The webECG solution is a complete cardiac monitoring system that uses data mining and analytics of EHR data to identify high-risk patients and allows providers to remotely monitor those patients. It integrates ECG acquisition, data storage, and risk scoring directly into the EHR to streamline cardiac care management. The solution aims to reduce costs and improve outcomes for conditions like heart disease through population health analytics and reduced readmissions enabled by remote patient monitoring.

1. Open App Challenge
webECG - a complete
and integrated cardiac
solution
Brock Heinz
Spaulding Clinical
February 2013

2. Solution Overview
… improving the management of high cost chronic disease while also addressing value-based care imperatives
High Level Solution Description:
The webECG solution is a complete and compelling answer to the burning questions
regarding preventing, diagnosing, and treating some of health care's most expensive
chronic diseases.
By leveraging flexible and dynamic analytics, providers can easily identify their highest risk
cardiac patients through a powerful modular data mining risk solution. Then, with a fully
integrated ECG device and platform, cardiac results are automatically saved to the EHR
regardless of whether the patient is in a physician office or in their home.
Problems Addressed:
Reduces cost and improves outcomes for a variety of diseases including, but not limited to
heart disease, hypertension, and pulmonary conditions.
Empowers providers to enhance patient engagement by supporting remote cardiac
monitoring, thus reducing 30-day readmissions for some of the most relevant chronic
conditions.
With customizable data mining capabilities, the solution is a powerful way to address
population health.
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3. Usability and Design - Setup
… how our application will be used by a healthcare provider and patients to improve outcomes
• Sites are configured via browser in cloud-based system
• Unlike traditional ECG solutions, there are no associated capital costs
• Sites receive a hand-held, FDA approved 12 lead ECG device (http://bit.ly/WdVtYk)
• Acquires up to 5 minutes of 12 lead ECG; can optionally collect 30 seconds of
patient / caregiver voice
• Client software is installed at the site – either via launcher buttons in the EHR or in
stand-alone mode
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4. Usability and Design – Data Mining / Analytics
… how our application will be used by a healthcare provider and patients to improve outcomes
• Modular framework allows providers to classify risk levels based on custom
criterion and population health analytics
• By default, system offers the clinically validated Framingham Risk Score
(http://bit.ly/11u4VvR) to estimate the 10-year cardiac risk of patients
• On a timed basis, data mining framework queries EHR for past and future
appointments (24 months in the past, and three months into the future)
• With each distinct patient, a clinical summary is pulled from the EHR, risk levels are
calculated by the algorithm, and the results are stored in a database
• Providers can visualize the risk scores via a web interface
• A color coded system that cross references appointments for a given day
(where EHR Tasks can be created directly from the web interface)
• A macro view that shows entire patient population – also exportable in Excel
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5. Usability and Design – Risk Mining
… how our application will be used by a healthcare provider and patients to improve outcomes

6. Usability and Design – Visualizing Risk
… how our application will be used by a healthcare provider and patients to improve outcomes
* simulated schedules and patients were used to make user interface more realistic

7. Usability and Design – Acting on Risk
… how our application will be used by a healthcare provider and patients to improve outcomes
* simulated schedules and patients were used to make user interface more realistic

8. Usability and Design – Client Software Interaction
… how our application will be used by a healthcare provider and patients to improve outcomes
• Launches natively in EHR: demographics and authentication are
automatic via UAI integration and launcher button framework

9. Usability and Design – Saving an ECG
… how our application will be used by a healthcare provider and patients to improve outcomes
• Both waveform and order / result (with proper 12 lead ECG billing code) is
seamlessly saved to EHR

10. Usability and Design – Over-Reading ECG
… how our application will be used by a healthcare provider and patients to improve outcomes
• Cardiologist measures / interpretations integrated with EHR

11. Usability and Design – Remote Patient Monitoring
… how our application will be used by a healthcare provider and patients to improve outcomes
• Key piece of the puzzle in managing transitions of care to reduce
readmissions
• System can easily be extended to the patient home
• Small size of device is ideal for caregivers and patients
• Client software is delivered via the browser; typically installs with only a
single click after entering an authentication code
• Authentication based on patient preferences – typically email address and
assigned password
• Demographics and patient picture are automatically obtained via UAI
• At upload time, ECG can optionally be saved directly to EHR
* mobile client software, including Windows 8, still in active development
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12. Development Stage / Integration Description
Code is complete and ready for Allscripts testing and approval (Enterprise EHR)
Data Mining / Analytics
• GetSchedule()
• GetPatient()
• GetClinicalSummary()
• GetPatientsByICD9()
• SaveTask()
• GetProviders()
Client Software Interaction – Physician Office and Remote
• GetUserAuthentication()
• GetPatient()
• SearchPatient()
• GetPatientByMRN()
Saving / Over-Reading ECG
• SaveDocumentImage()
• SaveOrderAndResult()
• GetOrderResultSets()
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13. Go to Market Plans
How will solution be brought to market?
• The solution will be offered as a stand-alone product or packaged with the Spaulding
webECG cloud-based electrocardiography system and integrated with Allscripts
EHR
Which Allscripts customer segments will be targeted?
• Clinics, physician offices, and hospitals, both independent and part of larger
integrated delivery networks (IDNs) using Allscripts electronic health records
• Accountable Care Organizations (ACOs) with the objective to improve clinical
outcomes, reduce readmission rates, and improve patient satisfaction
What is the proposed price point for the solution?
• Nominal one-time device fee, $7/ECG (based on volume)
• Access to Risk Calculation and Management: TBD
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14. Video Demonstration
• http://www.youtube.com/watch?v=ix49xDIeqok
• Available in 720p HD
Video Overview
• Introduction – framing of the problem and proposition of a solution
• System Setup – simple, browser-based, sites are configured in seconds
• Data Mining and Analytics – modular framework helps providers manage risk
• Client Software Interaction – tightly integrated with EHR
• Saving ECG – seamlessly append ECG to patient record (waveform and result)
• Over-Read ECG – cardiologist collaboration, updates to EHR are automatic
• Remote Patient Monitoring – simple install, extends care, integrated with EHR
• Summary
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15. Why Select this Solution?
• Complete cardiac system addresses management of high cost chronic
conditions
• Through data mining / analytics, empowers providers to be proactive about
addressing cardiac issues via population health
• Tightly integrated with the EHR, opportunities for error in data collection and
transcription are eliminated
• Collaborative system allows for seamless cardiologist interaction
• With integrated remote patient monitoring, providers can effectively reduce
30-day readmissions
• Addresses most relevant and costly challenges facing Allscripts’ customers
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