In a field where broken bones, ruptured appendixes, and concussions are the hallmarks of a relatively calm night, preparation makes all the difference. Having the right staffing, supplies, and knowledge on hand is important when dealing with relatively minor medical emergencies. In the face of a potential epidemic, preparation is critical.

As the H1N1 (swine flu) virus spreads, Emergency Medical Associates (EMA) is using SAP BusinessObjects software to stay one step ahead. By tracking key metrics and presenting data in terms that emergency room doctors and administrators can understand, EMA is able to alert federal health officials of possible outbreaks and help emergency rooms plan appropriately.

"By drilling down into specific syndromes in our patient reports, we can pinpoint spikes in fever and flu-like symptoms that are swine flu indicators," says Jonathan Rothman, director of data management at EMA. "Then we compare it with our large archive of historical information to figure out where we stand. When statistics for a particular symptom exceed standard deviation, we know we've got a problem on our hands.”

In an interview with SAPexperts, Rothman explained how EMA was able to layer SAP BusinessObjects components, such as SAP BusinessObjects InfoView and SAP BusinessObjects Dashboard Builder, on top of its pre-existing Oracle data warehouse to tailor its business intelligence (BI) solution.

EMA began collecting data from its emergency rooms in the late 1980s, when it realized that using computers to document care and track patients would be more cost-effective than shuttling paper back and forth from the emergency rooms to company headquarters. Since that time, the company has developed a robust toolset called Emergency Department Information Manager (EDIM) for data collection.

When hospitals contract EMA to run their emergency rooms, EMA installs EDIM to ensure consistent data. Doctors, nurses, and administrative workers enter relevant data into the system, which is then collected into an Oracle data warehouse along with billing and patient satisfaction data. EMA then applies SAP BusinessObjects tools to give doctors and hospital administrators the tools they need to make the right decisions going forward.

In the case of swine flu, that means tracking key metrics from more than 1.2 million patients annually that can help identify outbreaks and help the emergency rooms prepare. The most important metric tracks the number of people who report fever and flu symptoms, along with the timing of their visits. Other metrics include the number of emergency room visits for the month versus past months, the percentage of patients who walk out, the time of patient walk-in versus time of admittance, and the amount of time necessary to treat and release or admit a patient.

By measuring these metrics against a set of standard deviations that Rothman calculated, the EMA BI solution is able to send up red flags that could warn of a potentially dangerous increase in swine flu cases. Because the SAP BusinessObjects solution also draws on patient data such as home city or town, the software also helps track the geographic spread of swine flu.

Doctors and administrators can log into an extranet system called eMARS to access 27 customized dashboards that display relevant data. The data is presented in straightforward graphs, charts, and folders for fast navigation.

“The solution is tailored to communicate with our end users. All they care about is getting the information,” says Rothman.

Many of the data points can be compared to other emergency rooms in the EMA network, and the end user can drill down into data to determine whether any standard deviations represent a real threat.

“The goal is to have the technology be an alarm. You still have to make some human judgments with the data. We prefer to have the ability to sift through and drill down into data before we start calling the police or fire department,” says Rothman. “This is a true marriage between people, processes, and technology. You don’t see that too often.”

In fact, the EMA solution is unique among emergency medicine providers, according to Rothman. In the wake of the 9/11 terrorist attacks, EMA worked closely with the Centers for Disease Control (CDC) and the American Medical Association (AMA) to define key metrics for tracking both epidemics and potential biological attacks. As swine flu fears rose in the spring of 2009, EMA realized the important role that surveillance could play in helping its emergency rooms prepare for a possible epidemic.

“By having the right amount of medical resources available to patients in the most urgent times, we can provide proper treatment and help mitigate the spreading of the virus," says Rothman.

The best part, he says, is that the solution comprises SAP BusinessObjects functionality almost straight out of the box.

“EMA developed a business intelligence data management infrastructure, and we use it every single day. And the only way to do that was to use SAP BusinessObjects,” he says.

Davin Wilfrid

Davin Wilfrid was a writer and editor for SAPinsider and SAP Experts. He contributed case studies and research projects aimed at helping the SAP ecosystem get the most out of their existing technology investments.

If you have comments about this article or publication, or would like to submit an article idea, please contact the editor.