How to Get Started with MONAHRQ

1. How to Get Started with MONAHRQ • May 2014 • Note: This is one of seven slide sets outlining MONAHRQ and its value, available at http://monahrq.ahrq.gov/monahrq_resources.shtml#pres

2. What Is MONAHRQ? Windows-based software from the Agency for Healthcare Research and Quality (AHRQ) to help you and your organization create your own healthcare reports and websites • Evidence-based – uses measures, data sources, and reporting techniques that are based on research • Quick – generates reports and websites in days, not months • Easy – designed to be intuitive so no training is needed to use it • Flexible – allows customization to ensure that the reports and websites are relevant • Free – provided by AHRQ at no cost to anyone who wants to produce health care reports and websites The purpose of MONAHRQ is to help increase transparency by disseminating evidence-based information that is understandable and useful for improving health care safety, quality and affordability. For more information, see the “What Is MONAHRQ?” presentation

3. Overview of the Process to Use MONAHRQ

4. Get Ready for MONAHRQ • Make sure your computer meets the following system requirements: • Operating system: Windows® XP 32- and 64-bit; Windows Server ®2003 or higher 32- and 64-bit; Windows ®7 32- and 64-bit; Windows ®8 32- and 64-bit • 2 GHz processor speed and 2 GB of memory and disk space for MONAHRQ and associate components (Up to 4 GB may be required for certain elements. See http://monahrq.ahrq.gov for details.) • Ensure you have the necessary supporting software: • The free Microsoft .NET framework 4.5 (full) • Microsoft SQL Serveror SQL Server Express 2008 R2 or higher (free) or SQL Server Enterprise 2008 or higher (paid) • AHRQ Quality Indicators™ Software (optional, but necessary to calculate specific measures) • Uninstall previous versions of MONAHRQ (recommended, not required), once installation and testing of the new software is complete

5. Step 1: Download and Install MONAHRQ • Download the installation package from the MONAHRQ website and run the wizard (http://monahrq.ahrq.gov/monahrq_software.shtml)) • Decide what type of website to create based on your primary target audience(s): “consumer” only, or “all audiences” including those with more technical health care knowledge • See Section 1.3 of the Host User Guide at http://monahrq.ahrq.gov, or refer to the standalone “Decision Guide” at http://monahrq.ahrq.gov/MONAHRQ_v50_DecisionGuide.pdf • Open MONAHRQ, establish the connection between the application and SQL Server database, and proceed to the welcome screen

6. Step 1: Install MONAHRQ

7. Step 2: Prepare Libraries • Datasets Library: Download or prepare the files of health care data and/or quality measure results to import into your MONAHRQ database.These may include: • Inpatient discharge data • Emergency Department (ED) treat-and-release data • CMS Hospital Compare measures • AHRQ QIs™ • Medicare Provider Charge Data: Inpatient • Region Information File • Measures Library: Choose topics and subtopics, edit names and descriptions, and modify calculations and display options • Reports Library: Select and customize reports for the website to be generated.

8. Step 2: Prepare Libraries (continued)

9. MONAHRQ Data Sources • CMS Hospital Compare Measures. CMS calculates the Hospital Compare measures, including HCAHPS patient satisfaction survey results, and makes the results publicly available. AHRQ reformats these data and makes them available on the MONAHRQ download website. (http://monahrq.ahrq.gov/monahrq_data.shtml) • AHRQ Quality Indicators (QIs). MONAHRQ allows Host Users to calculate AHRQ QIs using their own inpatient discharge data. AHRQ provides two tools to calculate the AHRQ QIs: the AHRQ QI software for Windows (WinQI) and the AHRQ QI software for SAS. More information about calculating AHRQ QIs can be found at http://qualityindicators.ahrq.gov.

10. MONAHRQ Data Sources (continued) • Medicare Provider Charge Data (Inpatient). Includes hospital-specific charges for the top 100 most frequently billed discharges for more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments. • Inpatient Discharge Data. Host Users may supply their own Inpatient Discharge Data. MONAHRQ helps map these data to the appropriate format to support a MONAHRQ website. • ED Treat-and-Release Data. Host Users may supply their own ED treat-and-release data. MONAHRQ helps map these data to the appropriate format to support a MONAHRQ website.

11. Step 3: Define Hospitals and Regions Define the geographic location for your website by choosing Dartmouth Atlas Hospital Referral Regions (HRRs) or Hospital Service Area (HSA), or use a custom region These configuration files include the following: • Region definitions • Hospital definitions

12. Step 4: Create a Reporting Website MONAHRQ allows you to create and store multiple websites • Start by defining the website name, target audience, and a reporting time period • Select the health care datasets and quality measure results from the Datasets Library that you created in an earlier step • Choose and customize the measure attributes, such as name and description, based on your local needs • Store those changes in your MONAHRQ Measures Library so you can reuse them in other websites that you create with MONAHRQ • Select the reports to be included in your website based on the target audience that you chose • Store those changes in your MONAHRQ Reports Library so you can reuse them in other websites you create with MONAHRQ

13. Step 4: Create a Reporting Website (continued)

14. Step 5: Define and Customize Your Website Add information about the website you are creating, such as: • Website title • Geographic description • Logo – an image that will be displayed on each web page • Banner that will be displayed on each web page • Color and font styles used throughout the website For more information on customization options, see the Host User Guide, available at http://monahrq.ahrq.gov

15. Step 5: Define and Customize Your Website (continued)

16. Steps 6 and 7: Publish, Host and Update Your Website Step 6. Publish Your Website • Run the “dependency check” to identify any missing pieces or inconsistencies that need to be fixed before the website is published • Once the dependency check is done, MONAHRQ writes the website files to a directory that you select on a local computer or network Step 7. Host and Update Your Website • Compress, transfer and extract the website files of your new MONAHRQ-generated website to a web server or other hosting environment • Easily update your MONAHRQ-generated website(s) as new data become available, without having to start from the very beginning

17. Steps 6 and 7: Publish, Host and Update Your Website (continued)

18. Technical Support For questions or comments about using MONAHRQ, contact MONAHRQ Technical Assistance at MONAHRQ@ahrq.gov For more detailed instructions and further information about using MONAHRQ to generate reports and websites and reports, please visit http://monahrq.ahrq.gov and download: • MONAHRQ 5.0 Host User Guide (http://monahrq.ahrq.gov/MONAHRQ_v50_HostUserGuide.pdf): A comprehensive guide to using MONAHRQ, creating your website and reports and troubleshooting • MONAHRQ 5.0 Quick-Start Guide (http://monahrq.ahrq.gov/MONAHRQ_v50_Quick_Start_Guide.pdf): An overview of the steps to create website and reports using MONAHRQ

19. For Further Information Visit http://monahrq.ahrq.gov/ to access these additional slide sets: • What is the Value of Measurement and Reporting? • Why Use MONAHRQ for Health Care Reporting? • How to Get Started with MONAHRQ • What Types of Reports and Websites Can MONAHRQ Generate? • Who Uses MONAHRQ? • Future Plans for MONAHRQ and How to Get Involved To receive updates about MONAHRQ, ask to join our listserv by emailing monahrq@ahrq.gov