Simplify Downtime with

Data Repository

2012 MUSE International

Educational Session #1140

Friday June 1 3:30pm

Presenter: Ian Proffer

Data Repository & Downtime

Different Causes of Downtime

How MEDITECH’s Data Repository is a valuable patient data resource

Review of DR-based downtime solutions implemented by Acmeware

Planned or Unplanned Downtime

MEDITECH Updates

Hardware Failure

Network Failure

Power Failure

Typical MEDITECH Two-Tier Network

MAGIC, C/S or M/AT Application Servers

Data Repository SQL Server

Application data is

continuously

transferred to the DR

Client Application

DR Downtime Availability

DR is not subject to MEDITECH application or system downtime SQL Server databases are on a separate

system Ring release and version updates do affect

DR, but are typically after your system comes back online

SQL Server reports and data are easily automated and delivered to: physical files (e.g. Adobe .pdf, Excel, etc.) Server or PC-based datamarts (with UPS

protection)

Data Repository History

Early data integrity problems are now largely resolved

Incomplete application data addressed in 5.4 – 5.7 releases

5.4 Multi-threaded application transfers introduced to C/S

5.6 DTS (MAGIC 4336, C/S 2649) allows transfer grouping at the segment level

Acmeware automated table monitoring process proves successful near real-time transfers

Acmeware’s Implemented

Downtime Solutions

Offline – Optimized for paper Medication Administration Report (MAR) Provider Order Summary Nursing Intervention & Assessment Report

Online Availability Provider Order Summary Patient View Nursing Assessments Current Census Snapshot Scheduled Appointments Laboratory Results

Offline Patient Registration

Pharmacy MAR

Problem – With eMAR / BMV implementation, there is no real-time paper trail for medications. How can we resolve this in a downtime scenario?

Solution – Use the Data Repository Pharmacy data, updated in near real-time, to generate and distribute patient MAR reports to nursing unit PCs on an ongoing, 7/24 basis.

Downtime MAR - Schematic

NICU

Emergency Dept Surgical Step Down

Data Repository Pharmacy,

Admission,

and Nursing

Data latency from MEDITECH applications < 1 minute

SQL Server Reporting Services

produces and sends an Adobe

.pdf MAR Report to every

inpatient location on a

continuous 15 minute cycle

Backup Power

Printer

During MEDITECH

downtime, MAR Report is

available on the intranet or

via file share

Recent Meds

Future Meds

Rx Details

Patient Details

Provides paper

form for new

meds given

during

downtime

Downtime start

time is

determined by last

updated record in

DR pharmacy

Pharmacy MAR

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At client’s request,

this report

customized to look

like a standard

MEDITECH report

Provider Order Summary

Flowsheet Data

Intake & Output

Pain Assessment

Nursing Documentation - Interventions

Online Provider Order Summary

Lists provider

orders with most

recent first

Standard

demographic

header to match

MEDITECH’s

Patient View Assessment

This include patient assessment data

from admission clinical queries,

nursing assessments, or any patient-

based customer defined screen query

Reverse Chronological Order

Current Census Report

Census By Location

Basic demographic and

location information

Export Options

We have developed many

different flavors of this

relatively simple report

Scheduled Appointments During Downtime

Current data from

CWS Module

This report groups by

resource; we also have by

location and by service

versions

Current Laboratory Results

Recent Lab Test Results in

Reverse Chronological Order

Within a Department

Drill Down

Lab Test Results Details

Downtime Patient Registration Routine

Performs demo recall during registration process

Adds a new visit (and new Patient if not found in demo recall) to “downtime” database on SQL Server

Use DR’s dictionaries to perform lookups when entering data

When MEDITECH becomes available after downtime, registration data is scripted back into MEDITECH

Downtime Registration Schematic

Data Repository Server Live MAGIC, C/S or M/AT Applications

Before Downtime

During Downtime

After Downtime

Livedb

Downtimedb

Livedb Near Real-Time Transfers

Livedb Near Real-Time Transfers

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Downtimedb

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Downtimedb

Demo Recall

Downtime Registrations

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Discussion, Questions & Answers

Our other MUSE sessions

703 – Soup to Nuts – Data Repository 101

803 - Soup to Nuts – Data Repository 102

1176 - Finding the “Meaning” in Meaningful Use

Thank you.