category.
32:59So when when the search is about my patients,
33:03you technically have patient level access
33:06to all the patients within this search.
33:10So I'll show you how you can
33:12get there and look it up.
33:15So now this.
33:16The third portion within your
33:18search would be that slicer.
33:21Dicer allows you to apply certain
33:24measures for a population.
33:26So for this particular search,
33:28I'm basically looking for my patients
33:30where I am the primary care provider.
33:34They have a diagnosis of HIV.
33:36I have seen them at this SRC
33:39healing infection disease orchard.
33:41For this particular criteria I actually.
33:45This actually obeys the date range
33:47that I had put in here so that it will
33:51only pull up patients that have been
33:54seen at the healing center within
33:57the last six months and also put in
34:00that the patients need to be alive
34:03because sometimes you get patients
34:05who have a war diseased already.
34:08And I've sliced it according to
34:10the health maintenance topic,
34:11which is overdue for screening colonoscopy.
34:17Which is here.
34:19And I've actually set it to
34:22pull in information,
34:23whether it's regarding a colonoscopy versus
34:27colonography versus fit testing, etcetera.
34:31So as you can see,
34:33the logic for that is or.
34:38Now for this particular search I
34:40can also apply a certain measure.
34:42Currently it's number of patients,
34:45so I'll just click on the plus sign
34:47here so that I can see what measures
34:50are available for my particular search.
34:53So I can actually do a median
34:55age for instance.
34:57So I'll click on median
35:00and then age in years.
35:03So now automatically my graph on the
35:05left hand side will change and it
35:08will pull in the median age for the
35:11two populations that I have here.
35:13So on the left hand side the green bar
35:17shows me the the number of patients.
35:20Initially that have overdue colonoscopy
35:23and then the right hand side the
35:26purple or yeah I think that's purple.
35:29Purple Bar initially gave me the
35:32number of patients that do not have
35:36that particular overdue criteria.
35:38So now because they applied the measure,
35:42it now allows me to put it in it
35:44now actually put in that median
35:47age for these patients.
35:49So these are the other criteria
35:51that or the measures that you
35:54can apply for your patients.
35:56Now not it's not necessarily
35:57that all of this is available,
36:00but certainly you can see if that
36:03applies for your population and
36:05that Slicer Dicer is able to do it.
36:08So the 4th portion here on the
36:11middle column is
36:13the dates. I'll just ask this out.
36:17So when I click on dates.
36:20It puts this menu here where I can
36:23manipulate the specific dates that I want.
36:25Again as a default it's six months,
36:29but it can go as far as when Epic,
36:33when we, when we started with EPIC,
36:35which is way back in 2013,
36:382014 I think alright.
36:40And you can also slice it by year,
36:43by quarter.
36:44Certainly it depends on the search
36:47you're looking for if this particular.
36:50Spacing is appropriate or not,
36:54and we can show you specific ones later
36:58that actually applies the slicing by date.
37:04So now as you can see,
37:06this is a bar graph.
37:08It's a vertical bar graph.
37:09So that's what it's set in visual options.
37:12So there's about 12347 options that you have.
37:17You just click on the specific
37:19bar so that you can change it
37:22according to your preference.
37:24So what I did want to point out is
37:27this area called a detailed view.
37:34So the detailed view gives you
37:37actually the details with regards
37:39to who the patients are that came
37:42up for my particular search because
37:45I'm looking at the base my patients.
37:49This will actually give me
37:52patient level data,
37:53meaning it will give me the names
37:56of the patients that I'm looking at.
37:59I'm not going to do that right now
38:02just because of for Phi for HIPAA purposes,
38:05But basically what you do is click
38:08on this down shot run here to
38:11actually get patient level data.
38:16So if your patients are
38:18the base is all patients,
38:20then you won't actually be able
38:22to see patient level data.
38:25So it's about 446 at this point.
38:29So that's basically your general idea
38:31of your slicer dicer screen and how you
38:35could start a search for Slicer Dicer.
38:38So now we are actually going to
38:41break into two groups so that we
38:43can look at specific data models
38:46maybe or do some sample searches
38:48so that you can see you know other
38:52examples of how to use Slicer Dicer.
38:56And I think we've assigned you
38:59randomly to to to break out rooms.