RetroGuide



RetroGuide is a name of a research project in medical informatics focusing on using workflow technology in healthcare to analyze retrospective data about patient care.

The project was designed during 2004-2007. The methodology can be adapted to use data from any large healthcare institution. During the initial development phase the project was tested on data from Intermountain Health Care in Utah, USA.

The methodology requires two inputs from the user
 * a specification of a cohort of patients to be analyzed
 * a model of events (=scenario) which is to be tested against retrospective data

RetroGuide's output is then a set of hierarchically linked reports. Some of them are generated by default, some of them can be optional. RetroGuide enables export of results or original data elements into other programs via XML files and CSV files.

The most used tool to analyze retrospective terminology-coded retrospective data are SQL queries on a population datase. RetroGuide's approach is different from a query language since the tested scenario is executed on every patient in the analyzed population. It enables procedural features as opposed to declarative nature of SQL.

RetroGuide can be used in three main domains
 * quality improvement analyses
 * testing logic for decision support systems
 * retrospective, observational medical research

RetroGuide has been used on several clinical problems
 * investigating blood pressure control in diabetics patients
 * investigating pregnancy rate in female patients after treatment of Hodgkin lymphoma
 * investigating HEDIS quality improvement measures from NCQA
 * osteoporosis measure (OMW)
 * cholesterol control in cardiovascular patients (CMC)
 * investigating alternative glucose protocol logic for blood glucose control in ICU patients
 * course of care for diabetes
 * course of care for AMI
 * course of care for chronic kidney disease
 * detecting adverse drug events (respiratory failure after use of narcotics, Naloxone)