medCPU Advisor VTE Prophylaxis Reports Overview

VTE PROPHYLAXIS REPORTS OVERVIEW

At the time of implementation of any of the medCPU Advisor™ modules, key stakeholders at the Organization and medCPU experts decide what key clinical and compliance measures to track and report on. These metrics are continually monitored by medCPU and user behavior is tracked and analyzed in real time.

This aspect of medCPU expertise is particularly important for reports that are delivered daily to key stakeholders at the Organization because the data enables rapid follow-up, critical adjustments in clinical and compliance behavior, attention to potential problems close to the event’s occurrence, and positive feedback.

The medCPU Advisor™ is capable of prompting for and gathering a vast range of data, which is then generated via Performance Reports, Outstanding Reports, Quarterly Performance Reports, and Customized Data Reports.

Metrics can be added to or deleted depending on the Organization’s needs, including aligning metrics to report on behavior specific to CMS guidelines.

OUTSTANDING DAILY REPORTS Health Systems that have the medCPU Advisor™ VTE Prophylaxis module implemented receive daily outstanding reports that help to be proactive regarding clinicians’ performance and to follow-up with clinicians inperson: the quality nurse uses these reports to determine why VTE Prophylaxis had not been ordered by clinicians when the medCPU Advisor had alerted them that the patient was a VTE Prophylaxis candidate and follows up to correct identified deficiencies to best practice guidelines.

Sample report of outstanding patients with no VTE Prophylaxis by 08:00 of the 2nd day Reporting Time Period: 04/13/2016 08:00 Patients that did not receive VTE prophylaxis by 08:00 today: Patient’s Name

MRN

Deficiency

Unit

Room

Harold Robinson

4830183

VTE Prophylaxis medication early Day 2

3-E

0360-I

Wanda Williamson

4875698

VTE Prophylaxis early Day 2

3-E

0369-P

Daniel Bond

4492785

VTE Prophylaxis early Day 2

5-E

0559-P

Ambulating patients without documentation of a reason not to treat with VTE prophylaxis: Amy Rogers

Patient’s Name

4674784

VTE Prophylaxis early Day 2

3-E

0365-I

MRN

Deficiency

Unit

Room

Frank White

4341987

Physician confirmation needed VTE Prophylaxis not required due to patient ambulation

CCU

CCU-G

Amanda Gorinson

4040146

Physician confirmation needed VTE Prophylaxis not required due to patient ambulation

7-E

0753-P

Tina Sanchez

4724682

Physician confirmation needed VTE Prophylaxis not required due to patient ambulation

7-E

0755-P

Eric Knapper

medCPU, Inc. • confirmation www.medcpu.com Physician needed 4891062 VTE Prophylaxis not required due to patient ambulation

6-E

0665-P

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medCPU Advisor™

medCPU Advisor™ | VTE REPORTS OVERVIEW OUTSTANDING DAILY REPORTS Daily performance reports get compiled into aggregated quarterly reports with the goal of providing quantifiable data including user behavior and workflow to help improve clinical responsiveness to prompts, and adjust prompts based on trends that may show vulnerabilities. Quarterly medCPU Advisor™ VTE Prophylaxis module reports Include: patient population with inclusion and exclusion criteria, performance prior to medCPU prompts, performance following medCPU prompts, performance improvement percentage, prompting and performance timeline and performance trend over months.

The line graph below shows the performance measures over an 8-month period, from September 2015 to April 2016. Performance significantly improved from the point of patient admission to the time when the first medCPU Advisor prompt was fired 6 hours post-admission. There’s was further improvement in the early part of day 2 when a 2nd prompt was fired and the outstanding report was generated. Performance continued to increase in the later part of day 2 after a 3rd prompt had alerted. The medCPU Advisor continued alerting on day 3, despite the fact that this fell outside of the CMS 48-hour compliance window. This ensures that patients receive the best care possible.

Overall, performance improved up to 99% with the medCPU Advisor implemented.

The medCPU team of experts works with the organization stakeholders to constantly improve performance and reduce non-compliance to zero.

100% Sep-Oct’15 Nov-Dec’15 Jan-Feb’16 Mar-Apr’16

90% 87%

99% 98% 98% 97%

Sep’15-Oct’15

Outstanding Report

Nov’15-Dec’15

80% 77% 75%

outside 48-hour compliance window

Jan’16-Feb’16

Mar’16-Apr’16

70% 67%

60% w/o medCPU Prompts DAY 1 ADMISSION

w/medCPU prompts & reports DAY 1 6 HRS POST-ADMISSION prompt #1

DAY 2 06:00 OUTSTANDING REPORT

DAY 2 13:00 prompt #3

DAY 3 prompt #4

08:00 prompt #2

Includes: Inpatients with VTE prophylaxis indication Exclusion criteria: Outpatients, Hospital discharge earlier then 48h, Patient expired during current admission, Comfort measures only, Involvement in a clinical trial, Patient Refusal to VTE prophylaxis, Pregnancy or other obstetrics diagnosis

medCPU, Inc. • www.medcpu.com

E PROPHYLAXIS MODULE REPORTS OVERVIEW COMPLIANCE PERFORMANCE RATE The bar graph shows the dramatic improvement of prompt compliance. The data shows the number of non-compliance instances decreased over time from 140 in July 2014, to 5 in March-April 2016. The biggest improvement was seen from July 2014 to September-October 2014, when customized changes were introduced based on workflow insights. The graph shows a continuous trend of improving prompt compliance by clinicians.

140

120

mp

-co

non

80

ren

es t

anc

60

d

Instances

nst

ce i

lian

100

Adjustments made to medCPU Advisor prompts and workflow integration

40

20

0 Jul 2014 Go-Live

Sep-Oct 2014

Sep-Oct 2015

Mar-Apr 2016

Time

The medCPU Advisor VTE Prophylaxis module has been a successful CDS solution by complying with 3 critical requirements: 1. Must be extremely accurate – the accuracy level of the alerts must be at its highest, otherwise the tool will lose its credibility in the eyes of the clinical end users and will result in poor compliance.

2. Must not add workload on providers – the tool must align with the clinicians’ workflow and seamlessly integrate into their documentation habits. Any solution which requires additional documentation or a change in workflow habits will cause frustration among the physicians and clinical staff and will be detrimental.

3. Must add significant value to providers – CDS must be a tool the clinicians welcome openhanded and want to use as part of their clinical routine. The tool needs to be valued and wanted, and the clinicians cannot be forced to use it.

medCPU, Inc. • www.medcpu.com

VTE PROPHYLAXIS REPORTS OVERVIEW

REPORT TYPES

Performance

These daily reports list all measures with the relevant compliance cases (measure was

Reports followed) and non-compliance cases (fallout). Performance Reports are delivered to

specific stakeholders. The information gathered and reported on is an important tool for quality assurance, education, and to facilitate proactive education and improvement actions.

Outstanding

These daily reports help the Organization be proactive regarding clinicians’ performance

Reports and to follow-up with clinicians in-person. Based on the defined, customized metrics, the

recommendations provided through these reports assist in correcting deficiencies in the daily basis, that are identified by the medCPU Advisor™. In accordance with the enterprise-wide guidelines, protocols, evidencedbased medicine, the metrics can be further refined and defined by medCPU’s experts.

Quarterly Performance

These reports, based on daily aggregated reports, incorporate the

Reports established metrics in the performance reports and aggregated

over a quarterly period. The report is presented in person with medCPU experts and Organization-wide stakeholders. The presentation reviews and analyzes the clinical performance for a three-month period.

Among the features of these reports is the ability to indicate performance trends that may emerge. The goal of these reports is to provide quantifiable data including user behavior and workflow to help improve clinical responsiveness to prompts, and adjust prompts based on trends that may show vulnerabilities.

Customized Data

These reports are comprised of aggregated data and track performance and

Reports outcomes. The metrics are designed by category, for example, patient population,

hospital behavior, costs, imaging studies, incidence of mortalities, patients released to rehabilitation facilities, etc. Customized Data Reports are provided at a charge and delivered in an Excel sheet via email to designated individuals.

medCPU, inc. • www.medcpu.com

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medCPU Advisor™