Hysterectomy
Introduction
In this section we will: * identify which Hysterectomy procedures were excluded and why * identify which different Hysterectomy Repair subgroups were created and why
If you have questions or concerns about this data please contact Alexander Nielson (alexnielson@utah.gov)
Load Libraries
Load Libraries
library(data.table)
library(tidyverse)
## Warning: replacing previous import 'vctrs::data_frame' by 'tibble::data_frame'
## when loading 'dplyr'
library(stringi)
library(ggridges)
library(broom)
library(disk.frame)
library(RecordLinkage)
library(googlesheets4)
library(bigrquery)
library(DBI)
devtools::install_github("utah-osa/hcctools2", upgrade="never" )
library(hcctools2)
Establish color palettes
cust_color_pal1 <- c(
"Anesthesia" = "#f3476f",
"Facility" = "#e86a33",
"Medicine Proc" = "#e0a426",
"Pathology" = "#77bf45",
"Radiology" = "#617ff7",
"Surgery" = "#a974ee"
)
cust_color_pal2 <- c(
"TRUE" = "#617ff7",
"FALSE" = "#e0a426"
)
cust_color_pal3 <- c(
"above avg" = "#f3476f",
"avg" = "#77bf45",
"below avg" = "#a974ee"
)
fac_ref_regex <- "(UTAH)|(IHC)|(HOSP)|(HOSPITAL)|(CLINIC)|(ANESTH)|(SCOPY)|(SURG)|(LLC)|(ASSOC)|(MEDIC)|(CENTER)|(ASSOCIATES)|(U OF U)|(HEALTH)|(OLOGY)|(OSCOPY)|(FAMILY)|(VAMC)|(SLC)|(SALT LAKE)|(CITY)|(PROVO)|(OGDEN)|(ENDO )|( VALLEY)|( REGIONAL)|( CTR)|(GRANITE)|( INSTITUTE)|(INSTACARE)|(WASATCH)|(COUNTY)|(PEDIATRIC)|(CORP)|(CENTRAL)|(URGENT)|(CARE)|(UNIV)|(ODYSSEY)|(MOUNTAINSTAR)|( ORTHOPEDIC)|(INSTITUT)|(PARTNERSHIP)|(PHYSICIAN)|(CASTLEVIEW)|(CONSULTING)|(MAGEMENT)|(PRACTICE)|(EMERGENCY)|(SPECIALISTS)|(DIVISION)|(GUT WHISPERER)|(INTERMOUNTAIN)|(OBGYN)"
Connect to GCP database
bigrquery::bq_auth(path = 'D:/gcp_keys/healthcare-compare-prod-95b3b7349c32.json')
# set my project ID and dataset name
project_id <- 'healthcare-compare-prod'
dataset_name <- 'healthcare_compare'
con <- dbConnect(
bigrquery::bigquery(),
project = project_id,
dataset = dataset_name,
billing = project_id
)
Get NPI table
query <- paste0("SELECT npi, clean_name, osa_group, osa_class, osa_specialization
FROM `healthcare-compare-prod.healthcare_compare.npi_full`")
#bq_project_query(billing, query) # uncomment to determine billing price for above query.
npi_full <- dbGetQuery(con, query) %>%
data.table()
get a subset of the NPI providers based upon taxonomy groups
gs4_auth(email="alexnielson@utah.gov")
surgery <- read_sheet("https://docs.google.com/spreadsheets/d/1GY8lKwUJuPHtpUl4EOw9eriLUDG9KkNWrMbaSnA5hOU/edit#gid=0",
sheet="major_surgery") %>% as.data.table
## Reading from "Doctor Types to Keep"
## Range "'major_surgery'"
surgery <- surgery[is.na(Remove) ] %>% .[["NUCC Classification"]]
npi_prov_pair <- npi_full[osa_class %in% surgery] %>%
.[,.(npi=npi,
clean_name = clean_name
)
]
Load Data
bun_proc <- disk.frame("full_apcd.df")
hyst <- bun_proc[surg_bun_t_hysterectomy==T & cnt >2 & faci_bun_sum_med > 500]
hyst <- hyst[,`:=`(
surg_sp_name_clean = surg_sp_npi %>% map_chr(get_npi_standard_name),
surg_bp_name_clean = surg_bp_npi %>% map_chr(get_npi_standard_name),
medi_sp_name_clean = medi_sp_npi %>% map_chr(get_npi_standard_name),
medi_bp_name_clean = medi_bp_npi %>% map_chr(get_npi_standard_name),
radi_sp_name_clean = radi_sp_npi %>% map_chr(get_npi_standard_name),
radi_bp_name_clean = radi_bp_npi %>% map_chr(get_npi_standard_name),
path_sp_name_clean = path_sp_npi %>% map_chr(get_npi_standard_name),
path_bp_name_clean = path_bp_npi %>% map_chr(get_npi_standard_name),
anes_sp_name_clean = anes_sp_npi %>% map_chr(get_npi_standard_name),
anes_bp_name_clean = anes_bp_npi %>% map_chr(get_npi_standard_name),
faci_sp_name_clean = faci_sp_npi %>% map_chr(get_npi_standard_name),
faci_bp_name_clean = faci_bp_npi %>% map_chr(get_npi_standard_name)
)]
hyst %>% saveRDS(paste0("hysterectomy", Sys.Date(),".RDS"))
hyst %>% plot_med_density() %>% print()
## `stat_bin()` using `bins = 30`. Pick better value with `binwidth`.
hyst %>% get_tag_cor() %>% print()
## Warning in stats::cor(cor_data): the standard deviation is zero
## # A tibble: 219 x 2
## name correlation
## <chr> <dbl>
## 1 duration_max 0.528
## 2 anes_bun_t_upper 0.443
## 3 medi_bun_t_wound 0.432
## 4 medi_bun_t_cathet 0.430
## 5 surg_bun_t_colon 0.428
## 6 faci_bun_t_critical 0.411
## 7 surg_bun_t_rectal 0.401
## 8 anes_bun_t_cs 0.394
## 9 surg_bun_t_removal 0.376
## 10 duration_mean 0.374
## # ... with 209 more rows
hyst %>% plot_price_vs_duration() %>% print()
hyst %>% get_tag_density_information("anes_bun_t_upper") %>% print()
## Scale for 'y' is already present. Adding another scale for 'y', which will
## replace the existing scale.
## Scale for 'x' is already present. Adding another scale for 'x', which will
## replace the existing scale.
## [1] "tp_med ~ anes_bun_t_upper"
## Warning in leveneTest.default(y = y, group = group, ...): group coerced to
## factor.
## Picking joint bandwidth of 9530
## $dist_plots
##
## $stat_tables
hyst <- hyst[anes_bun_t_upper==F]
hyst %>% plot_med_density() %>% print()
## `stat_bin()` using `bins = 30`. Pick better value with `binwidth`.
hyst %>% get_tag_cor() %>% print()
## Warning in stats::cor(cor_data): the standard deviation is zero
## # A tibble: 215 x 2
## name correlation
## <chr> <dbl>
## 1 anes_bun_t_cs 0.465
## 2 duration_max 0.430
## 3 anes_bun_t_deliver 0.401
## 4 anes_bun_t_liver 0.401
## 5 medi_bun_t_cathet 0.392
## 6 surg_bun_t_delivery 0.388
## 7 surg_bun_t_liver 0.388
## 8 surg_bun_t_cesarean 0.34
## 9 medi_bun_t_inject 0.332
## 10 medi_bun_t_sodium 0.330
## # ... with 205 more rows
hyst <- hyst[duration_mean<3]
hyst %>% plot_med_density() %>% print()
## `stat_bin()` using `bins = 30`. Pick better value with `binwidth`.
hyst %>% get_tag_cor() %>% print()
## Warning in stats::cor(cor_data): the standard deviation is zero
## # A tibble: 213 x 2
## name correlation
## <chr> <dbl>
## 1 duration_max 0.486
## 2 anes_bun_t_cs 0.475
## 3 anes_bun_t_deliver 0.410
## 4 anes_bun_t_liver 0.410
## 5 medi_bun_t_cathet 0.401
## 6 surg_bun_t_delivery 0.396
## 7 surg_bun_t_liver 0.396
## 8 surg_bun_t_cesarean 0.347
## 9 duration_mean 0.346
## 10 anes_bun_t_bladder 0.334
## # ... with 203 more rows
hyst %>% get_tag_density_information("anes_bun_t_deliver") %>% print()
## Scale for 'y' is already present. Adding another scale for 'y', which will
## replace the existing scale.
## Scale for 'x' is already present. Adding another scale for 'x', which will
## replace the existing scale.
## [1] "tp_med ~ anes_bun_t_deliver"
## Warning in leveneTest.default(y = y, group = group, ...): group coerced to
## factor.
## Picking joint bandwidth of 4760
## $dist_plots
##
## $stat_tables
hyst <- hyst[anes_bun_t_deliver==F]
hyst %>% plot_med_density() %>% print()
## `stat_bin()` using `bins = 30`. Pick better value with `binwidth`.
hyst %>% get_tag_cor() %>% print()
## Warning in stats::cor(cor_data): the standard deviation is zero
## # A tibble: 200 x 2
## name correlation
## <chr> <dbl>
## 1 duration_max 0.456
## 2 anes_bun_t_bladder 0.374
## 3 anes_bun_t_removal 0.374
## 4 surg_bun_t_removal 0.362
## 5 duration_mean 0.354
## 6 surg_bun_t_remov 0.328
## 7 surg_bun_t_colon 0.324
## 8 medi_bun_t_inject 0.322
## 9 medi_bun_t_sodium 0.321
## 10 medi_bun_t_cathet 0.319
## # ... with 190 more rows
hyst %>% get_tag_density_information("anes_bun_t_bladder") %>% print()
## Scale for 'y' is already present. Adding another scale for 'y', which will
## replace the existing scale.
## Scale for 'x' is already present. Adding another scale for 'x', which will
## replace the existing scale.
## [1] "tp_med ~ anes_bun_t_bladder"
## Warning in leveneTest.default(y = y, group = group, ...): group coerced to
## factor.
## Picking joint bandwidth of 1410
## $dist_plots
##
## $stat_tables
hyst <- hyst[anes_bun_t_bladder==F]
hyst %>% plot_med_density() %>% print()
## `stat_bin()` using `bins = 30`. Pick better value with `binwidth`.
hyst %>% get_tag_cor() %>% print()
## Warning in stats::cor(cor_data): the standard deviation is zero
## # A tibble: 191 x 2
## name correlation
## <chr> <dbl>
## 1 duration_max 0.405
## 2 surg_bun_t_colon 0.351
## 3 duration_mean 0.341
## 4 medi_bun_t_inject 0.320
## 5 medi_bun_t_sodium 0.319
## 6 surg_bun_t_dilat 0.317
## 7 surg_bun_t_dilation 0.317
## 8 anes_bun_t_cs 0.317
## 9 faci_bun_t_discharge 0.317
## 10 surg_bun_t_vag 0.281
## # ... with 181 more rows
hyst_vag
hyst_vag <- hyst[surg_bun_t_vag == T]
hyst_vag %>% plot_med_density() %>% print()
## `stat_bin()` using `bins = 30`. Pick better value with `binwidth`.
hyst_vag %>% get_tag_cor() %>% print()
## Warning in stats::cor(cor_data): the standard deviation is zero
## # A tibble: 153 x 2
## name correlation
## <chr> <dbl>
## 1 surg_bun_t_coloproctostomy 0.337
## 2 duration_max 0.328
## 3 medi_bun_t_inject 0.314
## 4 medi_bun_t_sodium 0.312
## 5 surg_bun_t_defect 0.311
## 6 surg_bun_t_bladder 0.280
## 7 surg_bun_t_repair 0.280
## 8 duration_mean 0.279
## 9 path_bun_t_complete 0.222
## 10 path_bun_t_without_scope 0.218
## # ... with 143 more rows
hyst_vag[surg_bun_t_coloproctostomy==T] %>% nrow()
## [1] 1
hyst_vag[surg_bun_t_bladder==T] %>% nrow()
## [1] 24
hyst_vag <- hyst_vag[surg_bun_t_coloproctostomy==F & surg_bun_t_bladder==F]
hyst_vag %>% plot_med_density() %>% print()
## `stat_bin()` using `bins = 30`. Pick better value with `binwidth`.
hyst_vag %>% get_tag_cor() %>% print()
## Warning in stats::cor(cor_data): the standard deviation is zero
## # A tibble: 145 x 2
## name correlation
## <chr> <dbl>
## 1 duration_max 0.391
## 2 duration_mean 0.354
## 3 path_bun_t_without_scope 0.283
## 4 anes_bun_t_hysterectomy 0.268
## 5 anes_bun_t_vag 0.268
## 6 medi_bun_t_sodium 0.257
## 7 medi_bun_t_inject 0.253
## 8 anes_bun_t_anes 0.229
## 9 anes_bun_t_anesth 0.229
## 10 surg_bun_t_total 0.219
## # ... with 135 more rows
hyst_vag %>% get_tag_density_information("path_bun_t_without_scope") %>% print()
## Scale for 'y' is already present. Adding another scale for 'y', which will
## replace the existing scale.
## Scale for 'x' is already present. Adding another scale for 'x', which will
## replace the existing scale.
## [1] "tp_med ~ path_bun_t_without_scope"
## Warning in leveneTest.default(y = y, group = group, ...): group coerced to
## factor.
## Picking joint bandwidth of 1320
## $dist_plots
##
## $stat_tables
hyst_vag <- hyst_vag[path_bun_t_without_scope==F]
hyst_vag %>% get_tag_density_information("anes_bun_t_hysterectomy") %>% print()
## Scale for 'y' is already present. Adding another scale for 'y', which will
## replace the existing scale.
## Scale for 'x' is already present. Adding another scale for 'x', which will
## replace the existing scale.
## [1] "tp_med ~ anes_bun_t_hysterectomy"
## Warning in leveneTest.default(y = y, group = group, ...): group coerced to
## factor.
## Picking joint bandwidth of 1430
## $dist_plots
##
## $stat_tables
hyst_vag_btbv4 <- hyst_vag %>% btbv4()
hyst_vag_bq <- hyst_vag_btbv4[,
primary_doctor := pmap(.l=list(doctor_npi1=doctor_npi_str1,
doctor_npi2=doctor_npi_str2,
class_reqs="Obstetrics & Gynecology"
),
.f=calculate_primary_doctor) %>% as.character()
] %>%
#Filter out any procedures where our doctors fail both criteria.
.[!(primary_doctor %in% c("BOTH_DOC_FAIL_CRIT", "TWO_FIT_ALL_SPECS"))] %>%
.[,primary_doctor_npi := fifelse(primary_doctor==doctor_str1,
doctor_npi_str1,
doctor_npi_str2)] %>%
.[,`:=`(
procedure_type=4,
procedure_modifier = "Vaginal Hysterectomy"
)]
## [1] "multiple meet class req"
## [1] "TRAVIS JOHN BILANZICH" "DAREN OWEN GATHERUM"
## [1] "multiple meet class req"
## [1] "RUSSELL A SMITH" "ROBERT WENDALL LATER"
## [1] "multiple meet class req"
## [1] "GARY K FOWERS" "DAVID A KIRKMAN"
## [1] "multiple meet class req"
## [1] "CHRISTIAN D FROERER" "JEFFREY H BARTON"
## [1] "multiple meet class req"
## [1] "CRAIG L HURST" "KAREN BOHEEN"
## [1] "multiple meet class req"
## [1] "RUSSELL A SMITH" "ALICIA TABISH JONES"
## [1] "multiple meet class req"
## [1] "ROBERT MERRILL" "SUPHITHAYA ANDERS"
## [1] "multiple meet class req"
## [1] "SPENCER N COLBY" "AMANDA M. CLEVELAND"
## [1] "multiple meet class req"
## [1] "EDWIN RAY ENGLAND" "TRICIA ANNE TWELVES"
## [1] "multiple meet class req"
## [1] "CLAYTON SCOTT SYNDERGAARD" "BEN DOUGLAS WILLIAMS"
## [1] "multiple meet class req"
## [1] "TANDY GARTH OLSEN" "ERICA LYNN SMITH"
## [1] "multiple meet class req"
## [1] "JEFF DAVID NANCE" "STEVEN GREG NANCE"
## [1] "multiple meet class req"
## [1] "SPENCER N COLBY" "SCOTT F EPSTEIN"
## [1] "multiple meet class req"
## [1] "GEORGE C GOURLEY" "WAYNE R YOUNG"
## [1] "multiple meet class req"
## [1] "ALTON D BURGETT" "MATTHEW S WILSON"
## [1] "multiple meet class req"
## [1] "ANDREA JULIET HEBERT" "AMELIA PARRETT"
## [1] "multiple meet class req"
## [1] "WESLEY BOYD DAVIS" "JULIA JOHANSSON"
## [1] "multiple meet class req"
## [1] "JAMES P LAMOREAUX" "RYAN C. OLLERTON"
## [1] "multiple meet class req"
## [1] "BEN DOUGLAS WILLIAMS" "JOHN D NOLTE"
## [1] "multiple meet class req"
## [1] "ROBERT MERRILL" "JEFFREY DENNIS QUINN"
## [1] "multiple meet class req"
## [1] "JANE C BOWMAN" "SUPHITHAYA ANDERS"
## [1] "multiple meet class req"
## [1] "STEPHANIE DIANE HENDERSON" "BARBARA HURST"
## [1] "multiple meet class req"
## [1] "MICHAEL LAMAR TWEDE" "LAYNE A SMITH"
## [1] "multiple meet class req"
## [1] "SCOTT E HANSEN" "KATHLEEN M LANGER"
## [1] "multiple meet class req"
## [1] "BARRY A NOORDA" "ANNE SADLER BLACKETT"
## [1] "multiple meet class req"
## [1] "DANIEL FRED KAELBERER" "SPENCER EDMOND PIERSON"
## [1] "multiple meet class req"
## [1] "BROOKE LANE HANSEN" "LUCINDA J ROBINSON"
## [1] "multiple meet class req"
## [1] "DARREN HOUSEL" "DAVID BIERER"
## [1] "multiple meet class req"
## [1] "GAYLE M STEWART" "STEPHEN D LASH"
## [1] "multiple meet class req"
## [1] "CRAIG L HURST" "KAREN BOHEEN"
## [1] "multiple meet class req"
## [1] "EVAN JONES" "RYAN C. OLLERTON"
## [1] "multiple meet class req"
## [1] "SARA ELIZABETH WOOD" "AUDREY A JIRICKO"
## [1] "multiple meet class req"
## [1] "CHAD JEREMY CLARK" "JEANNE M FALK"
## [1] "multiple meet class req"
## [1] "RYAN NELSON JONES" "ANDREW THOMAS"
hyst_vag_bq <- hyst_vag_bq[,.(
primary_doctor,
primary_doctor_npi,
most_important_fac ,
most_important_fac_npi,
procedure_type,
procedure_modifier,
tp_med_med,
tp_med_surg,
tp_med_medi,
tp_med_path,
tp_med_radi,
tp_med_anes,
tp_med_faci,
ingest_date = Sys.Date()
)]
bq_table_upload(x=procedure_table, values= hyst_vag_bq, create_disposition='CREATE_IF_NEEDED', write_disposition='WRITE_APPEND')
hyst_total
hyst_total <- hyst[surg_bun_t_total == T]
hyst_total %>% plot_med_density() %>% print()
## `stat_bin()` using `bins = 30`. Pick better value with `binwidth`.
hyst_total %>% get_tag_cor() %>% print()
## Warning in stats::cor(cor_data): the standard deviation is zero
## # A tibble: 128 x 2
## name correlation
## <chr> <dbl>
## 1 surg_bun_t_colon 0.456
## 2 surg_bun_t_art 0.400
## 3 surg_bun_t_part 0.400
## 4 surg_bun_t_partial 0.400
## 5 surg_bun_t_removal 0.381
## 6 surg_bun_t_remov 0.345
## 7 path_bun_t_tumor 0.321
## 8 surg_bun_t_laparoscop 0.317
## 9 surg_bun_t_renal 0.316
## 10 surg_bun_t_lap 0.292
## # ... with 118 more rows
hyst_total %>% get_tag_density_information("path_bun_t_tumor") %>% print()
## Scale for 'y' is already present. Adding another scale for 'y', which will
## replace the existing scale.
## Scale for 'x' is already present. Adding another scale for 'x', which will
## replace the existing scale.
## [1] "tp_med ~ path_bun_t_tumor"
## Warning in leveneTest.default(y = y, group = group, ...): group coerced to
## factor.
## Picking joint bandwidth of 5180
## $dist_plots
##
## $stat_tables
hyst_total <- hyst_total[surg_bun_t_colon==F & surg_bun_t_partial==F & path_bun_t_tumor==F & surg_bun_t_renal==F ]
hyst_total %>% plot_med_density() %>% print()
## `stat_bin()` using `bins = 30`. Pick better value with `binwidth`.
hyst_total %>% get_tag_cor() %>% print()
## Warning in stats::cor(cor_data): the standard deviation is zero
## # A tibble: 122 x 2
## name correlation
## <chr> <dbl>
## 1 surg_bun_t_complex 0.209
## 2 medi_bun_t_cathet 0.209
## 3 surg_bun_t_remove 0.207
## 4 surg_bun_t_wound 0.202
## 5 surg_bun_t_lap 0.200
## 6 path_bun_t_immuno 0.194
## 7 path_bun_t_immunohisto 0.194
## 8 surg_bun_t_laparoscop 0.193
## 9 surg_bun_t_tags 0.193
## 10 surg_bun_t_drain 0.190
## # ... with 112 more rows
# hyst_total %>% get_tag_density_information("surg_bun_t_complex") %>% print()
hyst_total %>% get_tag_density_information("surg_bun_t_remove") %>% print()
## Scale for 'y' is already present. Adding another scale for 'y', which will
## replace the existing scale.
## Scale for 'x' is already present. Adding another scale for 'x', which will
## replace the existing scale.
## [1] "tp_med ~ surg_bun_t_remove"
## Warning in leveneTest.default(y = y, group = group, ...): group coerced to
## factor.
## Picking joint bandwidth of 2480
## $dist_plots
##
## $stat_tables
hyst_total <- hyst_total[surg_bun_t_remove==F & surg_bun_t_complex==F & surg_bun_t_drain==F & surg_bun_t_skin==F ]
hyst_total %>% plot_med_density() %>% print()
## `stat_bin()` using `bins = 30`. Pick better value with `binwidth`.
hyst_total %>% get_tag_cor() %>% print()
## Warning in stats::cor(cor_data): the standard deviation is zero
## # A tibble: 111 x 2
## name correlation
## <chr> <dbl>
## 1 path_bun_t_patho 0.162
## 2 path_bun_t_pathologist 0.162
## 3 path_bun_t_tissue 0.162
## 4 surg_bun_t_repair 0.160
## 5 path_bun_t_immuno 0.14
## 6 path_bun_t_immunohisto 0.14
## 7 surg_bun_t_defect 0.137
## 8 medi_bun_t_iiv 0.131
## 9 medi_bun_t_immun 0.131
## 10 medi_bun_t_immunization 0.131
## # ... with 101 more rows
hyst_total_btbv4 <- hyst_total %>% btbv4()
hyst_total_bq <- hyst_total_btbv4[,
primary_doctor := pmap(.l=list(doctor_npi1=doctor_npi_str1,
doctor_npi2=doctor_npi_str2,
class_reqs="Obstetrics & Gynecology"
),
.f=calculate_primary_doctor) %>% as.character()
] %>%
#Filter out any procedures where our doctors fail both criteria.
.[!(primary_doctor %in% c("BOTH_DOC_FAIL_CRIT", "TWO_FIT_ALL_SPECS"))] %>%
.[,primary_doctor_npi := fifelse(primary_doctor==doctor_str1,
doctor_npi_str1,
doctor_npi_str2)] %>%
.[,`:=`(
procedure_type=4,
procedure_modifier = "Total Hysterectomy"
)]
## [1] "multiple meet class req"
## [1] "BEN DOUGLAS WILLIAMS" "JOHN D NOLTE"
## [1] "multiple meet class req"
## [1] "E BRETT HORSLEY" "TANDY GARTH OLSEN"
## [1] "multiple meet class req"
## [1] "CLAYTON SCOTT SYNDERGAARD" "BEN DOUGLAS WILLIAMS"
## [1] "multiple meet class req"
## [1] "ALAN T RAPPLEYE" "BRYANT J BROWN"
## [1] "multiple meet class req"
## [1] "DAVID B YOUNG" "DOUGLAS A ALLEN"
## [1] "multiple meet class req"
## [1] "JOHN DOUGLAS MCCARTER" "KORY A. HARWARD"
## [1] "multiple meet class req"
## [1] "GEORGE C GOURLEY" "DAVID HARRISON BROADBENT"
## [1] "multiple meet class req"
## [1] "ALICIA TABISH JONES" "ROBERT WENDALL LATER"
## [1] "multiple meet class req"
## [1] "TRAVIS JOHN BILANZICH" "DAREN OWEN GATHERUM"
## [1] "multiple meet class req"
## [1] "TANDY GARTH OLSEN" "ERICA LYNN SMITH"
## [1] "multiple meet class req"
## [1] "REED J SKINNER" "JOHN DAVID LARAWAY"
## [1] "multiple meet class req"
## [1] "JOHN DOUGLAS MCCARTER" "KORY A. HARWARD"
## [1] "multiple meet class req"
## [1] "JENNIFER LYNN PARKER" "BRITNEY B BUNOT"
## [1] "multiple meet class req"
## [1] "RUSSELL A SMITH" "ROBERT WENDALL LATER"
## [1] "multiple meet class req"
## [1] "ROBERT MERRILL" "JEFFREY DENNIS QUINN"
## [1] "multiple meet class req"
## [1] "CLAYTON SCOTT SYNDERGAARD" "JOHN D NOLTE"
## [1] "multiple meet class req"
## [1] "SPENCER P. BARNEY" "JESSICA RAE HUNN"
## [1] "multiple meet class req"
## [1] "CRAIG D ASTLE" "BRADY BENHAM"
## [1] "multiple meet class req"
## [1] "TIFFANY KRISTEN WEBER" "PEGGY A. NORTON"
## [1] "multiple meet class req"
## [1] "MICHAEL LAMAR TWEDE" "LAYNE A SMITH"
## [1] "multiple meet class req"
## [1] "JEFF DAVID NANCE" "STEVEN GREG NANCE"
## [1] "multiple meet class req"
## [1] "BRYAN SETH PALMER" "STEVEN M BEVERLY"
## [1] "multiple meet class req"
## [1] "COBY THOMAS BROWN" "JEFFREY G ROGERS"
## [1] "multiple meet class req"
## [1] "SHANNON L TILLY" "BROOKE LANE HANSEN"
## [1] "multiple meet class req"
## [1] "JASON KEITH MORRIS" "JOHN DAVID LARAWAY"
## [1] "multiple meet class req"
## [1] "SUPHITHAYA ANDERS" "JEFFREY DENNIS QUINN"
## [1] "multiple meet class req"
## [1] "DARREN HOUSEL" "DAVID BIERER"
## [1] "multiple meet class req"
## [1] "WESLEY BOYD DAVIS" "JULIA JOHANSSON"
## [1] "multiple meet class req"
## [1] "DAVID E LUDLOW" "JOHN DAVID LARAWAY"
## [1] "multiple meet class req"
## [1] "JANE C BOWMAN" "SUPHITHAYA ANDERS"
## [1] "multiple meet class req"
## [1] "JEFF DAVID NANCE" "STEVEN GREG NANCE"
## [1] "multiple meet class req"
## [1] "RYAN NELSON JONES" "ANDREW THOMAS"
hyst_total_bq <- hyst_total_bq[,.(
primary_doctor,
primary_doctor_npi,
most_important_fac ,
most_important_fac_npi,
procedure_type,
procedure_modifier,
tp_med_med,
tp_med_surg,
tp_med_medi,
tp_med_path,
tp_med_radi,
tp_med_anes,
tp_med_faci,
ingest_date = Sys.Date()
)]
bq_table_upload(x=procedure_table, values= hyst_total_bq, create_disposition='CREATE_IF_NEEDED', write_disposition='WRITE_APPEND')