Infusion Pump Informatics Our Path Forward Ann Christine Catlin IPI Research and Development May 22, 2014

Infusion Pump Informatics Our IPI System 2009 – 2014 Metrics Reviewing IPI … 2009-2014 R&D Effort 2013-2014 What’s new? What does it take to keep IPI going? Working together to solve problems Research 2014-2015 Our ideas & how to make them work

Infusion Pump Informatics Our IPI System 2009 – 2014 : Metrics The IPI Community of Hospitals The IPI Community of Users 44 82 20 34

Infusion Pump Informatics Our IPI System 2009 – 2014 : Metrics IPI Hospital Alerts and Database Storage IPI Alerts and Database Size IPI Log Uploads 679 271 Almost 16 million alerts! Total Database Size 14580 MB = 14GB

Infusion Pump Informatics Our IPI System 2009 – 2014 : Metrics Charts & Reports Generated by the IPI Community Charts & Reports Generated by the IPI Community 19859

Infusion Pump Informatics Our IPI System 2009 – 2014 … the Cutting Edge What we did When Can anyone else? Smart pump data analysis right in your browser, available online from anywhere 2009 Carefusion, but not until 2011-2012 Full data sharing between different hospital systems No High level & detailed comparison charts between any # of hospitals 2010 Searchable, sortable reports for investigating data 2011 Automatic pivot tables Support for pumps from different manufacturers 2012 Clickable workflows for drilling-down to data of interest Normalized metrics for head-to-head compares 2013 Access to all your data, even after changing pump manufacturers 2014 New feature requests? You get exactly what you want, and fast Often Not often Verification and validation for every data value Always Not always

Infusion Pump Informatics Our IPI System 2009 – 2014 Metrics Reviewing IPI … 2009-2014 R&D Effort 2013-2014 What’s new? What does it take to keep IPI going? Working together to solve problems Research 2014-2015 Our ideas & how to make them work

Infusion Pump Informatics What’s New? Time-to-Override Reports

Infusion Pump Informatics What’s New? Time-to-Override Reports

Infusion Pump Informatics What’s New? Time-to-Override Reports

Infusion Pump Informatics What’s New? Time-to-Override Reports

Infusion Pump Informatics What’s New? Compliance Upgrades

Infusion Pump Informatics What’s New? Compliance Upgrades Upload Hospira compliance (it’s device specific and alert type specific) Upload Excel spreadsheets (Carefusion & Hospira) New: Carefusion KP compliance … validate first! 2 kind of KP compliance: actual infusions & infusion starts (counter starts) KP counter starts should be the same as CQI counter starts. Report is “Usage by Profiles” & both are affected by library updates KP vs CQI… count numbers different, compliance percentages different

Infusion Pump Informatics What’s New? Infusion types breakout & aggregation

Infusion Pump Informatics What’s New? Infusion types breakout & aggregation

Infusion Pump Informatics What’s New? Selects for datasets, facilities, …

Infusion Pump Informatics Changing devices? You can track & assess changes!

Infusion Pump Informatics Changing devices? You can track & assess changes!

Infusion Pump Informatics Our IPI System 2009 – 2014 Metrics Reviewing IPI … 2009-2014 R&D Effort 2013-2014 What’s new? What does it take to keep IPI going? Working together to solve problems Research 2014-2015 Our ideas & how to make them work

Infusion Pump Informatics Changes hit us from all sides. Almost daily. The Pump Manufacturers Carefusion Knowledge Portal: new definitions, new formats, new processing Hospira: new pump devices, new data, new formats Significant changes to database & GUI resulting from changes in pump data The Hospitals Changes in pumps and/or data reporting systems Partial pump replacements (SVH keeping PCA devices) New needs related to data and reports The Hub and IPI infrastructure New security model, HIPAA compliance Database server changes and database reconfiguration Platform upgrades, software upgrades, new workflows New 3rd party software – like graphics routines Network issues Performance upgrades, code “retooling” Database “restructuring”

Infusion Pump Informatics New Input Formats, Definitions & Validation Carefusion KP Alerts Monthly alerts = Field Limit + Cancel All Other Alerts KP vs CQI “All Available Columns” files are actually different (different sizes, different content) KP vs CQI Alert totals reported to users are different Hospira Hospital Changes Pump replacements (two hospital solution) Partial pump replacements (split device population) More complicated compliance data

Infusion Pump Informatics KP vs CQI Alerts Validation THANK YOU ANDY

Infusion Pump Informatics KP & CQI Alerts Timestamp Seconds THANK YOU ANDY

Infusion Pump Informatics Processing Alert Uploads, Timestamp Seconds, etc. Nightly hospital alert logs processing Long processing times when IPI not available Now processed off-line, so IPI is available 24/7 Alert logs and timestamp seconds Why does it matter? Hospitals with & without timestamp seconds Check at upload time will now be made Will never see this screen again 

Infusion Pump Informatics Our IPI System 2009 – 2014 Metrics Reviewing IPI … 2009-2014 R&D Effort 2013-2014 What’s new? What does it take to keep IPI going? Working together to solve problems Research 2014-2015 Our ideas & how to make them work

Infusion Pump Informatics Research 2014: Outcomes Analytics Presenting and understanding the outcomes of changes implemented as a result of IPI analysis Metrics identify how to measure “before” and “after” Can be tied to analysis that triggered the decision to change Annotation of change (Limit changes? Education? Policy? What else?) Graphical User Interface to build and display metrics and annotations You can set reports and we will send emails with links to remind user to continue to look at the “after” metrics

Infusion Pump Informatics Research 2014: Outcomes Analytics Intervention !

Infusion Pump Informatics Research 2014: Drug Limit Analytics Create a new “environment” for investigating and understanding drug limits across hospitals Uploading & viewing drug limit library datasets Database needs structure to support limit data and drug comparison requests Graphical interface needs a design to support requests and results display What are the parameters: drug, profile, therapy, library, soft/hard, min/max, other factors (concentration, …) Comments and annotations about changes to the libraries

Infusion Pump Informatics Your IPI Research and Development Group Couldn’t happen without them Sudheera Fernando Ruchith Fernando Sumudinie Fernando Ruwan Gamage Tharindu Mathews