216H Extracting and Exporting Pharmacy Data

1
216H Extracting and Exporting Pharmacy Data

• (Absolute Power)

2
Extracting and Exporting Pharmacy Data
(Absolute Power)

• Presenters
• Brett Vess, MBA CCP
• Health Systems Specialist
• Asheville, VAMC, North Carolina
• Mike Martinko, R.Ph.
• Pharmacy Applications Coordinator
• VAMC Chillicothe, Ohio

3
Extracting and Exporting Pharmacy Data
(Absolute Power) Class Description

• This Pharmacy sponsored hands-on class focuses on
  Pharmacy VistA files and file structures to
  extract data. The class also provides an overview
  on methods of exporting data into Excel, as well
  as tips and tricks on how to arrange the data to
  present user friendly information.

4
Extracting and Exporting Pharmacy Data
(Absolute Power)

• How to have
• Absolute
• Power
• over your pharmacy output data

5
Extracting and Exporting Pharmacy Data
(Absolute Power) Class Objectives

• Differentiate between Fileman output reports and
  VistA reports available in the various Pharmacy
  software packages.
• Illustrate possible uses of several Pharmacy
  VistA canned reports as they may pertain to
  possible user scenarios.
• Offer a hands-on exercise by importing a VistA
  fixed-width report into Excel.

6
Extracting and Exporting Pharmacy Data
(Absolute Power) Class Objectives

• Utilize numerous Excel tools to enhance and
  complement the displayed data.
• Import a Fileman delimited output file into Excel
  for use as a mail merge.
• Complete an example of a possible drug recall
  patient letter using mail merge.
• Present an overview of the Provider Profiling
  Program developed for VISN 5.

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Defining Delimited Reports and Fixed Width
Reports

• Importing into Excel converts text into a
  spreadsheet requires breaking text into columns
  and rows.
• Delimited
• Text is separated by a delimiter, usually an
  _at_ or to set column width.
• Example Fileman report output.
• Fixed Width
• Columns are set by the user, and require the text
  to be lined up vertically.
• Example Canned VistA report output.

8
VistA Software Package Reports (Canned
Reports)

• Explain when a canned report will suffice over
  a fileman search
• Advantages of canned reports
• Faster
• Less work intensive for user
• Less stress on system resources
• Disadvantages of canned reports
• May not print in optimum order
• May have unwanted spaces or columns
• May include undesired information

9
Extracting and Exporting Pharmacy Data
(Absolute Power)

• Each pharmacy software package has its own set of
  output reports.
• Each set of package reports has its own
  characteristics, advantages, and limitations.
• Outpatient can be prescriber-specific
• IV can be patient-specific
• Unit dose can sort or print using multiple
  criteria

10
Extracting and Exporting Pharmacy Data
(Absolute Power)

• Scenario 1 Outpatient drug cost and quantity
  monitoring requested for gross errors.

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Outpatient Reports Output Reports Cost
Analysis Reports

• Select Output Reports Option Cost Analysis
  Reports
• Clinic Costs
• Division Costs by Drug
• Drug Costs
• Drug Costs by Division
• Drug Costs by Division by Provider
• Drug Costs by Provider
• High Cost Rx Report
• Patient Status Costs
• Pharmacy Cost Statistics Menu ...
• Provider by Drug Costs
• Provider Costs
• Request Statistics

12
Outpatient Reports Output Reports Cost
Analysis Reports

• Select Output Reports Option Cost Analysis
  Reports
• Clinic Costs
• Division Costs by Drug
• Drug Costs
• Drug Costs by Division
• Drug Costs by Division by Provider
• Drug Costs by Provider
• High Cost Rx Report ltltltltltltltltltltlt
• Patient Status Costs
• Pharmacy Cost Statistics Menu ...
• Provider by Drug Costs
• Provider Costs
• Request Statistics

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Output Reports Cost Analysis Reports High Cost
Rx Report

• Select Cost Analysis Reports Option High Cost
  Rx Report

14
Output Reports Cost Analysis Reports High Cost
Rx Report

• Select Cost Analysis Reports Option High Cost
  Rx Report
• Beginning Date 6/1/07 (JUN 01, 2007)
• Ending Date 6/30/07 (JUN 30, 2007)

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Output Reports Cost Analysis Reports High Cost
Rx Report

• Select Cost Analysis Reports Option High Cost
  Rx Report
• Beginning Date 6/1/07 (JUN 01, 2007)
• Ending Date 6/30/07 (JUN 30, 2007)
• Dollar Limit (0-9999) 30//

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Output Reports Cost Analysis Reports High Cost
Rx Report

• Select Cost Analysis Reports Option High Cost
  Rx Report
• Beginning Date 6/1/07 (JUN 01, 2007)
• Ending Date 6/30/07 (JUN 30, 2007)
• Dollar Limit (0-9999) 30// 400

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Output Reports Cost Analysis Reports High Cost
Rx Report

• Select Cost Analysis Reports Option High Cost
  Rx Report
• Beginning Date 6/1/07 (JUN 01, 2007)
• Ending Date 6/30/07 (JUN 30, 2007)
• Dollar Limit (0-9999) 30// 400
• DEVICE HOME//

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Output Reports Cost Analysis Reports High Cost
Rx Report

• Fills That Cost at Least 400 for the Period JUN
  1,2007 to JUN 30,2007Page 1
• Run Date JUL 23,2007
• Rx Drug
  QTY Un.Cost Total Cost
• --------------------------------------------------
  ------------------------------
• 0000000 PEGINTERFERON ALFA-2B 150MCG/0.5ML SYR
  4 120.930 483.72
• 0000000 EPOETIN ALFA,RECOMB 20,000UNT/ML INJ
  4 103.635 414.54
• 0000000A ENOXAPARIN 80MG/0.8ML INJ SYRINGE
  0.8ML 20 25.243 504.86
• 0000000 OXCARBAZEPINE 600MG TAB
  180 2.377 427.84
• 0000000 CINACALCET HCL 60MG TAB
  90 11.778 1059.99
• 0000000 ETANERCEPT 50MG/ML INJ SURECLICK
  8 170.938 1367.50
• 0000000 PEGINTERFERON ALFA-2B 120MCG/0.5ML SYR
  4 119.840 479.36
• 0000000C RISPERIDONE 37.5MG/VIL INJ SA SUSP
  2 244.730 489.46
• 0000000A OLANZAPINE 10MG TAB
  90 6.444 579.96
• 0000000 PEGINTERFER ALFA-2A 180MCG/0.5ML SYR
  4PK 1 479.140 479.14
• 0000000A QUETIAPINE FUMARATE 300MG TAB
  180 2.420 435.51
• 0000000B OLANZAPINE 20MG TAB
  90 11.589 1043.01
• 0000000 ETANERCEPT 50MG/ML INJ SURECLICK
  4 170.938 683.75
• 0000000A QUETIAPINE FUMARATE 300MG TAB
  180 2.420 435.51

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Output Reports Cost Analysis Reports High Cost
Rx Report

• Sort by drug name, then by cost or amount
  dispensed to find possible outliers

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Output Reports Cost Analysis Reports High Cost
Rx Report (in Excel)
21
Output Reports Cost Analysis Reports High Cost
Rx Report (in Excel)
22
Extracting and Exporting Pharmacy Data
(Absolute Power)

• Scenario 2 To assist with purchasing drugs
  ahead (end of year funds become available),
  identify high cost/high volume outpatient
  dispense drugs for local fills only.

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Manual Pharmacy StatisticsPrescription
(Outpatient)

• Select Pharmacy Coordinator Menu Option Manual
  Pharmacy Statistics

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Manual Pharmacy StatisticsPrescription
(Outpatient)

• Select Pharmacy Coordinator Menu Option Manual
  Pharmacy Statistics
• The Pharmacy Benefits Management (PBM) report
  will extract
• statistics from one or more of the following
  files
• (files are listed below)
• Is this the monthly report?

25
Manual Pharmacy StatisticsPrescription
(Outpatient)

• Select Pharmacy Coordinator Menu Option Manual
  Pharmacy Statistics
• The Pharmacy Benefits Management (PBM) report
  will extract
• statistics from one or more of the following
  files
• (files are listed below)
• Is this the monthly report? NO

26
Manual Pharmacy StatisticsPrescription
(Outpatient)

• Select Pharmacy Coordinator Menu Option Manual
  Pharmacy Statistics
• The Pharmacy Benefits Management (PBM) report
  will extract
• statistics from one or more of the following
  files
• (files are listed below)
• Is this the monthly report? n NO
• Select Start Date

27
Manual Pharmacy StatisticsPrescription
(Outpatient)

• Select Pharmacy Coordinator Menu Option Manual
  Pharmacy Statistics
• The Pharmacy Benefits Management (PBM) report
  will extract
• statistics from one or more of the following
  files
• (files are listed below)
• Is this the monthly report? n NO
• Select Start Date 5/1/2007 (MAY 01, 2007)
• Select End Date 6/30/2007 (JUN 30, 2007)

28
Manual Pharmacy StatisticsPrescription
(Outpatient)

• Select Pharmacy Coordinator Menu Option Manual
  Pharmacy Statistics
• The Pharmacy Benefits Management (PBM) report
  will extract
• statistics from one or more of the following
  files
• (files are listed below)
• Is this the monthly report? n NO
• Select Start Date 5/1/2007 (MAY 01, 2007)
• Select End Date 6/30/2007 (JUN 30, 2007)
• Do you want a copy of this report sent to you in
  a MailMan message? NO// YES

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Manual Pharmacy StatisticsPrescription
(Outpatient)

• Select one or more of the following
• 1. IVs
• 2. Unit Dose
• 3. AR/WS
• 4. Prescription
• 5. Procurement
• 6. Controlled Substances
• 7. Patient Demographics
• 8. Outpatient Visits
• 9. Inpatient PTF Records
• 10. Provider Data
• 11. Allergies/Adverse Events
• Vitals/Immunizations Information
• The Provider Data report may take an extended
  amount of time to run.
• It is recommended that it be run during off peak
  hours.
• Select the code(s) associated with the data
  requested

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Manual Pharmacy StatisticsPrescription
(Outpatient)

• Select one or more of the following
• 1. IVs
• 2. Unit Dose
• 3. AR/WS
• 4. Prescription
• 5. Procurement
• 6. Controlled Substances
• 7. Patient Demographics
• 8. Outpatient Visits
• 9. Inpatient PTF Records
• 10. Provider Data
• 11. Allergies/Adverse Events
• Vitals/Immunizations Information
• The Provider Data report may take an extended
  amount of time to run.
• It is recommended that it be run during off peak
  hours.
• Select the code(s) associated with the data
  requested 4

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Manual Pharmacy StatisticsPrescription
(Outpatient)

• You have selected 4 - Prescription
• 13 - Laboratory Results
• Patient Demographic Summary
• Print Summary Only? NO//

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Manual Pharmacy StatisticsPrescription
(Outpatient)

• You have selected 4 - Prescription
• 13 - Laboratory Results
• Patient Demographic Summary
• Print Summary Only? NO// NO

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Manual Pharmacy StatisticsPrescription
(Outpatient)

• You have selected 4 - Prescription
• 13 - Laboratory Results
• Patient Demographic Summary
• Print Summary Only? NO//
• This report will automatically run as a
  background job.
• REQUESTED TIME TO RUN NOW//

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Manual Pharmacy StatisticsPrescription
(Outpatient)

• You have selected 4 - Prescription
• 13 - Laboratory Results
• Patient Demographic Summary
• Print Summary Only? NO//
• This report will automatically run as a
  background job.
• REQUESTED TIME TO RUN NOW// T_at_2000 (AUG
  23, 2007_at_2000)

35
Manual Pharmacy StatisticsPrescription
(Outpatient)

• You have selected 4 - Prescription
• 13 - Laboratory Results
• Patient Demographic Summary
• Print Summary Only? NO//
• This report will automatically run as a
  background job.
• REQUESTED TIME TO RUN NOW// T_at_2000 (AUG
  23, 2007_at_2000)
• Subj PBM TIMING for report MAY 01, 2007 to JUN
  30, 2007 from 538 CHILL
• 20095178 07/24/07_at_1509 7 lines
• From PHARMACIST,ONE In 'IN' basket. Page 1
• --------------------------------------------------
  --------------------------------------------------
  ----------
• Prescription JUL 24,2007_at_1354
  JUL 24,2007_at_1504 1 hrs, 10 min
• Laboratory Results JUL 24,2007_at_1504 JUL
  24,2007_at_1509 0 hrs, 5 min
• --------------------------------------------------
  --------------------------------------------------
  -----------

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Manual Pharmacy StatisticsPrescription
(Outpatient)

• Total Total Qty
• Drug Name
  Partials Fills Refills Cost Dispensed
• --------------------------------------------------
  ----------------------------------------------
• A D OINT
  1 3 0 3.84 240.00
• ABSORBASE TOP OINT
  0 2 0 9.08 908.00
• ACARBOSE 25MG TAB
  0 1 0 94.77 270.00
• ACARBOSE 50MG TAB
  0 5 1 209.25 555.00
• ACETAMINOPHEN 325MG TAB
  1 65 8 54.62 13006.00
• ACETIC ACID 0.25 IRRG SOLN
  0 1 0 4.00 2000.00
• ACETYLCYSTEINE 10 PF INHL SOLN
  0 0 1 8.51 90.00
• ACYCLOVIR 200MG CAP
  0 7 1 33.86 875.00
• ACYCLOVIR 400MG TAB
  0 10 0 33.62 675.00
• ACYCLOVIR 5 OINT
  1 3 0 240.40 75.00
• ADALIMUMAB 40MG/0.8ML INJ PEN KIT
  1 5 0 6606.80 20.00
• ADALIMUMAB 40MG/0.8ML INJ SYRINGE KIT
  0 0 2 2612.04 8.00
• ALLKARE PROTECTIVE BARRIER PAD C0374-44
  0 0 1 9.40 100.00
• ALLOPURINOL 100MG TAB
  1 14 4 54.81 1755.00
• ALLOPURINOL 300MG TAB
  0 5 1 23.00 420.00
• ALOE VESTA 3-N-1 CLEANSING TOP FOAM
  0 1 0 6.86 480.00

37
Extracting and Exporting Pharmacy Data
(Absolute Power)

• Scenario 3 Need to identify dispense drugs by
  quantity dispensed for inclusion in inpatient
  unit dose packaging hardware

38
Unit Dose Supervisors Menu Management
Reports

• Select Supervisor's Menu Option Management
  Reports Menu
• AMIS (Cost per Ward)
• Drug (Cost and/or Amount)
• PRovider (Cost per)
• Service (Total Cost per)
• Total Cost to Date (Current Patients)

39
Unit Dose Supervisors Menu Management
Reports

• Select Supervisor's Menu Option Management
  Reports Menu
• AMIS (Cost per Ward)
• Drug (Cost and/or Amount) ltltltltltltltltltltlt
• PRovider (Cost per)
• Service (Total Cost per)
• Total Cost to Date (Current Patients)

40
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE

41
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)

42
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS

43
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS DISPENSE DRUG

44
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS DISPENSE DRUG
• Select Dispensed Drug ALL//

45
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS DISPENSE DRUG
• Select Dispensed Drug ALL// RETURN

46
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS DISPENSE DRUG
• Select Dispensed Drug ALL//
• Sort drugs by DISPENSED DRUG, COST, or AMOUNT
  DISPENSED

47
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS DISPENSE DRUG
• Select Dispensed Drug ALL//
• Sort drugs by DISPENSED DRUG, COST, or AMOUNT
  DISPENSED AMOUNT DISPENSED

48
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS DISPENSE DRUG
• Select Dispensed Drug ALL//
• Sort drugs by DISPENSED DRUG, COST, or AMOUNT
  DISPENSED AMOUNT DISPENSED
• Print all drugs costing at least? (ALL)

49
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS DISPENSE DRUG
• Select Dispensed Drug ALL//
• Sort drugs by DISPENSED DRUG, COST, or AMOUNT
  DISPENSED AMOUNT DISPENSED
• Print all drugs costing at least? (ALL)
• Print all drugs with a dispensing amount of at
  least? (ALL)

50
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS DISPENSE DRUG
• Select Dispensed Drug ALL//
• Sort drugs by DISPENSED DRUG, COST, or AMOUNT
  DISPENSED AMOUNT DISPENSED
• Print all drugs costing at least? (ALL)
• Print all drugs with a dispensing amount of at
  least? (ALL)
• Select PRINT DEVICE

51
Unit Dose Management Reports Drug (Cost
and/or Amount)

• UNIT DOSE DRUG COST REPORT 08/23/07
  1234
• FROM 06/01/07 THROUGH
  06/30/07
• 
  TOTAL UNITS TOTAL
• DISPENSED DRUG
  DISPENSED COST
• --------------------------------------------------
  ------------------------------
• DOCUSATE NA 100MG CAP U/D
  6305.000 151.3200
• VALPROIC ACID 250MG/5ML SYRUP
  5099.000 56.5989
• ACETAMINOPHEN 325MG TAB U/D
  3989.000 71.8020
• OMEPRAZOLE 20MG EC CAP
  3432.000 1372.1136
• CALCIUM 250MG/VITAMIN D 125U TAB U/D
  2144.000 10.7200
• ASPIRIN 81MG EC TAB
  2049.000 7.9911
• DIVALPROEX 500MG 24HR (ER) SA TAB
  1913.000 1239.0501
• NITROGLYCERIN 0.4MG SL TAB U/D 25/BT
  1728.000 111.2832
• POTASSIUM CHLORIDE 8MEQ SA TAB U/D
  1627.000 13.0160
• RANITIDINE HCL 150MG TAB U/D
  1608.000 46.6320
• SODIUM CHLORIDE 0.9 INJ 2ML TUBEX
  1342.000 392.4008
• SENNOSIDES 8.6MG TAB
  1334.000 8.5376

52
Extracting and Exporting Pharmacy Data
(Absolute Power)

• Scenario 4 Help is required defining budget
  dollars spent by drug in unit dose.

53
Unit Dose Supervisors Menu Management
Reports

• Select Supervisor's Menu Option Management
  Reports Menu
• AMIS (Cost per Ward)
• Drug (Cost and/or Amount) ltltltltltltltltltltlt
• PRovider (Cost per)
• Service (Total Cost per)
• Total Cost to Date (Current Patients)

54
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)

55
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS

56
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS ORDERABLE ITEM

57
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS ORDERABLE ITEM
• Select Orderable Item ALL//

58
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS ORDERABLE ITEM
• Select Orderable Item ALL// RETURN

59
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS ORDERABLE ITEM
• Select Orderable Item ALL//
• Display the dispense drugs? Yes//

60
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS ORDERABLE ITEM
• Select Orderable Item ALL//
• Display the dispense drugs? Yes// N (No)

61
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS ORDERABLE ITEM
• Select Orderable Item ALL//
• Display the dispense drugs? Yes// N (No)
• Sort drugs by ORDERABLE ITEM, COST, or AMOUNT
  DISPENSED

62
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS ORDERABLE ITEM
• Select Orderable Item ALL//
• Display the dispense drugs? Yes// N (No)
• Sort drugs by ORDERABLE ITEM, COST, or AMOUNT
  DISPENSED COST

63
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS ORDERABLE ITEM
• Select Orderable Item ALL//
• Display the dispense drugs? Yes// N (No)
• Sort drugs by ORDERABLE ITEM, COST, or AMOUNT
  DISPENSED COST
• Print all drugs costing at least? (ALL)

64
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS ORDERABLE ITEM
• Select Orderable Item ALL//
• Display the dispense drugs? Yes// N (No)
• Sort drugs by ORDERABLE ITEM, COST, or AMOUNT
  DISPENSED COST
• Print all drugs costing at least? (ALL)
• Print all drugs with a dispensing amount of at
  least? (ALL)

65
Unit Dose Management Reports Drug (Cost
and/or Amount)

• Select Management Reports Menu Option Drug (Cost
  and/or Amount)
• Enter START DATE 6/1/07 (JUN 01, 2007)
• Enter STOP DATE 6/30/07 (JUN 30, 2007)
• Select drugs by DISPENSE DRUG, ORDERABLE ITEM, or
  VA CLASS ORDERABLE ITEM
• Select Orderable Item ALL//
• Display the dispense drugs? Yes// N (No)
• Sort drugs by ORDERABLE ITEM, COST, or AMOUNT
  DISPENSED COST
• Print all drugs costing at least? (ALL)
• Print all drugs with a dispensing amount of at
  least? (ALL)
• Select PRINT DEVICE

66
Unit Dose Management Reports Drug (Cost
and/or Amount)

• UNIT DOSE DRUG COST REPORT 08/23/07
  1156
• FROM 06/01/07 THROUGH
  06/30/07
• 
  TOTAL UNITS TOTAL
• ORDERABLE ITEM
  DISPENSED COST
• --------------------------------------------------
  ------------------------------
• ENOXAPARIN INJ
  333.000 6303.1640
• QUETIAPINE TAB
  3222.000 5153.9513
• RISPERIDONE INJ,SUSP,SA
  20.000 4490.6000
• RISPERIDONE TAB
  1635.000 4431.4697
• OLANZAPINE TAB
  395.000 2277.9825
• EPOETIN ALFA INJ,SOLN
  22.000 2002.9837
• DIVALPROEX TAB,SA,24HR (EXTENDED RELEASE)
  2433.000 1419.6981
• OMEPRAZOLE CAP,EC
  3432.000 1372.1136
• MEMANTINE TAB
  1009.000 1341.6724
• CLOPIDOGREL TAB
  486.000 1290.1842
• TIOTROPIUM CAP,INHL
  60.000 1150.8000
• ZIPRASIDONE CAP,ORAL
  383.000 1148.1012

67
Extracting and Exporting Pharmacy Data
(Absolute Power)

• Scenario 5 A medication (LORATADINE 10MG TAB)
  is identified as having an increase in dispensed
  quantity.
• Hands-on Exercise Identify the provider(s) who
  may be changing their prescribing practice.
• Drug Costs by Provider for Loratadine July 2007

68
Extracting and Exporting Pharmacy Data
(Absolute Power)

• Presenter
• Brett Vess, MBA CCP
• Health Systems Specialist
• Asheville, VAMC, North Carolina

69
Hands On LoratadineImporting into Excel
70
Excel Tips and Tricks Covered

• Importing text files
• Columns and Rows Principles
• Fix Headers and Rows
• Copy and Paste
• Copy and Paste Special
• Find and Replace
• Fill down
• Sum Functions
• Average Function
• Divide Function
• Concatenate Function

• Formatting Cells
• Sort/ Filter
• Intro to the power of Pivot Charts

71
Background FilemanDrug Recall
Select PHARMACY CHIEF, SUPVR AND APPL COORD MENU
Option file Manager for Users Select File
Manager for Users Option search File
Entries OUTPUT FROM WHAT FILE PRESCRIPTION//
-A- SEARCH FOR PRESCRIPTION FIELD STATUS -A-
CONDITION EQUALS -A- EQUALS ACTIVE -B-
SEARCH FOR PRESCRIPTION FIELD STATUS -B-
CONDITION EQUALS -B- EQUALS SUSPENDED
72
Background FilemanDrug Recall
-C- SEARCH FOR PRESCRIPTION FIELD DRUG 1
DRUG 2 DRUG ALLERGY INDICATION 3
DRUG ALLERGY INGREDIENTS (multiple) 4
DRUG EXPIRATION DATE CHOOSE 1-4 1 DRUG
-C- CONDITION CONTAINS -C- CONTAINS
METFORMIN -D- SEARCH FOR PRESCRIPTION FIELD
IF AC STATUS EQUALS "0" (ACTIVE)
and DRUG CONTAINS (case-insensitive)
"METFORMIN" OR BC Or STATUS EQUALS "5"
(SUSPENDED) and DRUG CONTAINS
(case-insensitive) "METFORMIN" OR
73
Background FilemanDrug Recall
-D- SEARCH FOR PRESCRIPTION FIELD IF AC
STATUS EQUALS "0" (ACTIVE) and
DRUG CONTAINS (case-insensitive) "METFORMIN OR
BC Or STATUS EQUALS "5" (SUSPENDED)
and DRUG CONTAINS (case-insensitive)
"METFORMIN" OR
74
Background FilemanDrug Recall
STORE RESULTS OF SEARCH IN TEMPLATE SORT BY
RX // PATIENT 1 PATIENT 2
PATIENT INSTRUCTIONS 3 PATIENT STATUS
CHOOSE 1-3 1 PATIENT START WITH PATIENT
FIRST// WITHIN PATIENT, SORT BY FIRST PRINT
FIELD PATIENTX 1 PATIENT 2
PATIENT INSTRUCTIONS 3 PATIENT STATUS
CHOOSE 1-3 1 PATIENT
75
Background FilemanDrug Recall
THEN PRINT FIELD " THEN PRINT FIELD PATIENT
(NOTE This is a colon, not semicolon) THEN
PRINT PATIENT FIELD STREET ADDRESS LINE 1X
THEN PRINT PATIENT FIELD "" THEN PRINT
PATIENT FIELD STREET ADDRESS LINE 2X THEN
PRINT PATIENT FIELD "" THEN PRINT PATIENT
FIELD CITYX 1 CITY 2 CITY
(CIVIL) 3 CITY (VA) CHOOSE 1-3 1
CITY THEN PRINT PATIENT FIELD "" THEN PRINT
PATIENT FIELD STATEX 1 STATE 2
STATE (CIVIL) 3 STATE (VA) CHOOSE 1-3
1 STATE
76
Background FilemanDrug Recall
THEN PRINT PATIENT FIELD "" THEN PRINT
PATIENT FIELD ZIP CODEX THEN PRINT PATIENT
FIELD "" THEN PRINT PATIENT FIELD THEN
PRINT FIELD Heading (S/C) PRESCRIPTION
SEARCH// METFORMIN SEARCH STORE PRINT LOGIC IN
TEMPLATE DEVICE 013299999999999
You will go up to Tools and do a Capture on the
Information. Go to Options, Display, go to the
tab that says VT Specific and change the columns
from 80 to 132. Print will become smaller.
This will run on your screen. Then go back up to
Tools and End the Capture
77
Background FilemanDrug Recall
THEN PRINT PATIENT FIELD "" THEN PRINT
PATIENT FIELD ZIP CODEX THEN PRINT PATIENT
FIELD "" THEN PRINT PATIENT FIELD THEN
PRINT FIELD Heading (S/C) PRESCRIPTION
SEARCH// METFORMIN SEARCH STORE PRINT LOGIC IN
TEMPLATE DEVICE 013299999999999
You will go up to Tools and do a Capture on the
Information. Go to Options, Display, go to the
tab that says VT Specific and change the columns
from 80 to 132. Print will become smaller.
This will run on your screen. Then go back up to
Tools and End the Capture
78
Hands-On Mailmerge Letter

79
Extracting and Exporting Pharmacy Data
(Absolute Power)

• Go ahead.
• Ask questions
• Make My Day..

80
VISN 5 Provider Profiling for Pharmacy
Introduction

• David Brett Vess, MBA
• Pharmacy Data Mgr.
• VISN 05

81
VISN 5 Provider Profiling for Pharmacy -
MARTINSBURG

• Established gt 7 years ago (Pre-VISN data mart)
• 1 Highest in Nation in Pharmacy Cost/Unique
• Distributed through Chief of Staff Clinical
  Service Chiefs
• Key Features
• Includes 3 data points Cost per Pharmacy Unique,
  Cost per Rx, Rxs per Unique
• 3 month simple moving averages
• Detailed List of Rxs for each Provider
• Outliers are analyzed further
• Data is used for CBOC Contract Provider
  Performance

82
VISN 5 Provider Profiling for Pharmacy -
MARTINSBURG
83
VISN 5 Provider Profiling for Pharmacy -
MARTINSBURG

84
VISN 5 Provider Profiling for Pharmacy - DC

• Two Types of Reports
• PuPs Cost per 30 day equivalent Rx
• PuPs National Initiatives
• PuPs Cost per 30 day equivalent Rx
• Distributed by COS Chief of Medicine
• Variation of the Martinsburg model (use of VISN
  data mart)
• All Rxs Converted to 30 day equivalent for a
  normalized monthly comparison
• Details of Rxs only for those who are outliers

85
Example DC Cost per 30 day Rx

• Two T

86
Example DC Detailed Rx Report

• Two T

87
DC PuPS National Initiative

• PuPs National Initiatives
• Clinical Champions (Cardiology, Primary Care,
  Geriatrics)
• Includes any or all of National Initiatives
• Specific data for Clinical Service and/or
  Provider
• 3 Types of Reports
• Scorecard Reports
• Not Met Only Reports
• Trending and Cumulative Reports
• Provider Survey to assess Provider Awareness,
  Education Needs, Potential Buy-In
• Educational Tools developed based on survey
  results
• CPRS tools menu
• Pocket Guide

88
Example DC PuPs

89
PuPs Scorecard Results

90
PuPs Scorecard Results

91
PuPs Not Met Reports

92
PuPs Not Met Reports

93
PuPs Trends Reports - Beta Blocker Initiative -

114,000 Annualized Cost Avoidance
DC
Primary Care
Sunny Clinic
Provider 2
94
Example DC Educational Tool

95
VAMHCs MUEs (Medication Use Evaluations)

• Medication Use Evaluation (MUE) widely recognized
  for innovation and functionality
• Use of Evidence-Based Guidelines
• At the point of decision by the Provider
• Informatics based-built into the electronic
  health record (CPRS)
• Feedback loop built in for Providers

96
Montelukast MUE (Medication Use Evaluation)

97
Appropriateness Montelukast

98
VAMHCs MUIs (Medication Use Indicators)

• Medication Use Indicators (MUIs)
• Limited of indicators
• Performance Period data covers 1 year
• Key features
• Rationale for indicator included
• Provider Performance for two periods
  (semi-annual) covering 12 months
• Shows Provider Peer Percentile ranking
• Innovative mass delivery of personalized
  information

99
VAMHCs MUIs (Medication Use Indicators)

100
Important Product Features

• Support from COS, Clinical Leadership
• Support Clinical Service Chiefs/Clinical
  Champions
• Provides Providers with specific to
  cost/utilization data
• Provides Providers with trended data over time
• Provides Providers with their specific comparison
  to Peers
• Used as part of Performance Appraisal Process
• Use of Evidence-Based Guidelines in Ordering
• Includes Providers lists of patient specific data
  to improve performance

101
What Should Be Included?

• Performance Monitoring and Management
• Support from COS
• Clinical Champions/Service Chiefs
• Provider Specific Cost/Utilization data
• Data trended over time
• Peer Comparisons
• Part of Performance Appraisal Process

Leadership Buy-In
Provider Buy-In
Closes the Loop

• Clinical Decision Support
• Use in Evidence Based Guidelines
• Provide Patient List/other specific ways to
  improve performance at the point of clinical
  decision-making

Patient Centered Actionable Information Needed
at the point of the Clinical Decision
102
Real Provider Buy-In

• Provider Specific Cost/Utilization data
• Data trended over time
• Peer Comparisons

• Data related to
• Improvement in Safe/Efficient practices
• Reducing Wasteful Use

Also, clinical decision support solutions
probably work best when they minimize barriers to
Provider workflow (minimize clicks, steps, and/or
time away from patient care)
103
Features Comparison

104
VISN 5 Provider Profiling for Pharmacy

• Questions ??