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Anatomy of a Pilot at Health 2.0 Provider Symposium - Optima


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Optima - Health 2.0 10th Annual Fall Conference

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Anatomy of a Pilot at Health 2.0 Provider Symposium - Optima

  1. 1. PRECISION piloting healthcare coordination in hypertension © optima integrated health
  2. 2. © optima integrated health2 Operations: Loss Due to Avoidable ED Visits and Hospitalizations For every 1000 patients with HTN, every year: Patients visiting ED for HTN-related symptoms and complications (50%) 500 Cost of ED Services (500 x $1,233) $600,000 Cost of Hospitalization (35% of ED visits @ $20,000/admission) $3,500,000 Cost of Rehabilitation/Ambulatory Services (50% of Hospitalizations @ $12,000/patient) $900,000 Cost of In-Patient Surgical Procedures (10% of Hospitalizations @ $70,000/patient) $1,050,000 Overall Cost of Care for the 500 Patients visiting the ED $6,050,000
  3. 3. optima4BP Demo: The Naked Analytic Intelligence
  4. 4. Medication Optimization Decision Support Workflow © optima integrated health4 Assessment Is BP lowering On Track? Do Nothing Ongoing Surveillance ACTION Generate Treatment Optimization Recommendation SURVEILLANCE Collection and Organization of Data Updates?  YES  NO ASSESSMENT Does treatment require optimization? YES NO YES NO ACTION sent to EHR In-Basket Risk Stratified Patient Roster
  5. 5. © optima integrated health5 EHR In-Basket Decision Support Recommendation Treatment Action: Consider adding a drug belonging to the class ACE Inhibitors (10.00 mg/day of lisinopril - gradually increase to 20.00 mg/day after 2 week(s) in the absence of side effects). Combination pills containing amlodipine & benazepril (ex. Lotrel) are available, for increased convenience and adherence. The current amlodipine dose is 25% of the maximum recommended therapy; consider increasing the dose. Consider discontinuing potassium supplements, if taken. Closely monitor serum potassium and creatinine. ACE Inhibitors represent the first line of anti-hypertensive treatment for a patient with chronic kidney disease. Implementing this suggestion is estimated to improve the overall treatment efficacy by 140%. Patient Case and Treatment Modeling Qardio® BP Arm Monitor Collected Data (38 data points over past 28 days): Measurement Min Max Average ± STD % of time at Target BP Systolic BP 147 181 162±21 9% Diastolic BP 49 104 90±17 38% Heart Rate 72 176 94±13 N/A
  6. 6. Outcomes 6 © optima integrated health  Interoperability: EHR - data “dump”  Care Coordination: adoption based on availability of RN support  Clinical Efficacy:  Implementation of optima4BP recommendation:  in BP  Inertia:  in BP/side-effects severity/symptoms
  7. 7. Lessons Learned 7 © optima integrated health  Interoperability: Chasing the Data - built own query and automation tools  Care Coordination: Risk Stratified Recommendations  Clinical Efficacy: Trusting the Analytic Intelligence
  8. 8. Next Steps 8 © optima integrated health  Ready to pilot/deploy optima4BP to other sites  Pipeline Development: optima4heart