Company: Brooks Rehabilitation
Company background: Brooks Rehabilitation is a recognized leader in providing a system of world-class rehabilitation solutions, advancing the health and well-being of our communities. We have more than 50 years of expertise empowering people to achieve their highest level of recovery and participation in life. Due to our wide range of services, from inpatient rehabilitation to ongoing outpatient care and beyond, our patients are able to remain within Brooks for their entire recovery journey. We work to ensure individuals are in the right setting for their needs, resulting in the best possible outcomes.
Contact: Mathew Raters
Title: Healthcare Data Analyst
Country: United States
Award Category: Innovative Problem Solver
Tell us about the business problem you were trying to solve?
While the opioid epidemic has highlighted the need to reduce opioid administration in the context of pain management, there lacks an established methodology to effectively track a healthcare facility’s performance in meeting this goal. As a result, we developed and implemented a visual analytics tool to accurately and effectively track and alert opioid medication administration changes over the course of each patient’s stay at our inpatient rehabilitation hospitals. This tool was implemented in conjunction with clinical processes aimed to reduce opioid administration and serves to validate hospital-wide efforts towards this healthcare initiative.
How did you use SAS to solve that business problem? What products did you use and how did you use them?
To complement our ongoing pain management initiatives, we developed a multi-faceted data strategy that provides convenient, timely, and detailed information to Brooks’ physicians about the administration of opioid medications to our patients. We extract medication and patient stay data from our electronic medical record system for all patient admissions to our inpatient rehabilitation hospitals. Using SAS Enterprise Guide, opioid medication dosages are converted to morphine milligram equivalents in order to standardize dosages among opioids with differing strengths. Additional data transformations are performed to ensure accurate dosage calculations for compound and transdermal medications. To measure opioid reduction, patients’ daily morphine milligram equivalents are aggregated and percent changes from admission are calculated weekly and at discharge. In July 2021, we implemented an interactive visualization tool based on this methodology displaying historical trends and active patient opioid administration changes using SAS Visual Analytics. Our operations and clinical teams continue to use and refine the dashboard to meet their ongoing pain management initiatives. In addition, automated daily notification emails using SAS Enterprise Guide are sent to individual physicians to alert on patients with increases in morphine milligram equivalent doses. The entire process is scheduled and automated using SAS Management Console.
What were the results or outcomes?
The SAS VA opioid dashboard has been successfully adopted by our Multimodal Pain Group to evaluate progress on opioid reduction goals. The tool is now an integral part of regular team meetings where patient pain management and satisfaction are discussed among physicians, nursing and therapy staff. To evaluate the tool’s contribution to opioid reduction, we compared differences in percent reduction in morphine milligram equivalents for six months before and after implementation. Since the implementation of this tool we have observed a significant and sustained reduction in opioid administration among our patients. The average percent reduction in morphine milligram equivalents from admission to discharge for the 6 month time period prior to implementing the tool was 25.3%, while the 6 month time period after implementation was 59.8% (p<.0001). Physicians are actively utilizing the alert emails on a daily basis and have provided positive feedback on the actionable insight provided. The emails allow physicians to easily monitor and adjust opioid usage during the entirety of each patient stay, resulting in improved prescriptive practices and use of alternatives to medication, such as manual therapies or therapeutic exercise, to address pain and manage patient needs appropriately.
Why is this approach innovative?
Prescription drug monitoring is crucial in the response to the opioid epidemic, however there is limited guidance on how to effectively track and aggregate opioid administration among patients admitted to an inpatient healthcare facility. Brooks Rehabilitation has developed an innovative data approach to provide clinical teams with a global overview of opioid administration among our patients and the ability closely monitor use at the individual patient level. This effort was initiated and led by physicians in partnership with the data analytics team, establishing a strong collaboration and successful adoption among clinical providers. We have greatly improved visibility regarding opioid medication administration facilitating a unified and holistic approach to pain management for our patients utilizing our inpatient rehabilitation hospitals.
What advice would you give to new SAS users?
As a new SAS user, it is important to understand that there are many training opportunities available to you. SAS offers a wealth of resources for learning and development, as well as other sources, such as, blogs and learning applications. When just starting out, three important steps for new users is to learn how to access your data, read SAS logs, and efficiently validate data for accuracy. It is important to begin simple by identifying a problem and working through to a viable solution, especially when working through a complex data process. Sometimes the best solution may not be feasible or practical, so you will need to be creative and think “out-of-the box” to find a solution to meet the business needs. In our case, our SAS VA opioid dashboard is extremely useful, but physicians on the floor needed an additional method to access the information to better accommodate their daily workflow. For this reason, we supplemented the dashboard by creating a SAS generated pdf report emailed directly to our individual physicians. Finally, collaborative effort among all stakeholders is paramount for successful implementation of any data project to effectively drive change.
