Moving Beyond StandardBMV Reports

Using Data Repository

Session 373Presented by: Ian Proffer

Session Agenda

Review eMAR and BMV benchmarking reports in MEDITECH applications and the Data Repository

Report development and deployment strategies

Example DR-based BMV scan rate and warning reports

Questions, answers, & discussion

Areas of Interest

Rx administration summary Doses administered, doses scanned

Administered with or without warnings

BMV scan rates, looking for improvements By location and user

By department and user?

BMV warnings analysis By location, drug, ordering provider, user,

etc.

Our Development Strategy

1. Review standard reports available in MEDITECH (MAGIC 5.61)

2. Identify corresponding data within MEDITECH Data Repository

3. Create reports and structures to present the same data in a more user friendly and meaningful way

4. Validate results against MEDITECH application reports

5. Look for additional methods to relate eMAR and BMV data to glean additional knowledge into success of BMV / eMAR effort

MEDITECH eMAR and BMV Reports

eMAR Measuring & Monitor Detail This report allows users to specify and

filter data by location, ordering provider, admin user, drug type, drug, and warning type.

It then summarizes medication dose administrations, scan rates, warnings, and patient verifications.

MEDITECH Report Sample

User-supplied criteria

Summary Stats

Warning Counts

Administration Warnings By Location and User

Where We Get eMAR & BMV Data

MEDITECH Data Repository Versions 5.61

Most Pharmacy data became available in DR in version 5.5 Includes all NPR DPMs / segments as

well as dictionaries Can be easily linked to data in

other MEDITECH applications

Data Repository in SQL Management Studio

6000+ tables containing most data from most MEDITECH applications

SQL Server 2005 (or 2000) Relational Database Management System with MEDITECH Application Data

eMAR and BMV Information in the DR

NPR DPM = PHA.RXSEGMENT = admin

NPR DPM = PHA.RXSEGMENT = dose.warnings

NPR DPM = PHA.STATSSEGMENT = emar.daily.admin.stats

Information about dose administration

eMAR Compiled Statistics

Dose Warning Detail

NPR DPM = PHA.RXSEGMENT = scanned.med.x

BMV scan activity

A Closer Look at MEDITECH’s Total Statistics

Totals for doses administered, scanned, administered with and without warnings, doses not administered, patients verified (by wrist band scanning) and total warnings.

Two categories: 1) Doses Administered 2) Doses Not Administered

Data Repository-Driven VersionUser-supplied criteria includes date range, but can also include Location, Ordering Provider, etc.

Totals provide same information as MEDITECH report and can show or hide detail data

Charts are easily incorporated to add visual impact – this example highlights improving scan rates

Report Development & Delivery Strategies

SQL Server 2005 stored procedures to extract detail and summary eMAR and BMV data from DR tables

SQL Server 2005 Reporting Services to summarize and sort data, provide interactivity and drill-through to related reports, and deliver reports via intranet, email, file share, or printer

SQL Server 2005 Analysis Services to perform multi-dimensional analysis

More MEDITECH Reports Scan Rates by User, by Location

SSRS Report DesignerVisual Studio 2005

• VS provides a graphical design environment to simplify report development•“Under the hood” complex coding takes place – dedicated IT developers can leverage powerful programming features

SQL Reporting Services (SSRS)Report Manager

Web-based administration• Organize into Folders• Security Profiles • Subscriptions• Snapshots

Uses local intranet (Microsoft ISS) to host reports and deliver to users

Reporting Services Versions

Reports can be exported in a variety of formats, or printed directly from your browser

Dates can easily be changed and the report re-run with one mouse click

Conditional formatting allows you to highlight values based on your own metrics

Scan Rate by DepartmentWith Drill-down to Employee

Very useful for clinical managers: location and department are two different things!

DR reports allow cross-module analysis, in this case PHA and PP

SSRS InteractivityRemember This Report?

Click on the date…

…and the date is passed to run this report.

Report Manager allows you to view and navigate reports just like a web page – very simple for staff to use.

MEDITECH Measuring and Monitoring Detail Report - Patient Statistics?

This is really a breakdown of Warnings by Location and Admin User

Acmeware Version Using Drill-Down

“+” Allows drill-down to totals by user and warning

Totals By Location

Totals By User

MEDITECH Measuring and Monitoring Detail Report - Warning Summary

Warnings issued over a date range broken by medications administered and not administered

Warnings percent is based on total warnings from Total Statistics Report

Admin Percent of Total

Acmeware Warning Summary Report

Filtering criteria can be changed immediately and the page refreshed

Dropdown Box allows one, multiple or <ALL> selection (SQL 2005)

Percentages based on Total Warnings

SQL Server 2005 Analysis Services

Cubes are Multidimensional Databases that allow data to be easily analyzed, sorted, filtered, and manipulated to look for trends, outliers, and other information hidden within the data.

What’s In a Cube?

Fact Tables define events occurring over time (e.g., patient visits, medication administrations, warnings, lab tests, etc.)

Measures are numeric computations of facts (e.g., count number of visits, total number of administration warnings, etc.)

Dimensions are the ways you might want to analyze the measures. Examples include items from MEDITECH dictionaries (e.g. providers, drugs, locations) as well as regular time increments (days, months, years).

BMV Warning Summary

Measures

Dimensions

Facts

Warning Analysis by Administered Location

Dimensions can be arranged to show logical groupings; subtotals are automatically updated.

Dimension data can be hidden, but used to filter summary data.

Warnings by Location With Chart

Chart can be displayed side-by-side with detail data, or on its own.

Warnings by User Chart

More Chart Analysis Options With a Few Clicks…

…for these nurses only.Chart type is quickly changed to show total warnings by month for Jan-April…

Differences Between Reporting Services and Analysis Services

SSRS reports: run and done User may or may not supply criteria Typically designed and maintained by IT staff Reports are designed to present specific,

detailed information SSAS data: dynamic and open

User decides what to see and how to see it Finished “report” is designed by user (within

constraints of your software) Allow immediate analysis of a variety of

information – great of revealing trends using summary data

Looking Ahead: Using DR Data to Measure Successful BMV/eMAR Use

Look for additional methods to correlate eMAR and BMV data Associate warnings with medication

administration

Analyze effect on adverse events Measure improvement in patient

outcomes Other indirect influences of BMV

and eMAR

Thank you!