Sage Growth Partners (SGP) recently announced survey findings on how clinical surveillance is prioritized and managed by healthcare delivery organizations. The survey of healthcare executives from hospitals across the U.S. was commissioned by VigiLanz, a clinical surveillance company, to assess their progress in the journey to higher value care and how they are using data analytics, EMRs and clinical surveillance tools to support their efforts.
The full report is available here. Key findings include:
Majority are using a clinical surveillance solution and see it as important to their organization
Most hospitals (96 percent) are using some sort of clinical surveillance solution, whether from a third-party, built in-house, or as part of their EMR. Four percent do not perform any kind of clinical surveillance.
The majority (88 percent) say clinical surveillance is extremely, very, or moderately important to their organization. Nine percent said it’s only slightly important, and 3 percent said it was not important at all or they did not know its importance.
Respondents identified the top five ways clinical surveillance can be most helpful today as: (No. 1) identifying adverse drug events, (No. 2) advancing antimicrobial stewardship initiatives, (No. 3) patient safety alerts, (No. 4) preventing inpatient infections, (No. 5) managing re-admissions.
EMRs aren’t meeting all hospitals’ clinical surveillance and data analytics needs
Most respondents (71 percent) said they invest in additional technology solutions to help them synthesize and understand EMR clinical data; 29 percent do not.
Forty percent of respondents use their EMR for clinical data analytics, 27 percent use it for financial data analytics, and 26 percent use it for operational data analytics. Five percent said their EMR does not offer any of those data analytic capabilities, and 2 percent said they do not leverage their EMR’s data analytic capabilities.
Of the respondents who use the clinical data analytics portion of their EMR, 29 percent said it works extremely or very well, 49 percent said it works moderately well, and 22 percent said it works slightly well or not well at all.
The return on investment (ROI) for clinical surveillance is clear
Some 79 percent said there is probably or definitely ROI from clinical surveillance solutions; 19 percent were unsure, 2 percent said there was probably no ROI.
The large majority (92 percent) said their clinical surveillance technology definitely or probably helps them improve quality, 8 percent were unsure. No respondents answered in the negative.
Link between hospital revenue and value-based care is strong going into 2019
About a quarter (23 percent) of respondents said at least 31 percent or of their revenue will be tied to value in 2019. Of those, 6 percent said more than half of their revenue will be tied to value.
Of respondents who solely use a third-party solution for clinical surveillance, more than one-third (37 percent) said over 31 percent of their revenue will be tied to value-based contracts in 2019.
Only 15 percent of respondents who solely use an EMR for clinical surveillance said over 31 percent of their revenue will be tied to value.
“As hospitals continue to take on more value-based payment models, their ROI for clinical surveillance will grow,” said David Goldsteen, MD, CEO of VigiLanz. “At the same time, our survey showed that those who use a third-party solution for clinical surveillance are also more involved in value-based payment models, suggesting that they view clinical surveillance is a key lever for their success. I believe that we will only continue to see hospital leaders and physicians choose these solutions for a broader spectrum of patient care insights than is available through EMRs. These insights lead to more optimal care decisions that help them meet quality and cost targets and will lead to greater success under value-based payment models now and in the future.”
VigiLanz and Cincinnati Children’s Hospital Medical Center announces a collaboration that leverages Cincinnati Children’s research on pediatric nephrotoxic kidney injury and VigiLanz’s capabilities to commercialize a solution for Acute Kidney Injury (AKI) in pediatric patients. Dubbed NINJA, or Nephrotoxic Injury Negated by Just-in-time Action, the solution enables real-time identification and monitoring of patients at risk for AKI due to exposure to nephrotoxic drugs.
Dr. Stuart L. Goldstein
“Pediatric acute kidney injury is a serious problem that traditionally could not be identified in real-time, which impacted our ability to identify the patients who most needed treatment,” stated Dr. Stuart L. Goldstein, MD, FAAP, FNKF, Director of the Center for Acute Care Nephrology and primary researcher on NINJA. “By partnering with VigiLanz, Cincinnati Children’s is applying our unprecedented research to a commercially-available solution that accurately characterizes pediatric AKI epidemiology, reducing AKI and improving patient outcomes.”
Commercially available to hospitals and health systems focused on mitigating pediatric AKI, NINJA automates a time-consuming manual screening process that includes evaluating patients for exposure to 57 nephrotoxic medications, imaging contrast dye, and recent renal testing. For medications, manual screening is limited to the last 24 hours, while the contrast dye evaluation requires reviewing records for the previous seven days to determine if it was received by the patient.
Leveraging NINJA algorithms built into VigiLanz rules, an AKI monitoring dashboard lists all patients that meet the NINJA exposure criteria, as well as the criteria that put the patient in the at-risk category. These criteria include medication exposure, serum creatinine data and patient history of AKI. When patients meet at-risk criteria, they are placed on the monitoring list in real time, where they remain until 48 hours after their risk has passed.
The platform also features metric outputs that can be customized with respect to service lines and time periods, while robust reporting tools provide the ability to trend conditions over time via automated run charts. It also enables automatic and customizable data extraction for all metric elements, including inpatient census by location or service line.
Guest post by Adam Klass, chief technology officer, VigiLanz.
Adam Klass
Here are some downright chilling patient safety statistics keeping healthcare leaders up at night: Each year more than one million hospital patients – that’s 136 per hour, every day – are affected by sepsis, and 280,000 die. In addition, 82 people in hospitals are affected every hour, every day, by hospital-acquired infections (HAI), and 217 experience a preventable Adverse Drug Event (ADE).
The good news is that an emerging category of technology known as enterprise intelligence resources (EIR) can empower clinicians to more quickly and effectively tackle these infections and ADEs – and even prevent them from occurring in the first place. By integrating and analyzing massive amounts of data generated by multiple sources, EIRs are not only able to identify at-risk patients, but also to tell frontline clinicians in real-time what is happening – and likely to happen – with their patients. Equally important, the EIRs fit seamlessly into clinicians’ workflows, generating only essential alerts.
Built on flexible, interoperable data architectures, EIR platforms extend the value of existing EMRs by integrating real-time clinical and business intelligence with predictive analytics to address sepsis, HAIs and ADEs as well as a wide range of other patient safety and public health risks such as deep vein thrombosis (DVT), venous thromboembolism (VTE), C. difficile (C.Diff), MRSA, surgery site infections, Ebola and MERS. Armed with EIR-provided actionable insights, clinicians can optimize appropriate interventions that improve patient outcomes, reduce patient safety risk and support quality initiatives.
Measurable benefits
Time is of the absolute essence in addressing patient safety risk, particularly in the case of sepsis. Research has shown that the earlier the intervention, the significantly lower the mortality and morbidity. EIRs can help significantly reduce sepsis risk by enabling clinicians to:
Identify at-risk patients earlier. Based on historical hospital data, an EIR can create a profile and scoring system to calculate a sepsis risk score for each patient, flagging those whose risk exceeds a pre-defined threshold.
Automatically track at-risk patients. The EIR closely monitors patients’ sepsis diagnostics and vital signs, and automatically updates their risk scores in the EMR.
Deliver appropriate alerts. The EIR notifies clinicians when interventions are required and continues to monitor patients so treatment can be adjusted according to defined protocols.
Implementing this approach has been shown to reduce sepsis occurrence by double digits. Most importantly, patients’ lives are saved. At the same time, reducing sepsis occurrence can also significantly reduce costs, given that sepsis accounts for 40 percent of ICU spending and nearly $29 billion in healthcare expenditures.
