DATA IN THE SERVICE OF THE PATIENT: IMPROVING PATIENT OUTCOMES AND PATIENT SAFETY WITH BETTER DATA

Transcription

1 DATA IN THE SERVICE OF THE PATIENT: IMPROVING PATIENT OUTCOMES AND PATIENT SAFETY WITH BETTER DATA Greg Adams, Vice President Wolters Kluwer UpToDate

2 Doctors Have Clinical Questions Unanswered clinical questions impact patient management decisions Approximately 2 out of 3 clinical encounters generate a question Physicians have approximately 11 clinical questions a day Answering all clinical questions could change 5 to 8 40 % of the time, the clinician knows the answer patient management decisions each day Covell, DG. Ann Intern Med 1985; 103:596; Green, ML. AM J Med 2002; 109:218; Osheroff, JA. Ann Intern Med 1991:575; Ely, JW. J Am Med Inform Assoc 2005; 12:217; Gorman, PN. Med Decis Making 1995; 15:113.

3 Staying on top of Medical Knowledge In 1965, only 39 randomized trials were published in medicine. In 2011, there were , which poses a seemingly insurmountable information challenge for clinical professionals who want to stay current with important information. There is too much information to be able to manage or digest.

4 Clinical Decision Support: Getting It Right In the Right Context & Format The Right Guidance At the Right Time The Right Decision

5 The Most studied Clinical Decision Support System Over 60 independent studies Have shown that UpToDate has a direct impact on quality of care and clinical outcomes such as a reduction of complications, mortality, and costs. We invite you to review the study data yourself:

6 UpToDate Changes Clinical Decisions 37% Researchers at Singapore s National University Hospital report that bedside use of UpToDate led to changes in patient care decisions Phua J, See KC, Khalizah HJ, et al. Utility of the electronic information resource UpToDate for clinical decision-making at bedside rounds. Singapore Med J 2012; 53:116.

7 Use of UpToDate Associated with Improved Outcomes Solucient 1 studied the impact of UpToDate on length of stay, complications, and patient safety 2 Significantly shortens length of stay Significantly lowers adverse outcome rates Significantly lowers complication rates 1. Solucient maintains the nation's largest healthcare database, comprised of more than 26 million discharges per year from 2,900 hospitals. 2. Bonis PA. Association of a clinical knowledge support system with improved patient safety, reduced complications and shorter length of stay among Medicare beneficiaries in acute care hospitals in the US. Int J Med Inform 2008; 77:745.

8 Researchers at Harvard University Find UpToDate Associated with Improved Outcomes Use of UpToDate Associated with... Improved Quality Every condition on Hospital Quality Alliance Metrics Shorter Lengths of Stay days over 1 year Lower Mortality Rates lives over 3 years Isaac T, Zheng J, Jha A. Use of UpToDate and outcomes in US hospitals. J Hosp Med 2012; 7:85.

9 Economic Impact of UpToDate at Salford Royal NHS Foundation Trust Forrester Research found Salford Royal NHS Foundation Trust (SRFT) recovered the costs of UpToDate in 90 days Benefits Included: Staff productivity Diagnostic test efficiencies Improvements in the quality of care ROI = 90 days Source: November 2011, Forrester Research: The Total Economic Impact Of UpToDate s Clinical Decision Support System For Healthcare Institutions: A Case Study Of Salford Royal NHS Foundation Trust in the UK

10 hospitals and clinics in 174 countries use UpToDate UpToDate around the world UpToDate has national contracts with the governments of Norway (2010), Iran (2011), Spain (2013), Saudi Arabia (2013), Oman (2014), and Jordan (2015) to standardize care based on UpToDate content. In other countries, such as the USA, The Netherlands, Switzerland, or Luxembourg, UpToDate is used in all hospitals.

11 Impact in Spain Estimated Clinical Decisions Changed (proj.) Estimated impact of UpToDate information on the Spanish Health System over the last few years Based on extrapolations from internally-collected data from individual subscribers feedback, experience in over hospitals in 174 countries, as well independent international studies

12 Integrating Clinical Decision Support in the Workflow In the Right Context & Format The Right Guidance At the Right Time The Right Decision

13 The Most Valuable HIT Initiative for Patient Care Which IT initiative produces the greatest benefit to the quality and safety of patient care? UpToDate CDS 54,31 EHR system erx 37,39 36,28 Alerts/reminders Patient ed CPOE 32,68 31,35 33,41 Order sets 26, Proportion ranking each initiative a 9 or 10 on a 10 point scale (n = 17,127) Source: UpToDate individual subscriber survey 2012

14 One Roadmap for the Future The European EMR Adoption Model in 7 Stages to Highest Quality in Patient Care Paperless patient record environment for highest quality of care, data continuity & full HIE Full electronic clinical decision support, and highest medication safety Completely electronic diagnostic image management Electronic order entry with decision support and result reporting Clinical ordering and documentation especially nursing care A patient-centered electronic data repository Electronic diagnostic and pharmacy department information

15 Increased Clinician Satisfaction with the EHR Users said that having UpToDate embedded in their EHR Is important to patient care % Enhances satisfaction with their EHR % Encourages utilization of their EHR % Source: July 2011 Clinicians Survey N = 1228

16 Increased Clinician Satisfaction with the EHR Users said that having UpToDate embedded in their EHR Is important to patient care % Enhances satisfaction with their EHR % Encourages utilization of their EHR % Source: July 2015 Clinicians Survey N = 2526

17 Conclusion Based on our experience throughout Europe and in over hospitals around the world, we are convinced that full use of REAL Integrated Clinical Decision Support would help: Improve quality of care Improve medical knowledge Reduce complications Reduce errors This will help save more lives This will help save more money.

18 THANK YOU! Greg Adams Vice President Wolters Kluwer UpToDate