How To Get Started With MONAHRQ

March 2015

Note: This is one of eight slide sets outlining MONAHRQ and its value,

available at www.ahrq.gov/professionals/systems/monahrq/resources/

What Is MONAHRQ?

Windows-based software from the Agency for Healthcare Research and Quality (AHRQ) that can help you and your organization create your own website-based, comparative health care performance reports.

• Evidence-based – uses measures, data sources, and reporting techniques that are based on the latest research

• Quick – generates websites and reports in hours or days, not months

• Easy – designed to be intuitive so no training is needed to use it

• Flexible – allows customization to ensure that the websites and reports are relevant

• Free – provided by AHRQ at no cost to anyone who wants to produce health care performance websites and reports

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.2

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Overview of the Process To Use MONAHRQ

Get Ready for MONAHRQ

1. 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 associated components (Up to 4 GB may be required for certain elements. See http://monahrq.ahrq.gov for details.)

2. Ensure you have the necessary supporting software:

► The free Microsoft .NET Framework 4.5 (full)

► Microsoft SQL Server or SQL Server Express 2008 R2 or higher (free) or SQL Server Enterprise 2008 or higher (paid). For Inpatient Hospital Discharge and Emergency Department treat-and-release datasets larger than 3GB, the recommendation is to use an Enterprise version due to memory limitations.

► AHRQ Quality Indicators™ software (optional, but necessary to calculate specific measures)

3. Upgrade from MONAHRQ 5.0 to 6.0 without uninstalling. This retains your previously loaded data and websites in the new MONAHRQ version.

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Step 1: Download and Install MONAHRQ

1. Download the installation package from the MONAHRQ website and run the wizard (http://monahrq.ahrq.gov/monahrq_software.shtml)

2. 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_v60_DecisionGuide.pdf

3. Open MONAHRQ, establish the connection between the application and SQL Server database, and proceed to the welcome screen

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Step 1: Install MONAHRQ

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Step 2: Prepare Libraries

1. 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 Hospital Discharge data

► Emergency Department (ED) Treat-and-Release data

► CMS Hospital Compare data

► CMS Nursing Home Compare data

► CMS Physician data

► AHRQ Quality Indicator™ results

► Medicare Provider Charge Data: Inpatient

► Region Information File

2. Measures Library: Choose topics and subtopics, edit names and descriptions, and modify calculations and display options.

3. Reports Library: Select and customize reports for the website to be generated.

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Step 2: Prepare Libraries (continued)

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MONAHRQ Data Sources

• CMS Hospital Compare Data. CMS calculates the Hospital Compare data, including HCAHPS patient satisfaction survey results, and makes the results publicly available.

► NOTE: AHRQ no longer reformats this data source, which can be directly downloaded from the CMS website: https://data.medicare.gov/data/hospital-compare. The original file is also available for download on the MONAHRQ website: http://monahrq.ahrq.gov/monahrq_data.shtml.

• CMS Nursing Home Compare Data. CMS calculates the Nursing Home Compare data including patient satisfaction survey results, and makes the results publicly available. The Nursing Home Compare data are available to download from the CMS website at: https://data.medicare.gov/data/nursing-home-compare

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MONAHRQ Data Sources (continued)

• CMS Physician Data. CMS compiles information about individual physicians, including medical group and hospital affiliation, and makes the results publicly available. MONAHRQ pulls CMS Physician data from Application Programming Interface (API) services provided by the CMS Website (http://data.medicare.gov).

• AHRQ Quality Indicator (QI) Results. MONAHRQ allows Host Users to calculate AHRQ QIs using their own inpatient hospital discharge data. AHRQ provides two tools to calculate the AHRQ QIs: QI Windows® software (WinQI) and QI SAS® software. More information about calculating AHRQ QIs can be found at http://qualityindicators.ahrq.gov.

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MONAHRQ Data Sources (continued 2)

• 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 Hospital Discharge Data. Host Users may supply their own Inpatient Hospital 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.

Step 3: Define Hospitals and Regions

Define the geographic location for your website by choosing Dartmouth Atlas Hospital Referral Regions (HRRs) or Hospital Service Areas (HSAs), or use a custom region.

These configuration files include the following:

• Region definitions

• Hospital definitions

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Step 4: Create a Reporting Website

MONAHRQ allows you to create and store multiple websites.

1. Start by defining the website name, target audience, and a reporting time period. NOTE: You can use the Decision Guide to help determine your audience (http://www.ahrq.gov/professionals/systems/monahrq/resources/MONAHRQ_v60_Decision_Guide.pdf).

2. Select the health care datasets and quality measure results from the Datasets Library that you created in an earlier step.

3. 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.

4. 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.

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Step 4: Create a Reporting Website (continued)

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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

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Step 5: Define and Customize Your Website (continued)

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Steps 6 and 7: Publish, Host, and Update Your Website

Step 6. Publish Your Website

1. Run the “dependency check” to identify any missing pieces or inconsistencies that need to be fixed before the website is published.

2. 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

3. Compress, transfer, and extract the website files of your new MONAHRQ-generated website to a web server or other hosting environment.

4. Easily update your MONAHRQ-generated website(s) as new data become available, without having to start from the very beginning.

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

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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 6.0 Host User Guide: A comprehensive guide to using MONAHRQ, creating your website and reports, and troubleshooting (http://monahrq.ahrq.gov/MONAHRQ_v60_HostUserGuide.pdf)

• MONAHRQ 6.0 Quick Start Guide: An overview of the steps to create websites and reports using MONAHRQ (http://monahrq.ahrq.gov/MONAHRQ_v60_Quick_Start_Guide.pdf)

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For Further Information

Visit http://monahrq.ahrq.gov to access these additional slide sets:

• What is the Value of Health Care Measurement and Reporting?

• What Is MONAHRQ?

• Why Use MONAHRQ for Health Care Reporting?

• What Types of Websites and Reports Can MONAHRQ Generate?

• Who Can Use MONAHRQ?

• Using MONAHRQ’s Open Source Framework

• Future Plans for MONAHRQ and How To Get Involved

To receive updates about MONAHRQ, ask to join our listserv by emailing monahrq@ahrq.gov.

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