scholarly journals Value Driven Outcomes (VDO): a pragmatic, modular, and extensible software framework for understanding and improving health care costs and outcomes

2014 ◽  
Vol 22 (1) ◽  
pp. 223-235 ◽  
Author(s):  
Kensaku Kawamoto ◽  
Cary J Martin ◽  
Kip Williams ◽  
Ming-Chieh Tu ◽  
Charlton G Park ◽  
...  
Keyword(s):  
Clinical Care ◽  
High Volume ◽  
Software Framework ◽  
Labor Costs ◽  
University Of Utah ◽  
The Hours ◽  
Adoption Satisfaction ◽  
Project Objectives ◽  
Extensible Software ◽  
Care Costs

Abstract Objective To develop expeditiously a pragmatic, modular, and extensible software framework for understanding and improving healthcare value (costs relative to outcomes). Materials and methods In 2012, a multidisciplinary team was assembled by the leadership of the University of Utah Health Sciences Center and charged with rapidly developing a pragmatic and actionable analytics framework for understanding and enhancing healthcare value. Based on an analysis of relevant prior work, a value analytics framework known as Value Driven Outcomes (VDO) was developed using an agile methodology. Evaluation consisted of measurement against project objectives, including implementation timeliness, system performance, completeness, accuracy, extensibility, adoption, satisfaction, and the ability to support value improvement. Results A modular, extensible framework was developed to allocate clinical care costs to individual patient encounters. For example, labor costs in a hospital unit are allocated to patients based on the hours they spent in the unit; actual medication acquisition costs are allocated to patients based on utilization; and radiology costs are allocated based on the minutes required for study performance. Relevant process and outcome measures are also available. A visualization layer facilitates the identification of value improvement opportunities, such as high-volume, high-cost case types with high variability in costs across providers. Initial implementation was completed within 6 months, and all project objectives were fulfilled. The framework has been improved iteratively and is now a foundational tool for delivering high-value care. Conclusions The framework described can be expeditiously implemented to provide a pragmatic, modular, and extensible approach to understanding and improving healthcare value.

Combining the Love of Art, Science, Business and Medicine to Innovate and Enhance Patient Health. Highlights from the 7th Annual Leaders in Medicine Symposium of the Cummings School of Medicine, Calgary, AB

2018 ◽  
pp. E51-E54
Author(s):  
Jennifer Beatty ◽  
Michael Peplowski ◽  
Noreen Singh ◽  
Craig Beers ◽  
Evan M Beck ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Clinical Care ◽  
Clinical Problem ◽  
Faculty Members ◽  
Guest Speaker ◽  
School Of Medicine ◽  
University Of Calgary ◽  
Patient Health ◽  
The University ◽  
Care Costs

The Leader in Medicine (LIM) Program of the Cumming School of Medicine, University of Calgary, hosted its 7th Annual LIM Research Symposium on October 30, 2015 and participation grew once again, with a total of six oral and 99 posters presentations! Over 45 of our Faculty members also participated in the symposium. This year’s LIM Symposium theme was “Innovations in Medicine” and the invited guest speaker was our own Dr. Breanne Everett (MD/MBA). She completed her residency in plastic surgery at University of Calgary and holds both a medical degree and an MBA from the University of Calgary. In her inspiring talk, entitled “Marrying Business and Medicine: Toe-ing a Fine Line”, she described how she dealt with a clinical problem (diabetic foot ulcers), came up with an innovation that optimized patient care, started her own company and delivered her product to market to enhance the health of the community. She clearly illustrated how to complete the full circle, from identifying a clinical problem to developing and providing a solution that both enhances clinical care and patient health as well as reduces health care costs and hospital admissions. The research symposium was an outstanding success and the abstracts are included in companion article in CIM.

scholarly journals Optimizing Test Utilization in the Clinical Microbiology Laboratory: Tools and Opportunities

2017 ◽  
Vol 55 (12) ◽  
pp. 3321-3323 ◽  
Author(s):  
Bobbi S. Pritt
Keyword(s):  
Health Care ◽  
Laboratory Test ◽  
Clinical Care ◽  
Clinical Decision ◽  
Clinical Microbiology Laboratory ◽  
Labor Costs ◽  
Support Tools ◽  
Widespread Availability ◽  
Limited Health ◽  
Clinical Decision Support Tools

ABSTRACTOptimal laboratory test utilization is important for providing high-quality clinical care and efficiently using limited health care resources. While microbiologists have long been advocates for appropriate laboratory test utilization, the widespread availability of electronic medical records capable of supporting clinician order entry and of clinical decision support tools (CDSTs) has provided expanded opportunities for implementing effective, automated test stewardship protocols. D. Nikolic et al. (J. Clin. Microbiol. 55:3350–3354, 2017,https://doi.org/10.1128/JCM.01052-17) describe the results of implementing a CDST at their institution to curtail stool microbiology testing for patients hospitalized for more than 3 days. Their intervention significantly decreased unnecessary test orders and saved their laboratory over $8,000 in reagent and labor costs during an 11-month postintervention period. That report provides an excellent example of how clinical microbiologists can use electronic tools to optimize laboratory test utilization in their health care system.

scholarly journals Impact of COVID-19 on patient–doctor interaction in a complex radiation therapy facility

2020 ◽  
Author(s):  
Isacco Desideri ◽  
G. Francolini ◽  
L. P. Ciccone ◽  
G. Stocchi ◽  
V. Salvestrini ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Radiation Treatment ◽  
Control Strategies ◽  
Clinical Care ◽  
Healthcare Providers ◽  
High Volume ◽  
Control Measures ◽  
Common Disease ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

Abstract Purpose In the last months, Italy faced a COVID-19 emergency and implemented preventive measures in order to protect patients and healthcare providers from a disease outbreak. The pandemic control strategies impacted patient experience directly. Questionnaires evaluating patients reported measures (PREMs) may assess critical issues and represent a helpful tool to measure the patient perception of healthcare service. Our aim was to prospectively assess patient satisfaction about doctor–patient interaction in a high-volume radiation therapy and oncology center during the COVID-19 pandemic. Methods Cancer patients receiving either systemic and/or radiation treatment underwent a survey. Two validated questionnaires (EORTC QLQ-C30, FACIT-TS-G version 1) and 14 specific questions evaluating patients’ perception of COVID-19 measures were administered. Results One hundred twenty-five patients admitted to our department from 1–30 April 2020 completed the questionnaires. The majority (66.4%) of patients were women and the most common disease was breast cancer (40%). The average Global Health Status (GHS) of EORTC QLQ-C30 was 61.67. Emotional functioning, social, and cognitive domains obtained scores of 75.48, 80.13, and 84.67, respectively. FACIT-TS-G results revealed 120 patients rated the treatments effective and 108 patients thought the side effects were the same as expected or better. Most (89.6%) rated their treatment good, very good, or excellent. Concerning COVID-19-related questions, patients reported overall very good level of information. Conclusions Despite the introduction of strict COVID-19 control measures, there was a high level of cancer outpatient satisfaction. The satisfaction levels may influence compliance, continuity of treatments, and patient–doctor communication, impacting the quality of clinical care in the next phases of the pandemic.

scholarly journals Assessing the Safety of Custom Web-Based Clinical Decision Support Systems in Electronic Health Records: A Case Study

2019 ◽  
Vol 10 (02) ◽  
pp. 237-246 ◽  
Author(s):  
Jeritt Thayer ◽  
Jeffrey Miller ◽  
Alexander Fiks ◽  
Linda Tague ◽  
Robert Grundmeier
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Care ◽  
Clinical Decision Support Systems ◽  
High Volume ◽  
Clinical Decision ◽  
Clinical Workflow ◽  
System Integrity ◽  
Electronic Health

Background With the widespread adoption of vendor-supplied electronic health record (EHR) systems, clinical decision support (CDS) customization efforts beyond those anticipated by the vendor may require the use of technologies external to the EHR such as web services. Pursuing such customizations, however, is not without risk. Validating the expected behavior of a customized CDS system in the high-volume, complex environment of the live EHR is a challenging problem. Objective This article identifies technology failures that impacted clinical care related to web service-based advanced custom CDS systems embedded in the complex sociotechnical context of a production EHR. Methods In an academic health system’s primary care network, we performed an inventory of incidents between January 1, 2008 and December 31, 2016 related to a customized CDS system and performed a targeted review of changes in the CDS source code. Additional feedback on the root cause of individual incidents was obtained through interviews with members of the CDS project teams. Results We identified five CDS malfunctions that impaired clinical workflow. The mechanisms for these failures are mapped to four characteristics of well-behaved applications: (1) system integrity; (2) data integrity; (3) reliability; and (4) scalability. Over the 9-year period, two malfunctions of the customized CDS significantly impaired clinical workflow for a total of 5 hours. Lesser impacts—loss of individual features with straightforward workarounds—arose from three malfunctions, which affected users on 53 days. Discussion Advanced customization of EHRs for the purpose of CDS can present significant risks to clinical workflow. Conclusion This case study highlights that advanced customization of CDS within a commercial EHR may support care for complex patient populations, but ongoing monitoring and support is required to ensure its safe use.

Capsule Endoscopy (CE) Re-Assessment in a High Volume Center (HVC) Identifies Significant Misinterpretations of the Community Gastroenterologists (CG) That May Impact Clinical Care

2008 ◽  
Vol 67 (5) ◽  
pp. AB91
Author(s):  
Patricio Ibanez ◽  
Peter Simpson ◽  
Gil Y. Melmed ◽  
Shahab Mehdizadeh ◽  
Mamatha Sadda ◽  
...  
Keyword(s):  
Capsule Endoscopy ◽  
Clinical Care ◽  
High Volume ◽  
High Volume Center

scholarly journals Predictors of fatigue in rheumatoid arthritis

Rheumatology ◽  
2019 ◽  
Vol 58 (Supplement_5) ◽  
pp. v29-v34 ◽  
Author(s):  
Katie L Druce ◽  
Neil Basu
Keyword(s):  
Rheumatoid Arthritis ◽  
Mental Health ◽  
Primary Care ◽  
Poor Prognosis ◽  
Clinical Care ◽  
Inflammatory Biomarkers ◽  
Future Studies ◽  
Care Costs ◽  
Existing Data

Abstract People with RA commonly experience fatigue. Fatigue is a key contributor to increased clinical care costs, primary care consultations and employment loss. Despite this, our understanding of the prognostic of factors of poor fatigue outcomes is lacking and fatigue is poorly managed. Examining longitudinal predictors of fatigue can identify both individuals ‘at risk’ of poor prognosis, and candidate mechanisms that are worthy of greater inspection. This review discusses the factors most commonly investigated as being implicated in the prognosis of RA fatigue. The available data appears to implicate generic factors such as pain, mental health, disability and sleep as consistent predictors of fatigue outcome, while the role of disease activity and inflammation seems less clear. However, the existing data are not without methodological limitations and there have been no specific studies primarily designed to investigate the inflammatory biomarkers of fatigue. Future studies are required to more comprehensively and robustly determine the mechanisms of fatigue.

scholarly journals REiNS: Imaging Evaluation of Plexiform Neurofibromas in Neurofibromatosis Type 1: A Survey-Based Assessment

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012437
Author(s):  
S. Ahlawat ◽  
K. Ina Ly ◽  
LM Fayad ◽  
MJ. Fisher ◽  
A Lessing ◽  
...  
Keyword(s):  
Neurofibromatosis Type 1 ◽  
Clinical Care ◽  
Demographic Data ◽  
High Volume ◽  
Neurofibromatosis Type ◽  
Whole Body ◽  
Imaging Evaluation ◽  
Plexiform Neurofibromas ◽  
Asymptomatic Children

Objective:Assess imaging utilization practices across clinical specialists in neurofibromatosis type 1 (NF1) for the evaluation of symptomatic and asymptomatic children and adults with or without plexiform neurofibromas (PNs).Methods:An IRB-exempt survey was administered to medical practitioners caring for individuals with NF1 at the Response Evaluation in Neurofibromatosis and Schwannomatosis (REiNS) meeting, September 2019. The survey included questions on respondent demographic data (9 questions), type of imaging obtained for asymptomatic (4 questions) and symptomatic (4 questions) people with and without PNs, and utilization of diffusion-weighted imaging (DWI, 2 questions).Results:30 practitioners participated in the survey. Most were academic neuro-oncologists at high-volume (>10 patients/week) NF1 centers. 26/30 respondents had access to whole-body (WB)-MRI. The most common approach to an asymptomatic person without PNs was no imaging (adults: 57% (17/30); children: 50% (15/30)), followed by a screening WB-MRI (adults: 20% (6/30); children: 26.7% (8/30)). The most common approach to a person with symptoms or known PNs was regional MRI (adults: 90% (27/30); children: 93% (28/30)), followed by WBMRI (adults: 20% (6/30); children: 36.7% (11/30)). WB-MRI was most often obtained to evaluate a symptomatic child with PNs (37% (11/30)).Conclusions:More than 90% of practitioners indicated they would obtain a regional MRI in a symptomatic patient without known/visible PN. Otherwise, there was little consensus on imaging practices. Given the high prevalence of PNs and risk of malignant conversion in this patient population, there is a need to define imaging-based guidelines for optimal clinical care and the design of future clinical trials.

Digitization of Drill Bit Inspections; User-Centered Design Methods to Automate Robotic Inspections

2021 ◽  
Author(s):  
Marrie Ma ◽  
Jeremy Murphy ◽  
Nader Salman ◽  
Zhen Li ◽  
Crispin Chatar ◽  
...  
Keyword(s):  
Product Quality ◽  
Flexible Manufacturing ◽  
Oil And Gas ◽  
Polycrystalline Diamond ◽  
High Volume ◽  
End Users ◽  
Industrial Robots ◽  
Inspection System ◽  
User Centered Design ◽  
Labor Costs

Abstract One unique facet of digital technology is the merging of separate technologies for new workflows and products. Like other industries, energy is also doing this. This project will automate the bit inspection process and this system will reduce labor costs, increase product quality, and improve bit performance. The innovation center is working on various aspects of the project, which aims to join automation technologies with robotic capabilities. Industrial robots are used extensively in traditional high-volume manufacturing applications. The high-mix, low-volume nature of oil and gas manufacturing operations has impeded deployment of automation solutions. Recent advances in sensors, computers, and machine learning now enable integrating robotics and automation technologies into these flexible manufacturing workflows. Driven by digital transformation, an automated inspection system for polycrystalline diamond compact (PDC) drill bits has been developed. The system uses high-resolution robotic 3D scanning, 2D imaging, and artificial intelligence to improve inspection efficiency and product quality. In our user-experience- (UX-) focused approach, we streamlined the user interface (UI) research methods to develop the robotic inspection UI and successfully tested the design with end users. This paper introduces the inspection system and improved workflows for the PDC bits, illustrates the innovative UX/UI development process, and targeted evaluation with the end users, which is crucial before deploying the system in production. We also concluded with some recommended improvements to guide future work.

Sign in / Sign up

Export Citation Format

Share Document