HOW TO LEVERAGE DATA TO MANAGE AND SAVE LIVES? - A WORLDWIDE AWARD WINNING SOLUTION José Pedro Almeida @jpedroalmeida_

• 5300 employees / 60 Dep. • 336 million euros/Year • 1100 Beds (60 ICU beds) • Opened since 1959

• Ranked #1 Since 2008 March 18th, 2013

José Pedro Almeida 913709072 [email protected]

São João Hospital Center – Porto, Portugal

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How Information Systems impact Management in Healthcare… Production Pharmacy

EMR

• Information is spread out in dozens of heterogeneous systems Laboratory

•

•

Quality

Millions of records are stored but there is no solution to analyze & correlate them in a fast manner

Supply Chain

No holistic view of how treatments & costs are related •

Lack of Data Quality Financial HR

Production

Pharmacy

EMR

Supply Chain

Laboratory

EDW / OLAP

Quality

Financial HR

What have we done differently?

BigData Patient Centric Model - Preparing the future Episodes Clinical Result

Diagnosis

Medical Procedures

Infections

Healthcare Providers

Surgical Procedures

Patient

Geography and Demograph y

Analysis & Exams

Medicines Nursing Procedures

& Cost of Treatment

Material

PATIENT PATHWAY

Who enters the hospital? What is done to the patient? How it’s done? What’s the treatment result? How much did he cost? …

Some Figures

300 million Records/ day

1.5 million Patients

100.000 questions answered/ year

500 analysis fields

560 Billion Pre Calculated Answers

1 billion dollars in medicines and material

650 Indicators

(….)

Working 24h/7h since January 2012

Powerfull Clinical Studies Capability

What drugs were consumed in 2015, related with the General Surgery inpatient, by patients between 35 and 65 years old, female gender, from outside the district of OPorto, with hipertension having a “Gastric Bypass” procedure? Who performed the operation? Did this population caught a nosocomial infection?

Strategic Management

Operational Management

Operation Theatre Live Perfomance

Business Gains – Phase I Indicator

Before HVITAL

After HVITAL

Decisions sustained on validated numbers

30%

95%

Time to answer complex question

2-3 weeks

30 seconds

Avg. Number of Management Studies (per year)

6.000

100.000

Business Processes with permanent Monitoring & Control

5

80

Number of refreshed indicators

50

650

Avg. Time (Business Process out of Control -> Detection)

5 days – 2 months

1h – 2days

Number of Workers following the Hospital KPI’S

5-10

500-1000

We had a Bunch of KPIs - But do they really transform an Organization?

You need to help those who are on the field…

Clinical challenges – Top Priorities

Antibiotic Stewardship

Infection Control

Clinical Deterioration Risk

Infections – How HVITAL helps in Infection Control? What kind of infections most concerns us?

How is it spreading among our patients?

What is an infection?

What is our infection rate?

How do we control the spread of infection?

Where is my Hospital Infection? How is it spreading? Infections – São João Spacial Mapping

Methicillin-resistant Staphylococcus aureus (2014)

Where is my Hospital Infection? How is it spreading? Infections – São João Spacial Mapping

Vascular Surgery Methicillin-resistant Staphylococcus aureus (2014)

How do we control the spread of infection?

EMR Real Time Alerts coming from DSS

Antibiotic Stewardship – A Worldwide problem

Antibiotic Stewardship – How HVITAL helps our clinicians…

Clinical deterioration – An Avoidable Phenomenon?

As many as 80 percent of hospitalized patients have

physiological parameters outside normal ranges in the 24 hours before intensive care unit (ICU) admission, and up to three-fourths of such patients have

at least one potentially life-threatening factor in the 8 hours before ICU admission. Tarassenko L, Hann A, Young D. Integrated monitoring and analysis for early warning of patient deterioration. Br J Anaesth. 2006;97:64-68.

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Clinical deterioration example Thursday, 16h30: admission to the ED, dx “respiratory infection” Friday: 1st evaluation by inpatient medical team • History HTN, …. BP 160/100mmHg, HR 86bpm, RR 20cpm • Blood Analysis where requested in the morning 11h30 – blood collected 12h30 – blood enters lab for analysis 14h30 – analysis result released

Fri: Hg 9g/dl (4g/dl), WBC 30x109/l (3x), CRP 364mg/l (4x), creatinine 1,7mg/dl (0,6mg/dl) Saturday, 3rd inpatient day 19h00 – patient found in shock 19h45 – CARDIORESPIRATORY ARREST

Patient dies

Sat, 8h: BP 110/60mmHg, HR 100/min, RR 22/min Sat, 15h30: BP 94/50mmHg, HR 115/min, RR 24/min, Temp 38,5ºC

Compile in seconds big amounts of data, that is impossible for a human, to gather and correlate in a timely maner

Patients admited to ICU 3 days earlier (700 euros/day * 3 days * 900 entrances) Potencial Savings: 1.5 Milion euros

Who is at Risk? Anticipate 30% of ICU admissions at least 7 days before the event occurs

Monitors in real-time, Ranks patients by risk, and Alerts health professionals of patient critical events, tendencies, and problematic relations between sparse facts.

How do you convince doctors to use HVITAL?

HVITAL was warning about potassium level decreasing rapidly 2 days before @ Insert Twitter Handle Here

A simple text message that might save your live….

International Awards & Recognitions

1st prize – MSHUG Innovation Award, HIMSS 2014 Florida (E.U.A), February 2014

1st prize – Big Data & Analytics Solution of the Year, London (UK), March 2014

Where are we heading?

We have a lot to learn!

Visit São João Hospital Center & Porto

THANK YOU! José Pedro Almeida Head of Business & Clinical Intelligence, Centro Hospitalar de São João (CHSJ) [email protected]

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