Lone Star Circle of Care

Lone Star Circle of Care (LSCC) is a Federally Qualified Health Center (FQHC) in central Texas providing exceptional and accessible patient-centered healthcare with a strong focus on the uninsured and under-insured population. Comprised of 26 locations in Texas, LSCC serves nearly 100,000 unique patients annually with a wide range of primary care services—including pediatrics, adult medicine, obstetrics/gynecology and behavioral health services.

When Alex Perez joined LSCC as the director of clinical analytics in 2019, he immediately saw an opportunity to modernize the organization’s data management and reporting processes.

LSCC relies on clinical data from its electronic health record (EHR) system to generate two reports that are critical to assessing performance and patient care on a continuous basis:

Uniform Data System (UDS) – Submitted annually to the federal government to report on the organization’s performance on clinical quality indicators (eCQMs) and financial measures, as well as a wide range of population demographics.

Clinical Provider Scorecards – Previously delivered on a biweekly basis, these aggregate reports provide drill-down views on how patients are measuring up against key clinical measures, for example, whether the patient has received the appropriate vaccines, screenings or other services.

“The Provider Scorecards let our clinicians know how they’re performing and whether their patients are up-to-date on services,” Perez said. “We use the results to improve patient care and health outcomes across our clinics, which affects our Clinical Quality Measures. That’s important because clinical performance can affect LSCC’s value-based contracts. For these reasons, data integrity, data visibility and accurate reporting are absolutely vital to our organization.”

When Perez joined LSCC, EHR clinical data was stored in a legacy data warehouse that was becoming an obstacle to analytics and reporting processes.

“Data extraction was inefficient, complex and time-consuming,” said Perez. “I had one full-time analyst dedicated to the process, and, every two weeks, he’d spend a couple of days compiling reports, which involved manually extracting and putting data into Excel spreadsheets.”

Data complexity and cumbersome reporting also led to poor visibility. “Visibility was also a problem with the clinical reports, because most clinicians didn’t know how to navigate advanced features of Excel. If they wanted more details, they had to open a service ticket, which would typically take 24-to-48 hours to resolve,” added Perez.

Finally, the analysts that built the legacy data warehouse had left LSCC, leaving Perez and his team without the institutional knowledge required to effectively manage and maintain it. 

Already a customer of Navisite’s database administration (DBA) services, Perez tapped the company’s data analytics experts to create a modern data warehouse and reporting solution.

“We wanted to build on our existing Microsoft stack, and Navisite was already a trusted partner,” said Perez. “They assessed and mapped our environment and architected a Microsoft SQL Server data warehouse leveraging Azure DevOps tools. They identified relevant data across disparate sources, cleaned it, and made it easily accessible. From there, we were able to leverage the same architecture for both UDS and the Provider Scorecards and build Microsoft Power BI dashboards based on our reporting metrics.”

With the modern data warehouse in place, Perez and his team can now extract, analyze and report on clinical data much faster and more easily than they could with the old database. Additionally, with the new dashboards, Perez no longer needs to devote an analyst to reporting processes, freeing his team to focus on strategic work that delivers value.

Perez also noted other benefits with the data warehouse and Power BI dashboards:

Increased data visibility – LSCC clinicians now have 24×7 on-demand access to the Power BI dashboards, which present up-to-date patient data and track reporting metrics in an easy-to-understand way.

Perez noted, “We no longer have to wait two weeks to see how we’re tracking against our eCQMs and other healthcare metrics. We can monitor our progress at any time and make corrections in performance areas where we may be falling short. Additionally, our clinicians have data at their fingertips, so they can get instantaneous answers to patient care questions, without having to rely on an analyst: not only do they know who needs attention, but now they also know why and where to focus that attention.”

Near real-time updates – Clinical data is now updated daily versus the old two-week cycle—empowering providers to address issues with timely, accurate information.

Enhanced data integrity – Standardized query codes for calculating eCQMs and other health metrics were developed, resulting in greater data accuracy and consistency in query responses. Perez and his team are also utilizing Azure DevOps Services (GIT Repositories) to track code changes to maintain the integrity of the data warehouse.

Increased innovation – With the modern data warehouse, the analytics team now has a development environment to deploy and test new code before it goes to production.

“Having a development environment is so beneficial because we can innovate and try new things without having to worry about new code breaking the reporting system and causing business disruption and downtime,” said Perez.

Agile methodology – The analytics team is also using Azure DevOps Services to institute two-week sprints for planning new code, which allows them to upgrade and change dashboards much faster than they could using the old database.

Now that Perez no longer needs to task his team with basic data extraction, they are working with Navisite to build new reports and dashboard offerings, including patient registries to track patient outcomes based on specific diseases. They also plan to focus on data modeling by building self-serving dashboards that will identify patient and operational care trends to improve patient outcomes.

“The level of expertise the Navisite team brings to the table is invaluable,” said Perez. “I can tap them for help whenever I need to without assuming the cost or hassle of finding and hiring a full-time expert.”