Background
Northeastern Vermont Regional Hospital (NVRH) is a community, not-for-profit, acute care, critical access hospital located in Vermont's historic Northeast Kingdom. NVRH provides primary and preventive care, surgical and specialty services, inpatient and outpatient care, and 24-hour physician-staffed emergency services. The hospital is the only facility in Vermont designated as a "Baby Friendly" hospital by the United Nations, and runs its clinical operations on the MEDITECH Expanse EHR platform.
NVRH was using MEDITECH's Business and Clinical Analytics (BCA) for reporting, along with a mix of SQL Server Reporting Services and manual spreadsheets. While BCA provided some useful information, it was an out-of-the-box solution built around preset data cubes that anticipated what the hospital's reporting needs would be. In practice, individual physicians, departments, and other stakeholders had specific analytical needs that the existing tools could not easily accommodate.
The Challenge
The core problem was a mismatch between how reporting was delivered and how it was actually needed. BCA's top-down, preconfigured approach meant that when a department director or clinician needed to see data sliced a particular way, the existing tools often could not deliver. Users had limited ability to drill deeper into the data, which created frustration. The hospital's reporting infrastructure was also fragmented across multiple platforms, making it difficult to maintain consistency or scale.
CIO Shawn Burroughs recognized that the hospital needed a solution flexible enough to build exactly what any given user required, rather than forcing everyone into the same predefined reports.
Beyond the tool itself, there was a deeper technical challenge. The MEDITECH Data Repository contains more than 18,000 tables spread across two databases and over 150,000 discrete data fields. Navigating that complexity to find the right data for a specific report requires deep, application-specific knowledge that most hospital IT teams simply do not have in-house.
"I don't care what visualization tool you use, you're not going to be able to answer questions unless you know exactly where each piece of data comes from. We have multiple departments, and they all have their own reporting and analytical needs. Meeting those needs requires locating exactly where each of the data elements are stored across all those thousands of tables and data fields. Acmeware has the experience to help us do that." - Daniel Deatrick, Manager of Data Analytics, NVRH
The Solution
NVRH chose Empower, Acmeware's analytics and business intelligence solution built for the MEDITECH EHR. Empower leverages Microsoft Power BI's intuitive interface and powerful visualization capabilities, paired with Acmeware's deep MEDITECH Data Repository expertise, to deliver interactive reports and dashboards tailored to each organization's specific needs. The combination of an inexpensive licensing model, a familiar Microsoft user experience, and Acmeware's ability to navigate the complexity of DR made Empower the right fit for a hospital that needed flexibility without the overhead of building data expertise from scratch.
The team uses SQL Server Management Studio for data modeling and creating stored procedures to handle data transformation before feeding results into Empower dashboards. A key strategic decision was to lean on Acmeware's knowledge of the Data Repository rather than trying to build that expertise internally. Deatrick's team described Acmeware as their go-to resource whenever they could not locate the right tables or fields within DR, noting that a group could spend years trying to acquire the level of MEDITECH Data Repository knowledge that Acmeware brings to the table. That partnership dramatically reduced the time required to move from a reporting request to a finished dashboard.
Rather than rolling out a standardized set of enterprise dashboards from the top down, NVRH adopted a bottom-up development approach. Instead of committees and lengthy requirements-gathering processes, a data analyst works directly with the person requesting a report. They sit together, identify exactly what data is needed and how it will be used, and build a custom dashboard specifically for that user. The team publishes iterative versions along the way, sending links and collecting feedback until the solution precisely matches the requester's needs.
Results and Benefits
Rapid, Word-of-Mouth Adoption
The bottom-up approach created its own momentum. Once early users received their personalized dashboards, word spread quickly throughout the hospital.
"Word of what we could do got out in a hurry. People would stop me in the corridors and ask about a solution we had created for one group and want their own custom dashboard. I try not to go to too many meetings, because every meeting I go to, I seem to come out with two or three new projects." - Daniel Deatrick
This organic adoption pattern meant NVRH never had to push staff to use Empower. Demand came from the users themselves.
Personalized Solutions That Drive Ownership
Because each dashboard is built collaboratively with the person who requested it, users develop a strong sense of ownership over their reporting tools. Deatrick noted that you do not have to nudge anyone into using a dashboard they helped build. They are invested from the start, and the result is a tool that directly answers their specific questions and supports their decision-making.
This iterative, one-on-one approach also produces more precise solutions. When the hospital began studying the need to expand its Emergency Department, the project director worked with Deatrick's team to create a custom Empower dashboard tracking concurrent ED patients, maximum concurrent patients by time of day and month, and other utilization data. At a glance, the director could see usage trends and drill into any specifics of interest.
In another project, the director of Diagnostic Imaging wanted to visualize when and where diagnostic equipment was being used, filterable across six years of historical data. Deatrick's team built a dynamic dashboard showing volume over time by equipment type, department, and provider. The dashboard helped provide insight into staffing needs by revealing equipment usage patterns by day of week and hour of day.
Drill-Down Capability and Speed
One of the most common frustrations with the previous BCA setup was the inability to look deeper into the data. With Empower, users can enjoy the convenience of high-level data visualization while drilling down to see whatever detail they need. Financial team members, for example, can download entire datasets into Excel with a couple of clicks and apply their own filters.
Performance also improved significantly. Because Deatrick's team selectively imports only the relevant tables from DR rather than querying the entire repository, Empower dashboards respond instantaneously. Users no longer have to wait for queries to process, a frequent complaint with the previous solution.
Faster Turnaround on New Projects
Acmeware's Data Repository expertise directly translates into faster project delivery. Deatrick described an anesthesia reporting project where assembling the right tables and fields would have been extremely difficult without Acmeware's guidance. Rather than spending weeks or months mapping the data, the team was able to move quickly because Acmeware already knew where to find the relevant information.
Responsive Support and Community
NVRH also values the responsiveness of Acmeware's support. When the hospital had a question about their Downtime Defender deployment and wanted to add a feature, Deatrick called, spoke with someone directly, and the issue was resolved on the spot. No trouble ticket, no multi-day wait.
Beyond direct support, the hospital benefits from Acmeware's Partnership User Group, which brings MEDITECH hospitals together every few months to discuss reporting strategies, share best practices, and talk through how they pull and visualize data. Deatrick describes it as a central hub for a community of MEDITECH data users, and finds it genuinely helpful to connect with peers facing similar challenges.
"Acmeware is our go-to if there's something we can't find inside the MEDITECH Data Repository, because they have so much experience working deeply in the DR." - Daniel Deatrick
