FAQ

Onboarding Process

  • There will be 2 data imports that will be needed to be pulled from your EHR that will allow the Medici to track both Days of Therapy (DOT) and Days Present to track Antimicrobial Use. They are required to be in a .csv format. 
    • ADT (Admissions, Discharges, Transfers) – All admissions, discharges, and transfers of patients within all inpatient and emergency room locations in your facility 
    • MAR (Medical Administration Record) – Record of every time a medication is administered to a patient 
  • It is possible to manually import these files, or setup up a SFTP connection to have the reports automatically imported. 
  • Once all the data is fully imported, the next steps will be: 
    • Mapping your Ingredients, Locations, Facilities, and Routes – Link to FAQ/Video 
    • Verify that all imported data looks correct based on expected antimicrobial usage. As well as, learn how to use and configure the Medici Analyzer to drill down into your data to get a better understanding of all your data, and create your own reports – Link to FAQ/Video 
    • Walk you through generating a CDA file in Medici to submit to the NHSN. Link to FAQ/Video

How to set up mappings?

How to use AU Analyzer?

How to generate CDA file for NHSN submission?

  • It is variable based on the size and what EHR you have, but we have gotten hospitals up and running with antimicrobial use reporting in a single day. 
  • We also have data interfaces to accommodate any EHR you have. 

MEDICI® is the platform that unifies the ASP team’s effort.

Pharmacist Monitor patients and perform chart reviews
Physician Approve interventions and analyze outcomes
Infection Preventionist Report to NHSN
Microbiologist Produce antibiograms for empiric therapy guidance
Information Technologist Ensure information flows properly within team

Data Import

  • All imports for Medici require .csv files from your EHR. It can integrate with any EHR brand that is available (Epic, Meditech, Cerner, etc.)
  • There are 2 Imports required to track Antimicrobial Usage.
    • ADT (Admissions, Discharges, Transfers) – Data of all admissions, discharges, and transfers between locations in your facility
      • This is used to track patient days across your facility
    • MAR (Medical Administration Record) – Record of every time medication is administered
      • This is used to track Days of Therapy for all antimicrobials across your facility.

Current Version Data Dictionary

Demo 2021 MAR

Demo 2021 ADT-1

  • EHR built-in reporting tools
  • SQL scripts
  • Login to your Medici account
  • Click on the Import button at the top of the screen
  • On the Import screen, click on the Select Import File button then pick the file you wish to upload
  • Select the File Type that corresponds with the selected import
  • In the bottom right corner of the screen, select the Column Mappings button to proceed to the next page
  • On the Column Mappings screen, you will pick how each column will be mapped when uploading. Medici will attempt to map each column as best they can. You can edit the column mapping instructions by clicking the Edit button. The Clear Columns button will also remove all column mappings.
  • The Column Edit button will list all columns that are required for the file to upload.
  • Once every column is mapped, click the Summary button to move forward.
  • On the Summary page, you can review how each column is mapped. Click the Import File button to approve the import.
  • You will then be able to see the progress of your import. The data will not be visible until the import is no longer processing.
  • Once the upload is complete, you will now see a Completed note under the new download, and it will also display the date range of data that was imported. Please note that the Medici Analyzer may still be running the calculations for the data, so it may be 5-10 minutes before you can analyze the newly imported data.
  • In Medici, select the Import button at the top of the screen
  • On the Import screen, you can see a record of all imported files. It has the following details for each import:
    • The date and time the file was imported.
    • The User that imported the file
    • A red or green circle indicating if the import was successful or unsuccessful
      • Green = successful
      • Red = unsuccessful
    • The date and total amount of records with the import.
  • You can view the raw data of everything imported in the Details tab of your Medici account.
  • In the dropdown, select the type of import, you want details for.
  • In the search fields, input the specific dates and filters you want to look for.

Setup

Please note that only existing users with the correct role will have access to create new users.

 

  • Login to your Medici account, and the navigate to the Setup menu.
  • Select Users from the dropdown
  • Click the Add button at the top of the screen to create a new user.
  • Fill out the username, last name, first name, and email address for the new user.

  • Under the Role section select a role for the new user.

    • SiteAdmin – View Analyzer, View Details, View and Change Bookmarks, Can Import Data, Access NHSN tab, Change Setup tab, View Analyzer Drill Down, Setup new Users
    • Analyst – View Analyzer and Analyzer Drill Down
    • SiteConfigurator – View Analyzer, View Details, View and Change Bookmarks, Can Import Data, Access NHSN tab, Change Setup tab, View Analyzer Drill Down
    • SuperAnalyst – View Analyzer, View Details, View and Change Bookmarks, Access NHSN tab, View Setup tab (cannot change), View Analyzer Drill Down
  • Under Facilities, either uncheck the Restrict user to only certain facilities, or select the facility you wish the user to have access to.

  • The User will be sent a welcome email to set their password.

  • The new user should now have everything they need to login to Medici. If you have any questions, feel free to contact our support team by the methods below:
    • Email: support@asolva.com
    • Phone: 877-543-1088 option 2
  • After logging into Medici, navigate to the Setup menu. and click on Location
  • You will see all Locations from your import. For the location you want to map, click on Select Medici Name.

 

 

  • If you would like a one-click setup, click Mapped Locations on the top right of the screen and select Add All Locations to instantly see data on the Analyze page.

 

 

 

 

 

 

 

  • You can then choose to map your location to an existing Medici location or to create a new Medici Name for mapping.

 

 

 

 

 

 

 

  • If you select Create Medici Name, you can set your display name, facility, and location type. There are also buttons to exclude this location from showing in the Medici Analyzer, add more than one location type, and more than one EHR name. Click the Save button at the bottom of the screen to save your changes. The display name and location type should match the corresponding location name in your NHSN account.

 

 

 

 

 

 

  • Your location is now mapped. You will see the location display name with a green thumbs up for all mapped locations.
  • Login to your Medici account, and the navigate to the Setup menu.
  • Select Users from the dropdown.

 

 

 

 

 

 

  • Click on the then click Disable User

 

 

 

 

 

  • The User is now disabled. They will no longer be able to login to Medici. To view disabled users, toggle the Show Disabled Users toggle on the Users page.

In the event of Formulary changes from the CDC, it may be required to map new ingredients in Medici to submit to the NHSN. Please note that only certain user roles have access to make these changes.

  • To start login to your Medici account and click on the setup button.
  • Click on the Ingredients button in the dropdown.
  • In the Ingredients list scroll down to the new medicine you want to map and select where it says –Select Medici Name—

  • Click on Create Medici Name

 

 

 

 

 

 

 

  • Assign the Display name and NHSN OID for the new medicine.
    • There is also a checkbox to exclude the Ingredient from the Analyzer.
    • Click the Save button to save the mapping instructions.
    • The Patterns section of the screen shows you how the system will pickup this Medicine from your HER
      • There is also a button to add a new pattern and to view the test patterns
      • You can also remove a pattern by clicking on the trashcan next to the pattern name.
  • Also, there is a button to add this new Medicine to the Exclusion list to report as N/A to the CDC
    • This is to be done when you can’t accurately report your antimicrobial usage for this medicine.

 

  • You will see a green thumbs up along with the mapped name in green when the ingredient has been mapped successfully.
  • Similar ideas apply to route set up and facility set up.

New facility requires a new subscription key. Please reach out to us using the contact information below:

No, prescribers/specialty/clinical indication are automatically mapped. They are optional fields to be included in the MAR file. Although these fields are not required for NHSN reporting, they are great information for internal analysis. We highly recommend including these fields in the MAR file.

Analyze

The Medici Analyzer for Antimicrobial Use can be used to run quick and easy reports of your EHR data. It is completely customizable to fit whatever data you are looking to run. Additionally, any report that you run can be bookmarked to be easily referenced again.

  • When logging into Medici, you will be defaulted to the Medici Analyzer. It can also be found when clicking the Analyze button, then click Antimicrobial Use.

 

  • On the Analyzer page you will see all the data we pull from your EHR that you can use to analyze trends listed under the Paging section.
    • Note that the following sections are optional in your data import, so you may not be able to filter with the sections below if they were not included on your MAR file upload.
      • Specialty
      • Prescriber
      • Clinical Indication
  • Once all settings are set, you can click the Run Report button to view the data in the Analyzer. There is also a button to save this report as a bookmark to be run later.

 

  • Once the report is run, to return to the settings or refresh the report, click the corresponding buttons in the top right of the screen.

 

  • Under the chart type, you can also change if you want to select a line, bar, or pie chart.
  • For each section, you can click and drag by hovering over the 3 lines. You can then drag the filter to any of the other sections of the Analyzer to change how the report will show.

 

 

  • The new category can be dragged to the Row or Column section.
  • For each section, you can select the filter icon to see all possible values for that section. You can click on each value to filter only for that specific value. There is also a search bar to search for that specific value. Additionally, there is also a select all button to select every option in that section.

 

 

  • The Filters on the Column section also allow you to set the date range with which you want to see the report.
    • The filter button contains many different options where you can either set your date range or use some preset date ranges.
    • There is also a Group button where you can choose if you want the data group by per month, per year, or per day.
    • Your selected setting will be displayed in green.
    • Click Apply to set your changes

In the Medici Analyzer, it is possible to bookmark reports, so they are easily accessible to be run again. You can also set the bookmark to be public, so all users can access the same reports as well. Please note that some of the actions that you may not have access to depending on your user access.

  • In your Medici account, first setup the Analyzer with the desired filters.
  • Once the filters are added, click the Add Bookmark button

 

 

 

 

  • You can assign a Name and Description for your new bookmark

 

 

 

  • This will add the bookmark to your user. To access your bookmarks, click the Bookmarks button on the Analyzer Filters page.

 

 

  • Your bookmarks will be saved under the My Bookmarks section.
    • You can also click the star button to favorite a report as well which will have the report show up in the favorites section.

 

 

  • To be able to make a bookmark viewable by all users, click on the Bookmark Manager.

 

 

 

  • In the Bookmarks Manager, you will see all bookmarks in the system. Under the Shared Folders, you can set a bookmark to be seen by all by adding it to the Public Shared Folder. From the Bookmarks Manager, you can also disable reports, unfavorite reports, change the allowed facilities, and delete each bookmark.

 

  • Once a bookmark has been set public, it can be found underneath the Public group of each user’s bookmarks.

After the Analyzer has been run, you may be wondering how you can drill down into the data put forth by the Analyzer to verify that it all looks good. See the steps below for how you can do this in Medici.

  • In the Analyzer, set your desired filters, and click run report to view the data.

 

 

 

 

  • Once the report runs, you can click on the data cell that you want to drill down into. You have a choice of seeing the data within Medici (limit of 500 lines), or downloading the details (limit of 5000 lines)

 

 

 

  • If View Details was selected, you will see the details that contributed to the Analyzer’s calculation within the Medici application.

 

 

  • If you chose to download the details, they will be downloaded as a .csv file to be viewed in Excel.
  • After you have run a report with the Analyzer tab, it is possible to both export the data into an Excel .csv file for future analysis and create a printable graph of the data for your own use as well.
  • Login to your Medici account.

 

  • In the Analyzer, put all desired filters for the report and click Run Report.

 

 

 

 

  • Once the report generates in Medici, click the download button at the top of the screen and the report data will be downloaded onto your computer in a .csv file.

 

 

 

 

  • To print out the page, right click on the Medici page, and click the Print button.
  • The Measure field can be customized for the type of data you wish to see by clicking the dropdown in the measure field.
  • The following are the list of measures that you can track with the Analyzer
    • DOT – Days of Therapy
    • Day Present
    • DOT per 1000 days present
    • Patient Days
    • DOT per 1000 patient days
    • Admissions
    • Encounters

Please see definition from CDC NHSN below:

“Days present are the number of patients present at any time on a given day in each patient care location. Patient days are the number of patients present in each patient care location during the once daily census count.

For example, a patient admitted to the medical ward on Monday and discharged two days later, on Wednesday, will contribute three days present to the medical ward because the patient was there at some point during each of the three calendar days (Monday, Tuesday, and Wednesday). If this medical ward used midnight as the time of their daily census count, this same patient would only attribute two patient days because they were present for the midnight census count on Monday and Tuesday only.“

Below are the column, row, measure, and filter settings for common reports run in the Analyzer

  • Track the DOT usage over the past calendar year per Location
    • Row – Location
    • Column – Last Calendar Year
    • Measure – DOT

See which medication is most common for each location

  • Row – Medication
  • Column – Last Calendar Year
  • Measure – DOT
  • Filters – Location – Select specific location you want to analyze

See which Specialty most prescribes one medication the most in a certain location

  • Row – Specialty
  • Column – Last Calendar Year
  • Measure – DOT
  • Filters
    • Location – Desired location
    • Medication – Desired medication

NHSN Submission

Yes, we are proud to say that Asolva’s cloud-based software system Medici® is the first vendor product to have passed Antimicrobial Use (AU) validation for the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN) reporting (https://www.cdc.gov/nhsn/cdaportal/au-sds/vendor-list.html).

To be able to submit the CDA file from Medici to the NHSN, there are some setup information that will need to be pulled from your NHSN account. Below is all information you will need before you can be setup.

 

  • Location Codes for all Inpatient Locations plus ED and 24 Hour Observation in your NHSN account.
  • After logging into Medici, you will need to navigate to the Setup button.
  • In the setup dropdown, select Facility.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  • In the Setup Facilities page, click on the Medici Facility Name for your Facility.

 

  • Select Edit Medici Name under the Medici Facility Name dropdown.

 

 

 

  • Under the Facility, input the OID that has been assigned by the NHSN.

 

 

  • Additionally on this menu, you can choose to exclude this facility from showing up in the Analyzer. Click save to keep all your changes.

 

 

 

 

 

 

 

 

 

 

 

 

 

  • Your OID will now be listed under the Classification section of the Facility mapping.
  • To map each of your locations. Navigate to your location mapping, click Setup and then Location.

 

 

 

 

 

 

 

 

 

 

 

 

 

  • Select the Medici location name and click Edit Medici Name. Note: NHSN requires that all inpatient, ER, and 24-hour observation locations be mapped.

 

 

  • In the Medici mapping, select the Location type. The Location Code must map exactly to the Locations setup in your NHSN account.

 

 

 

 

 

  • Repeat the last 2 steps for every inpatient, ER, and 24-hour observation locations.
  • Once all your locations are setup, you are now ready to start generating the file to import into NHSN. Select NHSN at the top of the screen in Medici.
  • Select the Facility you want to generate and click Find

 

 

 

 

  • In the top left of the screen, you will see a dropdown with each mapped NHSN location, and a Facility Wide Inpatient (FacWideIN) option to review your antimicrobial usage. Additionally, it will also show the Admissions and Days Present for the selected location.

 

  • In the middle of the screen, you will see the breakdown of your facility’s antimicrobial usage for all drugs that the CDC requires. It is broken down by route and total. You can review to make sure that the numbers look correct, and then Click Validate to move forward, or Close to cancel.

 

 

  • Once you have clicked Validate, you will be returned to the NHSN page. You will then want to click on the same month again where it says Validated. There are 3 options you can select.
    • Details – Return to the antimicrobial breakdown page from the previous step
    • Submit – Move the submission forward, and set it to be ready for NHSN submission
    • Delete – Invalidate the previous step and return the month to the Start button.

 

  • Once the month has been submitted, you will now see a blue Submitted button under the month. You will want to click on the Submitted button again and see 3 more options.
    • Details – View the antimicrobial breakdown page for the month
    • Download – Download the CDA file required for NHSN submission.
    • Delete – Invalidate the data and return the month to the Start button.

 

 

 

  • Once the file is downloaded, you are now ready to upload your data into NHSN. See the link below for how to submit the data into the NHSN website.
  • Link to NHSN AU FAQ