Biosurveillance, Quality Reporting at Point of Care

At HIMSS11 several companies are debuting bio-surveillance products to allow clinicians to react at point of care to provide interventions to the patient. One product, from the Falls Church, Va.-based CSC is called CareVeillance that is currently in production at partner institution the University of Kansas Hospital (KUHA). Another is Waukesha, Wis.-based GE Healthcare’s actionable health alerts that allow physicians to monitor foodborne illnesses.

CareVeillance
David Classen, partner and chief medical officer of CSC’s Healthcare Group notes that the CareVeillance product grew out of the challenges resulting from old-school data mining processes—or as he calls them “healthcare archeology”—where an army of nurses did manual data pulling. This process was further hindered an organization’s EMR that couldn’t flow all the data in from disparate systems like laboratory, surgical, administration.
“We were becoming increasingly aware that [organizations were] putting business intelligence systems in, but not leveraging data at bedside,” Classen says.

The CareVeillance project started two years ago with KUHA, which Classen says had a history of innovation and great performance on quality measures. CSC designed the user interface with KUHA input by using the IRIS method, a total visual process that allows design-on-the-fly capability. Once the design is created in front of the user, Classen describes, the system generates the requirements automatically, which allows designers to show users in real-time what they want. This process limited the amount of tweaks that needed to be made after the initial design.

The CareVeillance product monitors eight different conditions including acute myocardial infarction, thrombo embolism, sepsis, pneumonia, abnormal glucose, which allows clinicians to intervene at the point of care and also synthesizes the data for quality reporting. Instead of over-burdening clinicians with alerts, Classen says that a care referee or care coordinator creates the link between the information the system creates and the front-line clinicians. These care coordinators are often nurses with care management backgrounds. (For instance, KUHA has a sepsis coordinator.)

For the future Classen hopes to be able to use the system to predict the patient’s risk of re-admittance, which he notes will be especially be helpful as the industry moves toward accountable care organizations. He also hopes to create line bundles, like the bundles that the Institute for Healthcare Improvement has, which are common interventions that clinicians can take for certain disease states. He also notes that this fall CSC will release a study that analyzes the before and after CareVeillance cost impacts at KUHA.

GE, CDC Partnership
GE healthcare, with partner the Centers for Disease Control and Prevention (CDC), has finished a full year of feasibility studies for its biosurveillance tool. The project’s first use case explores foodborne illness, which CDC estimates the U.S. to have 48 million cases yearly. The Alliance of Chicago Community Health Services, with participation from the Chicago Department of Public Health, has collaborated to develop and implement the pilot program since 2009. Fred Rachman, M.D., CEO of the Alliance of Chicago Community Health Services, says that foodborne illness was chosen as the symptoms can be easily mistaken for other illnesses, and only with a tool like this can clinicians see other occurrences in the patient population to make appropriate care decisions. GE hopes to expand this tool for adverse event reporting.