Inpatient Pharmacy Data Extraction

1. Inpatient Pharmacy Data Extraction January 2012

2. Course Objectives • Justify the need for management reports and prove their utility in maintaining and improving quality in the operation • Prioritize reports required by various quality and regulatory bodies for outpatient and inpatient pharmacies. Explain usage and maintenance requirements

3. Objectives • Utilize Inpatient Pharmacy management reports effectively • Distinguish between various reports • Describe the utility of each report • Recall reports that should be run at scheduled intervals

4. Objectives (cont) • Describe implementation of major projects from a management perspective • Planning • Implementation Approach • Pitfalls & Lessons Learned • Maintenance & Fine tuning

5. Inpt Pharm Management Reports • IV Reports • Unit Dose Reports • ADT Reports

6. IV Reports Menu • Active Order List (IV) • This report will show all orders that are active from the time that this report is run. This report is similar to the ward list, since the ward list also contains all active orders when it is run. However, this report: • Can be run at any time rather than at a start of coverage time. • Will not affect the calculation of labels after order entry. (After order entry the program will check to see if the ward list has been run to calculate the # of labels needed for the 'ACTION' prompt.) • Will contain all types of IV orders (Hyperals, Admixture, Piggybacks etc.). • Inpatient Stop Order Notices • Allows the user to print a report of selected patients' UNIT DOSE orders, IV • orders, or both UNIT DOSE and IV orders that have expiration dates between two • user selected dates.

7. IV Reports Menu • IV Drug Formulary Report (IV) • This report will allow you to print out all information on any of your defined IV DRUGS. • Patient Profile Report (IV) • This option will allow a patient profile to be printed to a printer. With each profile printed a view of each order within the profile can also be printed. • Renewal List (IV) • This option prints a list of all orders which need to be renewed on the user specified date. These orders will expire on the given date if they are not renewed.

8. IV Management ReportsFirst Half • Active Order Report by Ward/Drug (IV) • This option allows the user to generate a listing of all active prescriptions for a specific ward (or all), and for a specific drug (or all). • AMIS (IV) • This report computes the AMIS data concerning the IV workload of the pharmacy, by ward. Only those wards with a dispensing amount will be included. You will be prompted for a start date (date to begin capturing data), and an ending date (date to stop capturing data). • **NOTE: Canceled, recycled, or destroyed IV bags are not subtracted out of the total bag count on the AMIS report.

9. IV Management ReportsFirst Half • Drug Cost Report (132 COLUMNS) (IV) • Lists dispensing information for IV drugs. • May be run for a single drug, all drugs, non-formulary drugs, a specific category of drugs, a VA class of drugs, a specific IV type, or by cost. • May be run for a single or all IV Rooms, and may also include ward and patient dispensing data. • PCR Patient Cost Report (132 COLUMNS) (IV) • Generates a report which captures the total IV dispensing cost for a specific patient. • User enters the range of dates for which data is to be captured, and the name of the selected patient. • Report lists the patient name, SSN, DOB, ward, weight, diagnosis, and the date range selected. • For each drug ordered, lists the drug name, amount dispensed, destroyed, recycled, or cancelled, total cost of each drug, and a grand total for the selected patient. • Includes ward and patient dispensing data.

10. IV Management ReportsSecond Half • PSD Patients on Specific Drugs (80 columns) • Lists patients on specific primary drugs, dispense drugs, or VA classes of drugs. • If more than one primary drug, dispense drug, or VA class of drug is chosen, only patients with orders containing all the drugs or classes will be shown. • The user may choose to list all orders, only IV orders, or only Unit Dose orders. • Provider Drug Cost Report (132 columns) (IV) • Enter a provider's name or ^ALL for all providers. • This report calculates the total cost of drugs prescribed by provider within a specified date range.

11. IV Management ReportsSecond Half • Ward/Drug Usage Report (132 columns) (IV) • Captures the total IV dispensing cost for a drug, by ward. • Enternterthe start date (date to start capturing data), and a stop date (date to stop capturing data). • At the "Select DRUG" prompt, you may enter: • A specific drug • ^ALL for all drugs • ^NON for all non-formulary drugs • ^CAT for a category of drugs • ^VADC for a specific drug class. • At the "Select WARD" prompt, you may enter: • The name of a specific ward • ^ALL for all wards • ^OUTPATIENT for outpatient locations only.

12. IV Management Reports: AMIS (IV) • List of all IV’s dispensed & average cost: • User selects time frame • Canceled, recycled, or destroyed IV bags are not subtracted out of the total bag count • List sorted by ward: • Within ward, by IV type (A, P, S, C, H) • Sub totals for each ward, grand totals • Recommendation: run report on regular basis, e.g. monthly: • Periodically run one year data and divide by 12

13. Example of AMIS (IV) report • 30 day time period selected (June 2009) • Totals = workload data for selected time period

14. IV Management Reports: Drug Cost Report • Number of doses (bags) dispensed, recycled, cancelled, & destroyed • Cost for each drug and totals • Can separate out by ward or skip ward data • Can print all drugs, by IV type, or only one drug • Lots of paper if you run the full report • 132 columns – use condensed print • Recommendation: use to look at only onedrug

15. IV Management Reports: Drug Cost Report Example – single drug (Daptomycin) chosen, past 30 days data

16. IV Management Reports:Patient Cost Report • Select individual patient • Lists IV meds and associated costs • 132 columns JAN 29,2010 PATIENT COST REPORT FOR: PAGE 1 PATIENT,DEMO GRANDFATHER PID: 1234 DEC 30,2009 THROUGH JAN 29,2010 WARD: INPATIENT 202-A DOB: FEB 20,1940 SEX: MALE Weight (kg): 108.34 DX: CELLULITIS DRUG NAME DISPENSED (DESTROYED) RECYCLED CANCELLED DRUG COST ==================================================================================================================================== CLINDAMYCIN 900MG ADV 10800.00 MG 0.00 0.00 0.00 $ 29592.0000 CefAZOLin 1GM 19.00 GM 0.00 0.00 0.00 $ 31.3500 SODIUM CHLORIDE 0.9% 50 ML 1850.00 ML 0.00 0.00 0.00 $ 1387.5000 =============== GRAND TOTAL: $ 31010.8500

17. IV Management Reports: Patients on Specific Drugs (PSD) • List of all patients on one or more drugs • Choose IV, UD, or both • Choose orderable item, dispense drug, or VA drug class • Can choose more than one drug • Select “# of matches” • If looking for only one item, enter 1 • If looking for patients on both drugs, enter 2

18. IV Management Reports: Patients on Specific Drugs (PSD) • Example 1: All patients with dispense drug Morphine 4mg syringe

19. IV Menu – Management Reports: Patients on Specific Drugs (PSD) • Example 2: patients on both clopidogrel & omeprazole

20. IV Management Reports:Provider Drug Cost Report • Lists drug costs by provider • Only lists totals (no breakdown by drug) • Possibly useful if providers are allowed to use non-formulary drugs • Two versions: condensed (80 columns) and regular (132 columns) PROVIDER DRUG COST REPORT (CONDENSED): PAGE:1 DEC 30,2009 THROUGH JAN 29,2010 ALL PROVIDERS ALL DRUGS ALL IV ROOMS PROVIDER TOTAL COST ================================================================= IV ROOM: INPATIENT ADAMS,JOHNATHAN C $ 824.33 ARNOLD,BENEDICT U $ 580.34 FRANKLIN,BENJAMIN W $ 59204.88 JEFFERSON,THOMAS S $ 64524.65 ================= GRAND TOTAL: $ 125314.20

21. Unit Dose Reports • 7 7 Day MAR • 14 14 Day MAR • 24 24 Hour MAR • AP1 Action Profile #1 • AP2 Action Profile #2 • Authorized Absence/Discharge Summary • Extra Units Dispensed Report: • Allows the user to print the Extra Units Dispensed Report by patient, ward, or a ward group. • Shows the amounts, date dispensed and the initial of the person entered the dispensed drug.

22. Unit Dose Reports • Free Text Dosage Report: • Allows the user to print a list of free text dosages for Unit Dose orders that were entered over a range of dates, as well as the frequency with which they occurred, and the ordering provider. • Inpatient Stop Order Notices: • Allows the user to print a report of selected patients' UNIT DOSE orders, IV orders, or both UNIT DOSE and IV orders that have expiration dates between two user selected dates.

23. Unit Dose Reports • Medications Due Worksheet: • Allows the user to print the Medications Due Worksheet by patient, ward, or ward group. • The worksheet shows the patient's orders that are to be administered within a 24 hour period. • Patient Profile (Extended): • Allows viewing all of the orders on file for a patient (not just since last discharge). • All orders that have not been purged can be viewed, or a date entered to from which to start searching.

24. Unit Dose Management Reports • AMIS (Cost per Ward): • Report that shows total units dispensed, total cost, and average cost per unit dispensed for each MAS ward. • The complete totals for all wards is at the end of the report. This report can be run for any date range selected. • Drug (Cost and/or Amount) : • Allows the user to print a report of the cost of dispensed drugs within a date range entered by the user. • This report can be sorted alphabetically by drug name, by descending order of total drug cost, or by descending order of total dispensed amount. • Limits may be employed to show only those drugs above an entered total cost and/or dispensed amount. • Non-formulary items are flagged as such.

25. Unit Dose Management Reports • PSD Patients on Specific Drug(s): • This 80 column report lists patients on specific primary drugs, dispense drugs, or VA classes of drugs. • If more than one primary drug, dispense drug, or VA class of drug is chosen, only patients with orders containing all the drugs or classes will be shown. • The user may choose to list all orders, only IV orders, or only Unit Dose orders. • PRovider (Cost per): • Prints a COST BY PROVIDER report for a date range entered by user. This report shows each medication, the amount dispensed, and cost for each provider. • This report also shows sub-totals for each provider and totals for all providers at the end of the report.

26. Unit Dose Management Reports • Service (Total Cost per): • Allows user to run a TOTAL COST PER SERVICE report for a date range entered. • The report will show the total units dispensed, total cost, and average cost per unit dispensed for each service. • Totals for all services are printed at the end of the report. Total Cost to Date (Current Patients) • Total Cost to Date (Current Patients): • Allow the user to see the total Unit Dose cost to date of patients currently admitted. • The user can run this report for a ward group, ward, or number of separate patients.

27. Unit Dose Management Reports: AMIS (Cost per Ward) • Shows total number of doses dispensed, total cost, and average cost per unit dose: • Time frame selected • Broken down by ward with totals • Recommendation: • Run monthly • Periodically run 1 year data and divide by 12

28. Unit Dose Management Reports: Drug (Cost / Amount) • Shows # of doses of each drug dispensed, and cost: • Time frame selected • Can break down by ward or just show totals • Can choose one or more drugs, orderable items, or VA Drug Classes • Utility: to evaluate usage pattern of drugs for inventory purposes, or cost information

29. Unit Dose Management Reports: Provider (Cost per) • Sorted by provider (one or more), then drug: • Total units dispensed for each drug, cost • Grand total & cost, average cost • Time frame selected • Utility – “heavy” prescriber identification

30. ADT Reports • Pharmacy may not have access to these reports because they are under the Admission/Discharge/Transfer menu. • Chief Pharmacist can request option for: Inpatient Reports Menu… [BDG REPORTS MENU] (No key required). • ADT Reports Menu: • CIC Current Inpatient Census • CIL Current Inpatient Listings • VAH View Admission History • ASR ADT Statistical Reports • 1. Average Daily Patient Load (ADPL) • 2. Inpatient Statistics by Ward • 3. Inpatient Statistics by Service

31. ADT Reports • Current Inpatient Census: • Displays number of patients currently admitted. • Does not display patient information. • Useful to determine staffing.

32. ADT Reports • Current Inpatient Listings: • Report showing individual patient data: • Multiple pre-configured options – can select to print by ward, service, insurance data, severity of illness, etc. • Useful to take to rounds, discharge planning meetings, etc. • This example is by ward (includes all services).

33. ADT Reports • Current Inpatient Listings (continued) • If choose by service, list is condensed: • Less room for notes

34. ADT Reports • View Admissions History • View all admissions and discharges at your facility for a selected patient • Only shows dates of admission & discharge, not diagnoses or other data

35. ADT Statistical Reports:Average Daily Patient Load • ADPL: • Select time frame. • Sort by ward or service. • Provides total patient days and average census over time period selected. • Inpatient staffing is based on ADPL.

36. ADT Statistical Reports:Inpatient Statistics by Ward • Inpatient Statistics by Ward: • Report of ADT activity, sort by ward or service. • Useful to evaluate LOS (length of stay).

37. Questions?