We cant Cure Cancer, But we can Cure this Medicare Chart [Chart Busters]

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This post is from GuestBuster Jeff Weir in our Chart Busters series.

Note: The post slightly longer, but worth every word. Just get a cup of coffee and soak in to this visualization goodness. (Also, click on any image to see its full version)

Over at the FlowingData blog, they’ve been talking about this pretty slick looking Choropleth Map that shows how Medicare returns vary across the United States:

Medicare Chart Critique Figure_1

The above shows total Medicare reimbursements in 2006, either by Hospital Referring Region or by State, depending on the radio button. Using the dropdown box, you can change it to this:

Medicare Chart Critique Figure_2

…which is how the data looks if you overlay it on a Giraffe. Oops, I forgot to rotate it before saying that. Bear with me a moment…

Medicare Chart Critique Figure_3

There. See the Giraffe now? Good.

A picture is worth a thousand words, or so they say. But is a Choropleth worth the many line charts and clowns that you could squeeze into the same valuable screen real estate? Let’s find out, by evaluating what this particular chart does well, and what it does poorly, and whether other charting methods might better convey its information.

Words and music.

Right off the bat, there’s a simple way that the authors could improve this chart. While they include a description below the chart to point out what the data is, and where it came from, they miss something just as important…what they concluded from all of this. So before we consider adding – say – bullet graphs, let’s consider adding some bullet points. A few sentences can tell readers important stuff that would otherwise remain hidden in an undownloaded PDF report. Insights like:

  • Care is often better in low-cost areas.
  • Growth in returns are only partly explained by advancing technology, and
  • Differences in growth rates across regions seem largely due to discretionary decisions by physicians that are influenced by the local availability of hospital beds, imaging centres and other resources-and a payment system that rewards growth and higher utilization.

Straight off the bat, this would make the graph a better graph…without even messing with its form.

But mess we must…

…because lurking below the chlorophyll green of this Choropleth Map are a few serious charting oversights. Ready? Let’s check ’em out.

Scale? Fail!

First, check out the legend.

Medicare Chart Critique Figure_4

Crikey…its bands are as discrete as Bruno. Its scale is about as even as my temperament. It varies about as much as =RANDBETWEEN(PaydayBankBalance, UsualOverdraft).

If you fire up Excel and look at the spread covered by each range, you see just how arbitrary the different price bands are:

Medicare Chart Critique Figure_5

Whoa…the spread of that $9k to $16k band is nearly 15 times larger than two of the other bands. That can’t be good, can it?

Nice profile

If you were to graph financial spread of each group against the aggregated number of Hospital Referral Regions that fall within each spread, you get something like a histogram. The difference between the sizes of these bands is about as different as the number of performers on stage at a Bob Dylan concert in 1964 compared with 1974. See for yourself:

Medicare Chart Critique Figure_6Medicare Chart Critique Figure_7

1964 1974

Oops, wrong graphic. Try this:

Medicare Chart Critique Figure_8

Normally histograms have equal widths for each band, but here I want to highlight just how unequal the bands used are. Plus, this lets us regroup the data into evenly spread $1k bands, and overlay it on the first distribution, to see how it compares. Here’s one that I prepared earlier, with the red line as the regrouped data…

Medicare Chart Critique Figure_9

Vastly different picture isn’t it. The red is kinda like Data Pig’s heart rate before he eats chocolate covered bacon on Saturdays, and the blue is how his ECG would look when he’s in the ambulance, on the way to the hospital.

This makes it very hard to answer that important question “…compared to what?” With such different sized bands, how can we compare one to another? How can we be sure that the distributions within each band will even allow us to?

For instance, take the highest band spread of $9k to $16k: without any further information to go on, we might assume that the median (i.e. middle) value for districts in this category is midway between the $9k to $16k boundaries, like this:

Medicare Chart Critique Figure_10

But that’s like assuming that Simon and Chartjunkle (oops, Garfunkel) have equal talent. We’d be wrong. Verywrong. In actual fact, there’s only three data points to the right of our guessed median line. And as for the 55 hospital regions in Group Five that fall to the left of it…well, they all get tarred with the same brush those worst three performers. The actual median for this group is a lot further left, as shown below:

Medicare Chart Critique Figure_11

This means that over half the data in this 5th band actually falls much closer to the far left of the graph than to the far right of the same group it’s been placed in.

You can see this better if you add a one-dimensional strip plot above the graph, which gives an idea of where the 300 odd values fall within the entire range:

Medicare Chart Critique Figure_12

Whoa…looks like we’ve got a few outliers to contend with.

What a State we’re in…

This seemingly arbitrary ‘bucketing’ effect is exacerbated when aggregating the different hospital regions into State-wide totals. Except this time regions are being penalised by arbitrary geographical boundaries, as well as the arbitrary financial ones above.

Take Texas for example. Aggregating everything up to the State level, Texas appears in that highest band. Yet at the Hospital Referral Region level, one third of its 22 different hospital fall below the national average, and the median for the whole State is around $8,800. So we better be careful making assumptions from a State-wide view, because the Choropleth averages some very diverse costs over some very large chunks of real estate.

To see just how diverse, let’s rank the entire US values from smallest to largest, and highlight where the Texas readings fall within that range:

Medicare Chart Critique Figure_13

What can we tell from this? Firstly, nearly all regions nationwide fall between $5k and $10k. Secondly, there are a few outliers that really skew the picture at the high end. Thirdly, in the Texas case, the State average is boosted somewhat by 3 Texan districts that happen to be among the worst 10 culprits nationwide – one of which is clearly an outlier at $15k. Unfortunately for the lower cost Texan regions, they’re guilty by geographical association…kinda like being kidnapped and held for a zillion dollar ransom, just because you happen to live in the same State as Bill Gates.

So what do we get by aggregating to State boundaries? Probably more blurring than insight. After all, what good would a weather report be to Texans if it only reported the average weather they could expect as a State! Instead, it’s better to keep the aggregation at the Hospital Referral Region level. That way, we can look at this:

Medicare Chart Critique Figure_14

…and ask things like “Wow, why such a difference between Waco and the surrounding bits of Texas?” and “What the hell is Alaska doing there?”

Legends in the making…

What’s far worse that this though is that when looking at the State-wide map, the legend is now really, really wrong.

Here’s the legend next to the actual State-wide figures, for comparison:

Medicare Chart Critique Figure_15

Whoops…the graph title has changed to reflect we’re now looking at Medicare spending per beneficiary per State; i.e. State averages. The legend is still looking at Hospital Referral Region averages, which have a much greater spread. For instance, the Choropleth shows six States as being dark green regions, and the legend says they fall somewhere within $9k to $16k. But the actual data shows they fall in a $9.4k to $9.6k range. Oops! Slight misrepresentation, there.

How to fix it

Obviously this graph really should use a quantitative scale with equal increments; one that changes to reflect the selection that users make. What’s more, colors should have just enough variation so as to highlight any important differences, without being overwhelming or mistaken for camouflage.

But is a Choropleth Map the best way to present this data in the first place? If you want something for people to play with online, then maybe…but if you want to compare things very closely to other things, then maybe not.

For sure, a Choropleth Map looks cool, and it has what Tusha Metha calls “natural context”. But from an analytical perspective, a Choropleth only really reports how one thing changes with regards to geography. If geography is a major determinant – or if you want to show people how things look in their own back yard compared to others – then perhaps this is the piece of kit you need. But if there’s other factors that have much more sway on your data than geography, then perhaps not. For instance, we might want to see whether population density plays a significant part in Medicare returns, given the likely economies of scale from providing healthcare to densely populated regions vs. urban regions. Nows the time to break out a scatter plot:

Medicare Chart Critique Figure_16

Hmmm…looks promising. (Note: I’ve used State-wide data for the above…ran out of time to track down densities in the different Hospital Referral Regions, which is what I’d prefer to do.)

Or we might want to zoom in on the best or worst offenders, and see just how different they are to each other, and to the median value:

Medicare Chart Critique Figure_17

Conclusion

I think a better, fairer Choropleth Map at the Hospital Referral Region level would be interesting. But I don’t think it would be enough. To quote from Stephen Few’s latest book Now you see it: “Color is good at drawing your attention to something if used sparingly, but is one of the ‘pre-attentive attributes’ that is not quantitatively perceived in and of themselves”.

Whereas lines and 2D precision are very precise ways to encode quantitative values.

So when it comes to answering the ‘Compared to what’ question, I don’t think you can beat this:

Medicare Chart Critique Figure_18

 

Choropleth Maps in Excel

For information on the implementation of Choropleth Maps in Excel, check out Tushar Mehta’s excellent resources.

For more information on the pros and cons of Choropleth Maps, check out the Clearly and Simply blog, where Robert has built on Tushar’s excellent approach to produces some great downloadable templates. He also offers advice on potential drawbacks of Choropleth Maps, such as:

  • No visualization of development over time
  • No information on exact values (unless you are implementing tooltips including the data)
  • Very limited direct comparability of the regions
  • Possible perception problems with regards to the size of regions (e.g. Rhode Island on a US map)
  • Possible misinterpretation because the size of a region may have a greater impact on the user’s visual perception than the intensity of the fill color
  • Requirement of real estate on a dashboard

His recommendation: carefully consider whether or not a Choropleth Map is the best visualization for your purposes. Check out his dashboard of Lithuania at a glance to see how he mitigates some of the potential problems by incorporating other graphs into the display.

I used Robert’s template to produce this State-wide Choropleth Map of total Medicare spending per enrollee, 2006 using the same Medicare ranges as the Choropleth that’s the subject of this post:

Medicare Chart Critique Figure_19

…then I replotted the graph using data that had been regrouped $1k bands:

Medicare Chart Critique Figure_20

While I don’t advocate this approach, it’s interesting that even though this is aggregated to State-wide totals, you can see significant differences between the graphs.

Right, that’s it. I’m off to the Hospital to see someone about my writers cramp…

About the Author

Jeff is a Business Analyst from Wellington, New Zealand who has recently discovered a strong interest in Data Visualization. He swears by Edward Tufte and Stephen Few as much as he swears at Excel 2007. He’s so new to advanced Excel, that 2 years ago he had to ask a work friend what the dollar signs in $A$1 meant. Now that he knows that, he’s trying to find out what the dollar signs in $A$2 mean.

Note from PHD:

Thank you Jeff. Your passion and knowledge is truly outstanding. I have a whole pack of donuts waiting for you.

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49 Responses to “Project Management Dashboard / Project Status Report using Excel [Part 6 of 6]”

  1. [...] display milestones Part 4: Time sheets and Resource management Issue Trackers & Risk Management Project Status Reporting – Dashboard Bonus Post: Using Burn Down Charts to Understand Project [...]

  2. Alex says:

    Excellent!

    I was looking forward to this and you've done it again...Shame I can't claim it was all my own work 😉

    ps hope you're getting enough sleep

  3. Izabel says:

    Excelent !!! Tks to share your knowledge with us.
    Izabel
    Sao Paulo - Brazil

  4. Miguel says:

    Nice job!.

    I'm also keen on PM Excel Dashboards. Please, take a look at

    http://screencast.com/t/TyaxH5r4mDf

    That's one example of my Project control Spreadsheets.

    Cheers

  5. [...] haired Dilbert hat zum Abschluss einer Artikeserie zum Thema Projektmanagement mit Excel eine Anleitung zum Bau eines Projekt-Dashboards veröffentlicht. Ein Dashboard ist eine Visualisierungsform für große Mengen von meist [...]

  6. Rishil says:

    Quite a nice and helpful article. I am sure excel is one of the most used application across many many big companies. And your info on project status update using excel would surely be usefull. Keep up the good work on this blog site. Also to share there are some open source flash-based graphing and charting solution which caould also be used on any project..
    http://askwiki.blogspot.com/2009/07/how-to-create-quality-charts-using.html

  7. Chandoo says:

    @Alex, Izabel .. thank you 🙂

    @Miguel: Thank you. Your dashboard looks very good. It is inclined towards the budget and finances of the project. I have kept those aspects out of this series. May be I will revisit the financial aspect of projects at a later point.

    @Rishil: Thank you. Yes, you can create flash based charts (or even simple image based charts) and embed them in a project dashboard that can be published to the team using intranet (like sharepoint). This is how large companies usually do it. Thanks for sharing the Askwiki article.

  8. Tim says:

    Great looking dashboard!! Do you have a version for the Mac versions of Office available?

    Thanks

  9. ravi says:

    Chandoo,
    this is great piece of collating info.I liked it and shall try using it in office.
    Thanks for the all hard work behind this.

  10. Mrigank says:

    Chandoo,

    Kudos. This is really as simple as it gets for laymen. We did this sort of stuff in Consulting - but this can now become really simple for people. Will have my team look at this! Great work.

    thanks,

    Mrigank

  11. [...] I suggest reading my 7 part series on project management using excel. Starting with Excel Gantt Charts to Project Dashboards. [...]

  12. bw says:

    Just downloaded the project management template bundle...great!

    Have you done anywork on a Project Portfolio Dashboard template?

  13. Chandoo says:

    @Bw... Thanks for getting a copy of the templates. 🙂 I have worked on few assignments where we built such templates. But these are similar to other regular dashboard templates. I will share some of these ideas in a later post someday. Meanwhile if you have any ideas on how to structure project portfolio dashboard, let me know using comments or email.

  14. [...] to display milestones Time sheets and Resource management Issue Trackers & Risk Management Project Status Reporting – Dashboard Bonus Post: Using Burn Down Charts to Understand Project [...]

  15. [...] display milestones Time sheets and Resource management Part 5: Issue Trackers & Risk Management Project Status Reporting – Dashboard Bonus Post: Using Burn Down Charts to Understand Project [...]

  16. [...] to display milestones Time sheets and Resource management Issue Trackers & Risk Management Project Status Reporting – Dashboard Bonus Post: Using Burn Down Charts to Understand Project [...]

  17. Josh L says:

    Thanks fro the great ideas! To get a sense of the layout and design of a Dashboard more geared toward Cost and Schedule anaysis, check out the example Dashboard at http://www.ProjectDashboards.com which was built entirely in excel.

  18. DS says:

    hey,

    i just need a simple Chart where by i can show some of the projects by % wise. no dates required.

    1st column Project name and 2nd column will be status (filled with %). can you pls help me out.

    Thanks.

  19. Chandoo says:

    @DS... if you have excel 2007, you can use data bars in conditional formatting for this purpose.

  20. Larph says:

    Hi Chandoo - this series is an excellent resource and tutorial, thank you for sharing.

    When I sat down to consider what my dashboard should look like, one of the most important features for me is to be able to maintain version control and to show simply on what version is on display.

    Apart from the naming convention of the file name, is there a good way to do this within a dashboard? I'd be interested to hear your thoughts!

  21. Chandoo says:

    @Larph: Welcome 🙂

    > You can do version control thru Macros (but always remember that your audience can disable macros)

    > Another option is to use a static time stamp / version number in the title page of dashboard that you update manually whenever you make changes to the file

    > In excel 2010, you can keep track of file versions from File menu. This can be used to select a previous version of dashboard.

    > Best option is to use a version control system like SVN or upload files to Sharepoint or something like that. This will take care of versioning for you (although it is a bit technical and dashboard audience may have difficulty figuring the versions out).

    > The easiest option is to use filenames and the CELL() formula to get the version number (or date) from the filename so you can show it on the dashboard.

  22. Di says:

    Hi Chandoo... I'm following you from Brazil...
    I would like to thank you for the tips about excel, mainly with dashboards ... It helped me a lot …
    Take care...

    Di

  23. Kelly Fidei says:

    On the dashboard when I print, the text is blanked out in the middle of the Issues list - suggestions on how to fix?

  24. Neil Joseph says:

    Hi Chandoo, do you have an equivalent Project Management Dashboard / Project Status Report for MS Office 2010?

  25. Paul Brown says:

    As a Microsoft trainer I'm interested in your choice of Excel for project management. I'm assuming that you've tried Microsoft Project and have decided not to use it? We get folks on our MS Project courses who've tried to use Excel for PM purposes and none of them have made such an impressive project plan, but I wonder is it worth all the effort?

  26. Arc Nteimam Finomo says:

    This looks very interesting. How may I be a part of this

  27. Stephanie says:

    Does this template work in Google Spreadsheets?

  28. Thierry Lutonto says:

    Many thanks for sharing your expertise with us. Keep up the good work 🙂

  29. ppm software says:

    Heya i'm for the first time here. I came across this board and I to find It really helpful & it helped me out a lot. I am hoping to offer one thing again and aid others like you helped me.

  30. Adam G says:

    Hi Chandoo,
    Your PM dashboards impressed me so much that I've downloaded the Portfolio and Project Management package.  All of the documents look very professional.
    I was going through the Portfolio dashboard and I had a question.  
    When I enter in additional holidays they are highlighted in the gantt chart.  Is it possible so that the name of the holiday shows up in the highlighted area of the gantt chart.
    Thanks
    Adam

  31. alan foster says:

    can you confirm that the downloads will work on a mac - excel for mac v14.3.6

    thanks

  32. Paul says:

    Made a slight variation on the schedule sheet,

    1. Add a date column for start
    2. In week column cell use =weeknum() and link to date cell
    3. Hide week column

    When you enter in a date for each task the week number is populated accordingly
    simple but more effective, you can also dynamically link the date cell to your MSP project file for even more automation!!

  33. Irick Burris says:

    I purchased a copy of the project management dashboard excel file. I misplaced the password to unlock the file and make modification. Can you please resend the password.

    Thank much in advance...

  34. ninemsn.com.au says:

    Hi there! I just would like to give you a big thumbs up for your great info
    you've got right here on this post. I'll be returning to your website
    for more soon.

  35. Vijay says:

    I bought ur project management template just want to know how to hide the budget section from portfolio?

  36. Squirrel says:

    Hi, Thanks - very good job you've prepared!
    You've inspired me as well 🙂
    Best regards

  37. mj says:

    Hello!
    I am using a gantt chart template which i got from your website. All is good just when I add all my acitivities in data spreadsheet and then go back to gantt chart to view them, I only see first 9 and then I need to keep scrolling for the next ones. is it possible to see most of the activities if not all in the single frame.
    thanks for answering!

  38. Sanford says:

    This is my first time pay a visit at here and i am actually happy to read all at alone place.

  39. gerald says:

    I am interested in your dashboard; downloaded the locked version, unable to use it...do you have a user guide that is available that I can see and use on the locked version?

  40. Arun says:

    Please send me daily newsletter

  41. Ramya says:

    Hi,
    I downloaded the PM dashboard and the gantt chart only has dates till the year 2016. How do I change this to include 2017 FY as well.
    When I enter a activity for this year , it fails to show up on the chart.

  42. Hari says:

    Hi

    Would.like to purchase the project management .kits

    Pls share the payment link in INR

    Also share your contact number to speak with you

    Regards
    Hari
    9384825926

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