Take Note

The medical group turns notes into data that can be analyzed and compares results of its infant care facilities.

At the same time, Pediatrix developers standardized data entry. Free-form entry fields gave way to drop-down lists of common conditions. For example, Bryant says, respiratory distress syndrome is now recorded the same way in every instance throughout the system; previously, it was sometimes abbreviated, sometimes described with a synonym, and generally recorded with inconsistencies that made it difficult or impossible to track trends.

When Bloom's practice was acquired and he joined Pediatrix in 1998, RDS was already fueling basic research and being used to produce internal report cards so NICU staffs could make comparisons. But he saw greater potential for the data to be translated into action.

"When I joined, they were on the cusp of taking it to the next level, but weren't certain which direction to go," Bloom says. "It took me two years to get their attention, that there might be a simple way to make this useful."

Bloom pointed to a technique he previously used to reduce the frequency of infections acquired during hospital stays. The Demonstrated Best Processes methodology he advocated, created by the Lombardy Group consulting firm, boils down to contrasting the processes used at high-performance and low-performance operations to identify meaningful differences.

For all the contributions RDS has made, Bryant and project manager Pam Thomas, Pediatrix's director of clinical services and a former NICU nurse, have concluded they've pushed the current system as far as it can go. So BabySteps, a new data entry system created with Visual Basic and SQL Server, is being phased in to replace NeoData, a Microsoft Access program. The central RDS database is also being reworked into a more sophisticated data warehouse, also based on SQL Server.

BabySteps is being set up to expand in size and scope reliably, while the new data warehouse is designed to take researcher queries efficiently.