What’s Going on in the Operating Room?
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What’s Going on in the Operating Room?. MUSE International Session #314 May 29, 2009 Glen R. D’Abate. Educational Session Overview. We will discuss why we care about “what’s going on in the OR”

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Muse international session 314 may 29 2009 glen r d abate

What’s Going on in the Operating Room?

MUSE International Session #314

May 29, 2009

Glen R. D’Abate

Educational session overview
Educational Session Overview

  • We will discuss why we care about “what’s going on in the OR”

  • We will look at the specific events of interest in the OR that are used to help determine “what’s going on”

  • We will look at a collection of technologies available to assist in analyzing “what’s going on in the OR”

  • We will demonstrate a series of reports using these technologies that finally shed light on “what is really going on in the OR”

About the operating room or
About the Operating Room (OR)

  • OR resources are among the most expensive in a healthcare organization

  • Efficient use of OR time is the major factor of total OR activity costs

  • A single OR room’s fixed and variable costs can exceed $1,000 / hour (exclusive of staff)

  • Optimizing OR resources has a direct impact on the bottom line

How do we know what s going on
How Do We Know “What’s Going On”

  • The MEDITECH ORM Scheduling Module collects a significant amount of “event activity” data related to processes in the OR

  • Different implementation of ORM at different sites can impact the granularity of event data available…more is better

  • Retrospective analysis of event data can reveal patterns and trends needed to implement optimized OR resource utilization

Orm events available for analysis
ORM Events Available for Analysis

  • Utilization based on a comparison of scheduled time in the OR versus actual time in the OR

  • Operating Room Delay Reasons

  • Specific OR Event Time Requirements

    • Start of Procedure (Entrance into OR)

    • Initial Incision

    • Incision Closed

    • Procedure Ended (Exit of OR)

    • Interval Between Last Procedure End and Next Procedure Start

Analysis of technologies employed
Analysis of Technologies Employed

  • Data is stored in the MEDITECH Data Repository (DR) Module

  • SQL Server Store Procedures generate and update the ORM datamart

  • SQL Agent Scheduled Jobs automate the process of refreshing the ORM datamart

  • Microsoft SQL Server Reporting Services (SSRS) enables custom report development

  • SSRS Report Builder allows users to build their own reports

  • SQL Server Analysis Services OLAP Cubes allow easy slice & dice of data

  • Microsoft Internet Information Server (IIS) hosts the ORM Analysis portal solutions

Orm datamart
ORM Datamart

DR Server

demodb_ORM datamat

This strategy uses the MEDITECH DR but could be accomplished directly against the ORM application database using the OpenGate or IPortal product

Datamat tables (updated using DR data on a regular basis

Muse international session 314 may 29 2009 glen r d abate

ORM Datamart Generation Schematic



Report Datamart

LIVE Data extract and normalization from DR livedb to datamart database (batch process)

Batch Update

Pre-Designed SSRS Report

Production Environment

Ad-hoc Report Designer Reports



Report Datamart

SSRS Report Generation

OLAP Reports

1 orm demonstration ssrs reports
1. ORM Demonstration SSRS Reports

  • Actual Surgery Time versus Estimated Surgery Time Reports

  • Delay Reasons Reports

    • Delay Reason for First Case Report

    • Delay Reason by Surgeon Report

    • First Case Delay Missing Reason Report

  • Event Time Span Report

    • Entrance to Incision Report

    • Close to Exit Report

    • Close to Next Incision Report

    • Exit to Entrance Report

Ssrs report deployment options
SSRS Report Deployment Options

  • Reports can be ad-hoc (with or without parameters)

  • Reports can be pushed to a file-share on a schedule

  • Reports can be e-mailed on a schedule

  • Snapshots of report data at a specific time can be taken

  • Reports can be rendered in web-format (html or xml), text, image format, Adobe, Excel, and more

2 orm report builder features
2. ORM Report Builder Features

  • Report Builder provides the ability for a non-programmer (power-user) to generate flexible, sophisticated ORM reports

  • Report Builder has a drag & drop, user-friendly GUI that allows report developers to easily layout, format, and preview custom developed reports

  • Report Builder provides three default templates

    • Table (columnar report)

    • Matrix (cross-tab or pivot table report)

    • Chart Reports

  • Report Builder can develop parameter-driven reports to filter, format, or display data based on user input.

3 orm olap cube features
3. ORM OLAP Cube Features

  • OLAP Cubes allow any user (with virtually no training) to generate 100s of view of ORM data

  • OLAP Cubes view ORM measures (i.e., summarized numeric data).

  • OLAP Cubes allow any user to slice-and-dice data looking for trends across dimensions (i.e., MEDITECH dictionaries)

  • OLAP Cubes allow users to “drill-down” into ORM data from general summary to the transaction detail level

Advantages orm datamart approach
Advantages ORM Datamart Approach

  • Reports can be custom designed to meet specific data, summarization, and formatting requirements

  • Takes full advantage of Microsoft Reporting and Analysis Services software that is available as part of the SQL Server system

  • Provides web-based access to reports for easy distribution and use

First case on time by provider 2 091
First Case On Time by Provider (2/09)

Best Practice is >76% On Time Starts