Knowledge Activity: Applied Data Analytics II

(Informatics)

Prerequisites
1. Use of Microsoft Excel® is required to complete this activity
2. This activity is the second activity in a sequential 5-activity series. Completion of the
activity below is required to successfully complete this activity:
 Orientation to Data Analytics I

Student instructions
3. If you have questions about this activity, please contact your instructor for assistance.
4. You will review a de-identified patient chart to complete this activity. Your instructor has
provided you with a link to the Applied Data Analytics II (Informatics) activity. Click on
2: Launch EHR to review the patient chart and begin this activity.
5. Refer to the patient chart and any suggested resources to complete this activity.
6. Document your answers directly on this activity document as you complete the activity.
When you are finished, you will save this activity document to your device and upload
this activity document with your answers to your Learning Management System (LMS).

The activity
Shoreline Birth Center is a major metro birth center that delivers the most babies in the area.
According to Shoreline’s website, [Shoreline] “has long been a leader in caring for women,
children and families. Our Birth Center is a beautiful example of our commitment to providing
you with state-of-the-art healthcare in a warm, soothing environment. And as the hospital that
delivers the most babies in the metro area, our commitment to families is clear. From our
outstanding nursing and medical staff, to our state-of-the-art Level III NICU and high-risk
maternity unit, the Shoreline Birth Center takes every step to ensure you are comfortable, both
physically and emotionally, during your stay with us.”

Last week the local paper did an article on the nation's high rates of Cesarean (C-section)
deliveries. The journalist featured interviews with Shoreline Birth Center doctors and patients
who either performed or had undergone Cesarean deliveries. The Birth Center feels that the

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press will negatively impact their bottom line and have asked you to review their data and
present the facts.

You have access to the following private patient data elements via the Shoreline EHR database.
 Patient demographics
 Vital signs
 Medications
 Diagnoses
 Labs
 Active problems
 Visit dates and times
 Procedures
 Test results
 Clinical notes

Access the de-identified EHR of a Shoreline patient that accompanies this activity under 2:
Launch EHR and determine whether the data would be helpful to collect to address the public
concern. Explain your answers.

Questions
Patient demographics
1. Describe which, if any, specific demographic data should be collected and why. This
information is found on the Registration Tab.
Four specific demographic data should be collected, including the date of birth (age), sex
and race. These demographic data are essential to conduct various analysis of patient
data, such as variation by age, sex or race. The results of these analyses inform the
determination of pregnancy risk.
Vital signs
2. Describe which, if any, specific vitals data should be collected and why. This information
is found on the Vitals Tab.
Blood pressure, pulse, temperature, and SpO2 data should be collected. This data could
indicate a higher risk birth with abnormal results.
Medications

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 3. Describe which medication administration fields, if any, should be collected. This
information is found on the Meds Tab and can be examined by clicking on any
administered medication order.
Data of high-risk medications fields should be collected. It could be used as a secondary
indicator of a higher-risk delivery.
Diagnoses & Problem lists
4. Describe which diagnosis or problem fields, if any, should be collected and why.
Problems and diagnoses are listed together on the Problems Tab.
Problems and diagnoses that are currently active should be collected. The data on the
problems and diagnoses provide essential insights on high-risk births.
Visit dates and times
5. Describe which fields, if any, should be collected. This data can be found on the
Encounters Tab in the Account section.
Encounters from a pre-determined date window should be determined, and only data
within the date window should be included in the data.
Procedures
6. Describe which fields, if any, should be included for procedures. This data can be found
on the Claims Tab in the Account section.
Procedures from within a date window should be determined.
Test results
7. Describe which fields, if any, should be included for test results. This data can be found
on the Labs Tab.
The test results should be collected under lab data as secondary data collected via a
related problem or diagnosis.
Clinical notes
8. Describe which fields, if any, should be included for clinical notes. This data can be
found on the Notes Tab.
Clinical notes should include details of collected from problems, diagnoses, or
procedures. The notes include details explaining aspects of the data coded that would
be harder to collect via these fields.

Critical thinking
9. Which of the above data elements do you think is the most important data element to
generate the Shoreline Birth Center’s rate of Cesarean delivery? Why?
Procedure is the most important data element. The importance is because it is the one
critical element needed to determine the rate of Cesarean delivery at Shoreline.

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 10. Describe how you will use this data element to calculate Shoreline’s rate of Cesarean
delivery.
I will take the total number of births by procedure code during a specific period. The
Cesarean procedures will then be divided by the total number of birthing procedures.
Review the resource, National birth statistics (found under 1: Overview & Resources along
with this activity document) to answer the questions below.

11. What was the national rate of Cesarean delivery in the U.S. in 2016? (Hint: see page 7 of
the resource)
31.9%
12. What was the national rate of Cesarean delivery in the U.S. in 1996? (Hint: see page 7 of
the resource)
20.7%
13. What was the national rate of Cesarean delivery in the U.S. in 2009? (Hint: see page 7 of
the resource)
32.9%
Critical thinking
14. Why should the calendar year 2016 be used to collect birth data to compare Shoreline’s
rate of Cesarean delivery to the national rate?
The calendar year 2016 should be used because it has an available national rate. The
national rate allows comparison of the same period at Shoreline Birth Center.
Open the resource Shoreline birth data (found under 1: Overview & Resources along with this
activity document) in Microsoft Excel®. A file with 4 columns of data will open. Follow the steps
described below to analyze the data and calculate the 2016 rate of Cesarean section delivery at
Shoreline Birth Center.

Create a pivot table with ‘Type of Birth’ as the Rows and ‘Type of Birth’ as the ∑ Values. ∑
Values should then appear as ‘Count of Type of Birth’. See screenshot below. Please refer to the
pre-requisite activity Orientation to Data Analytics I for a step-by-step refresher on how to
create a pivot table.

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Answer the following questions.

15. How many deliveries were reported at Shoreline Birth Center in 2016?
8,379
16. How many of these deliveries were vaginal?
5,530
17. How many of these deliveries were by Cesarean?
2,849
18. What was the rate of vaginal delivery?
66%
19. What was the rate of delivery by Cesarean?
34%

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 20. How did Shoreline’s rate of Cesarean delivery compare with the national rate of
Cesarean delivery in 2016?
Shoreline's rate of Cesarean delivery was 2.1% higher than the national Cesarean
delivery rate of 31.9% in 2016.
21. Draft a statement to explain your findings to the Shoreline Birth Center administrative
team.

In the period of the year 2016, 34% of births at Shoreline Birth Center were delivered via
Cesarean.

Critical thinking
The medical director believes that the Birth Center has a high C-section rate because they are
the area’s only high-risk birth center and, therefore, receive a higher percentage of high-risk
births. She believes that Shoreline’s high rate of C-section is related to the high-risk births and
that C-section results in a safer birth experience for these families. Refer to the private patient
data elements listed at the beginning of this activity and answer the following questions.

22. How, in general, could this hypothesis be proven?

The above hypothesis could be proven by studying the rate of Cesarean for high-risk
births versus the rate for low-risk births. This is necessary because the hypothesis
includes the assumption that Cesarean deliveries result in a safer birth experience, the
birth outcome (for mom and baby) should be compared to national norms.
23. What types of data elements could be used to prove this hypothesis? List the data you
would include with your rationale for each element.
Data elements indicating the birth outcomes of both mother and baby. These elements
may include the following types:
Age
Birth outcomes from admissions to ICU or NICU
Insurance type
High-risk diagnoses
Number of previous pregnancies, live births, and C-sections
Race/ethnicity
Read the resource Difference Between Descriptive and Inferential Statistics (found under 1:
Overview & Resources along with this activity document). Answer the question below.

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 24. Based on the provided definition, does this data analysis involve descriptive or
inferential statistics? Why?

Submit your work

Document your answers directly on this activity document as you complete the activity. When
you are finished, save this activity document to your device and upload this activity document
with your answers to your Learning Management System (LMS). If you have any questions
about submitting your work to your LMS, please contact your instructor.

Learning objectives
1. Analyze technologies for health information management (4)
2. Interpret statistics for health services (5)
3. Manage data within a database management system (5)
4. Identify standards for exchange of health information (3)

References
Gabrenya, W.K. Jr. (2003). Inferential Statistics: Basic Concepts. Chapter in Research skills for
psychology majors: Everything you need to know to get started. Melbourne: Florida
Institute of Technology.

Haelle, Tara. (May 10, 2018). Your Biggest C-Section Risk May Be Your Hospital. Consumer
Reports. Retrieved from: https://www.consumerreports.org/c-section/biggest-c-section-
risk-may-be-your-hospital/

Martin JA, Hamilton BE, Osterman MJK, Driscoll AK, Drake P. Births: Final data for 2016.
National Vital Statistics Reports; vol 67 no 1. Hyattsville, MD: National Center for Health
Statistics. 2018.

Surbhi, S. (May 9, 2016). Difference Between Descriptive and Inferential Statistics. Retrieved:
https://keydifferences.com/difference-between-descriptive-and-inferential-
statistics.html

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