Profitability By [Fill in the Blank]

Using the MEDITECH DR and SQL Analysis Services to Quantify

ProfitabilityBy Glen R. D’Abate Acmeware, Inc.

Objective

To develop a SQL Query Analyzer-based On-Line Analytical Processing (OLAP) Cube that will provide information about profitability measures across a wide variety healthcare business parameters

Project Design Environment MEDITECH Data Repository MAGIC 4.9 on SQL

Server 2000 MEDITECH ADM, ABS, B/AR, & CA Applications Cost Accounting data could be provided by a

third party with minor modifications SQL Server Analysis Services Implemented on

DR Server Internet Explorer 6.0 used to browse the OLAP

cube on an ASP.NET web page that resides on Internet Information Server (Web-Server)

We could also use Microsoft Excel to browse cube

Project Design Strategy Identify OLAP Measures Identify OLAP Dimensions Build SQL Server View with Fact Table

Containing Measures and Foreign Keys to Dimensions

Build SQL Server Views for Dimension Tables

Construct OLAP Cube and Process it Deploy Cube to Web Page

OLAP Measures A set of values that are based on a

column in the cube's fact table and are typically numeric

In our cube: Count of Visits Receipt Total Cost Total Charge Total Expected Reimbursement Profitability (Calculated Total) Expected Profitability (Calculated Total)

OLAP Dimensions The ways by which would like to break out and

view the measures “slice and dice” Dimensions often correspond to MEDITECH

dictionaries Time Dimension are treated special in Analysis

Services and can be defined with a hierarchy (i.e., Year / Quarter / Month / Day)

Dimensions can have a hierarchy (i.e., MDC -> DRG, ProvderGroup -> Provider, InsuranceGroup -> Insurance)

Dimension are limited to 64K entries at any hierarchical level. As a results, to use AccountNumber, we must associate it in a DischargeDate -> AccountNumber hierarchy

Dimensions In This Project: Admission (Inpatients) or Service (Outpatients)

Date Transaction Procedure Charge Category Diagnosis Discharge Disposition Discharge (Inpatients) or Service (Outpatients)

Date AccountNumber Facility Final DRG Financial Class Insurance Location Patient Status Attending Provider ServiceThere are dozens of other potential dimension fields that could have been selected for this project

Fact Table The central table in the OLAP schema that

contain the numerical Measures and Foreign Keys relating facts to the Dimension tables

A SQL Server View is used to bring together data from multiple tables in the DR to a single Fact table

All columns in the Fact table should have data values. NULL data must be substituted with a value (“<U>”)

DR Tables used in Fact Table BarVisits (demographics) BarVisitProvider (Attending Provider) AbsDrgData (Final DRG) BarChargeTransactions (Charges, Charge

Category, Transaction Procedure) BarCollectionTransactions (Receipts) CaStandardCosts (Costs) BarInsuranceLedger (Expected

Reimbursement)

Fact Table View (Foreign Keys)

If there is any chance that a NULL value could be present, replace it with ‘<U>’

Append leading zeros to DRGs to display in a more typical form

Use only left component of the diagnosis

For dates, use an integer identifier in dimension and fact tables

Fact Table View (Measures)

UNION

UNION

Expected Reimbursement is at the Visit level, not the Transaction Level

Receipts and Adjustments come from Collection Transactions

Charges come from Charge Transactions

Dimension Table ViewExample Dimension View for the Location Dimension

Use the MIS Dictionary with Locations

The LocationID and Name are concatenated together when more detail is required in the cube

‘<U>’ is included via a UNION in all dimension to account for any NULL values

SQL Analysis Manager

Dimension are defined in a wizard using the Views that were set up in SQL Server

Data Source Links to DR ‘livedb’

Profitability Cube Defined

Once SQL Views are defined, SQL Analysis Manager is used to construct the Profitability cube and related components

OLAP Cube Components

Data Source Fact Table Dimension Tables Measures Calculated Measures Design Storage Schema

Select the DR Server

Select Security Profile

Select Cube Database

Tool for Building Cubes

Entering a Cube using the Cube Editor

Fact Table

Dimension TablesAnalysis Services has useful Wizards that assist in configuring the cube

Measures are available from the Fact table (View) and are inserted into the cube definition

Adding Measures to the Cube

EXPECTED REIMBURSEMENT – COSTS

COSTS

How to compute Profitability?

RECEIPTS – COSTS

COSTS

Expected Profitability?

Adding Calculated Members

Formula expression for Profitability added to Cube

All Cube data and many pre-defined functions are available in the Calculated Member Builder

Cube Design Storage Options

Browsing Data in the Cube Editor

The Analysis Server provides a rudimentary browser to give a quick ‘reality check’ that the cube is compiling correctly

Deploying the Cube in Visual Studio

It is also possible to deploy cubes using SQL Server Reporting Services, albeit a bit cumbersome

Visual Studio .NET solution. Originally deployed as Visual InterDev 6.0 Solution

ActiveX Control – Pivot Table 10. 0 Office Component

Web Page with Cube on Internet Information Server

Visual Studio .NET project is deployed to an instance of IIS

This example includes the Active Server Page (ASP) with the Profitability Cube ActiveX control within a Web Application (AcmeView) that has other OLAP Cubes

AcmeView Web Application in IIS

Browsing the Cube using IE