Outcome cohorts

An outcome cohort is the group of deidentified facts behind a reported rate. Each cohort carries a number, a name, a cohort date, the organization it belongs to, the outcome definition it measures and the person who owns it. It also carries a revision number. Every review decision, operation run and state change points at a specific revision, so a rate published last quarter can still be explained after the cohort has been corrected.

A cohort moves through Configured, Collecting, Validated, Analyzed and Published. The Outcomes Analyst sets up the cohort against an active outcome definition and starts the construction workflow, either from the Healthcare Analytics Overview page or by hand. The workflow records an operation run with numbered steps and writes the status change to state history with the actor and the source revision.

• One owner per cohort. The Owner field names the person accountable for the revision, and the “My outcome cohorts” view lists only their work.
• A recorded consent basis. The cohort and each of its facts carry a consent basis value, so a reviewer can see under what terms the data was used.
• Counts held on the cohort. patient count, session count, conversion count, target completions and cohort exposure hold the totals that feed the rate.

Agree what each count field means for each outcome definition. For a readmission measure, decide whether session count holds index admissions and conversion count holds readmissions inside the window, and record that choice in the outcome definition’s policy reference. Agree how cohort numbers are assigned and which source record id identifies the cohort in the source system. Decide which organizations each analyst can see, and who may change a cohort’s owner once collection has started.

Take a monthly readmission cohort for one organization. The Outcomes Analyst creates it with status Configured, links the active outcome definition and starts construction. Confirm that a second start with the same operation key returns the existing run and does not create another one. The cohort should move to Collecting, with one state history row naming the analyst, the revision and the operation key.

Next, ask the Analytics Manager to find the cohort on the “Cohort lifecycle board” and the Clinical Reviewer to find the pending review decision for the same revision. Both should see the same revision number. If the analyst changes the cohort date after a review decision exists, the change should need a new revision instead of altering what the reviewer is looking at.

• Cohort lifecycle board — every cohort grouped by status, with its owner, organization, definition and revision.
• My outcome cohorts — the cohorts the signed-in person owns, with cohort date and patient count.
• Published outcome cohorts — cohorts whose rates have been published, with completion date and exposure.

• Cohort construction to validation: Build a cohort revision, load its facts and accept or reject each one.
• Independent review to publication: Approve the exact revision and publish its outcome rates.

Review the implementation plan and the data model before preparing your import files.