Clinical Reporting using Meditech

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Clinical Reporting using Meditechs Data
Repository

• Jamie McDonald

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Hays Medical Center is a regional referral center
for northwest Kansas, located in the City of
Hays, Ellis County, Kansas, a community with a
population of approximately 20,000.
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• Services offered at Hays Medical Center
• Inpatient and ambulatory surgical services
• Obstetrical services
• Level II neonatal intensive care services
• Medical and radiation oncology services
• Diagnostic imaging services, including magnetic
  resonance imaging (MRI), computerized tomography
  (CT), mammography and sonography, nuclear
  medicine
• Two cardiac catheterization labs and one
  peripheral vascular lab
• Open Heart Surgery
• Emergency service staffed by physicians 24 hours
  a day
• Pulmonary medicine and neuroscience
• Rehabilitation therapies
• Patient and clinical education
• Center for Health Improvement

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• Hays Medical Center has 192 licensed beds
• 172 acute beds (including 12 ICU and 12 CPCU
  beds)
• 22 inpatient rehabilitation beds

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• Services offered at Hays Medical Center
• Physician Offices including 27 employed
  physicians, 7 locum physicians, and 13 mid-level
  providers. Specialties include
• Cardiovascular Surgery
• Cardiology
• Neurology
• Pediatrics
• Surgery
• Family Practice
• Internal Medicine
• Pulmonology
• Obstetrics-Gynecology
• Oncology
• Psychology

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• Hays Medical Center, Inc. Hospital Statistics for
  2006
• Historical Utilization Data Fiscal Year Ended
  June 30,2006
• Adult Admissions Adult Patient Days
• Acute care 5,614 Acute
  care 22,697
• Rehabilitation
  375 Rehabilitation 4,402
• Total Adult Admissions 5,990 Total Adult
  Patient Days 27,099
• Newborn Admissions 687 Newborn Patient
  Days 2,040
• Total Admissions 6,677 Total Patient
  Days 29,139
• Births
  681 Inpatient Surgeries 2,434
• Ambulatory Surgeries 4,513

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• Hays Medical Center Meditech History
• Initial GO LIVE June 1, 2003, with Client Server
  5.3
• ADM/MRI/ABS AP
• BAR GL
• ITS MIS
• MM NPR
• OE PHA
• PP SCH/OR

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• Hays Medical Center Meditech History
• Subsequent GO LIVES
• Nov 2003 --MPM Scheduling/PBR
• May 2004 PCS, EMR, LAB, DR
• August 2004 Pilot Program for POM
• Sept 2004 5.4 SR 1
• Jan 2005 PWM / PCM
• Feb 2005 EAR (Scripting Transcription only)
• April 2005 -- EDM (Patient Tracker only)
• August 2005 More of EAR PWM, AOM
• February 2006 5.5 SR 2
• January 2007 -- BMV
• March 2007 5.5 SR 2C (Update for LSS)

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• Hays Medical Center Meditech
• Future GO LIVES
• June 2007 - MIG
• October 2007 5.5 SR 5
• March 2008 - QA/RM
• April 2008 EDM
• June 2008 Oncology
• December 2008 - Scanning/Archiving (to replace
  Valco)

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Why use the data repository?

• Complex reports are much easier to write using
  T-SQL than NPR
• Process time dramatically decreases
• Easy to join data across modules
• Data from multiple sources (Pyxis)
• Dynamic drill down reporting
• Ease of exporting data
• Various front end reporting tool options

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Keys to Reporting Clinical Data

• Take the time to understand the process and the
  specific needs of the department
• Automate as much as possible
• Write code to be as efficient as possible
• Document within your code
• Setup alerts
• Exception Reporting
• Nursing document which assessments and queries
  are being replaced

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Report Examples

• Nursing
• Picc Lines
• Restraints
• Inpatient Therapy (OT,ST,PT)
• Acuity
• Medical Oncology
• Cancer Type
• Scheduling
• Pharmacy
• Drawer Errors
• Possible Deviations

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What information needs to be included for picc
lines?

• Need all attempts and successful picc line
  insertions summarized by Nurse.
• All Picc Line Orders
• All Picc Line Related Charges
• Exception report

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Basic Steps Picc line

• Transfer daily information on picc line
  documentation via DTS
• To minimize process time
• Link visits to OeOrders and BarChargeTransactions
• To obtain order and charge information
• Use SQL Reporting Services to display summary
  data along with drill down detail

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Picc Line Summary Report
Drill down to Nursing detail
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Picc Line Nursing Details
Drills down to patient orders and billing
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Picc Line Orders and Charges
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Restraints

• What data do we need?
• Number of initiates and removes
• Data summarized by department with detail
• Basic Steps
• Transfer data daily to separate table (for past
  12 months)
• Query data from 12 month table
• Currently displayed in CyberView

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Restraints
Drop down for last 12 months
Locations from selected month above
Accts from selected dept
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Inpatient Therapy
What information do we want?

• Number of patients relative to inpatient volumes
• Units of Service
• Number of refusals
• Treatment numbers by type
• Summary by department and therapist
• Drill down to detail information

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Basic steps for Inpatient therapy

• Census data from Adm transferred to a separate
  table on a nightly basis for current fiscal year
• Patient Count by Therapy Assessment
• Defined refine criteria for refusals
• Units of service from Its or Bar
• Totals by treatment type
• Summarized data with drill down to daily
  summaries and detail

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Inpatient Therapy
This report automatically runs when link or
report is selected
Select month for daily drill down
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Monthly Therapy patients vs. Inpatient Volumes
(OT,PT,ST)
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Drill down daily summary (OT, PT, ST)

• Vertical market opportunities
• Discuss specific market segment opportunities
• Address distribution strategies for those markets
  or segments
• Address use of third-party partner role in
  distribution to vertical markets

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Therapy Summary by Selected Department
Department drop down Physical Therapy Occupational
Therapy Speech Therapy
Current drill down items
Current drill down items
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PT drilldown on Selected Month
Drills down to daily by month and therapist
Drills down to refusal comments
Drills down to nursing documentation details
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Refusal drill down for PT
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Daily Summary by Therapist
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Current fiscal year by Therapist
There is a therapist drop down selection at the
top of the report
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Acuity Reporting

• Acuity Assessment
• Calculate acuity based on latest care level
  documented
• Report for charge nurses to run dynamically
• Data is run on a schedule to report data by
  location and the number of patients per level

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Acuity Assessment
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Charge Nurse Acuity Report
Drills down to nursing documentation
Drills down to patient count by acuity level
Drills down to adm patient detail
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Drill down on current census from Nursing Acuity
Show those that have not had acuity documented
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Acuity Drill down on Location
(This data is also stored in a data mart every 6
8 hours)
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MEDONC CLINIC REPORTING

• What do we want to know?
• What are the percent of patients and cancer types
  being seen in the clinic?
• How we calculate the numbers?
• Patients are selected on all cancer type drgs
• Data is grouped by first cancer drg
• The stats are summarized by current month to date
  and current year to date

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Medonc Cancer Types
Drills down to patient level detail
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Medonc Exam appointments

• What do we need to know?
• Actual appointment times vs. scheduled
  appointment time?
• How do we get the data?
• Link appointment to OeOrders (thru sch
  dictionary) and then to ItsOrderExams
• Group data by appointment types
• Create exception reporting

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Medonc Actual appointment times
Drills down to patient detail
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Medonc exception report (exam times)
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Medonc Exception Report (OeOrders)
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Pyxis Data

• What do we want to accomplish?
• Easy access to Pyxis Data
• Link Pyxis data with Meditech drug
  administrations
• Provide alerts for possible diversions
• Report on drawer failures
• Provide discrepancy data to pharmacy and nurse
  mangers

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Pyxis Med Data

• Move Pyxis archive files over to DR
• Acmeware Inc. Geoff Grouten
• Drawer failures and errors
• Group by type of failure
• Group by Station and Drawer
• Define method of diversion alert still refining
• Links to MT med administrations
• Comparative data by patient

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Pocket Errors by Type of Error
Drills down to station
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Pocket Error Drill Down
Drills down to drawer, sub drawer, and pocket
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Pocket Error Summary by Station(Drawer, Sub
Drawer, Pocket)
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High Usage Summary
Drills down to Pyxis transactions and then from
pt acct links to admins within Meditech
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PHA Diversion Reports in development

• High usage (possible diversion) will be
  determined by standard deviation
• Comparative data within the unit drug for date
  range
• Drill down to patient data with transactions from
  Pyxis and meditech drug administrations
• Linked to other controlled medications for user
• Discrepancy reports
• Pharmacy
• Nurse managers

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Home Page Reporting Service Manager
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Thank you for attending!
Thanks to Acmeware, Blue Elm, and
CyberView/Medisolv for the invaluable help over
the past few years.

• Jamie McDonald
• Hays Medical Center
• Hays, KS 67601
• jmcdonal_at_haysmed.com
• 785-623-5023