Abbott Point of Care Solutions - CADTH.ca - Improving Health... · CADTH Presentation Abbott Point of Care ... Press Ganey Associates. Emergency Department Pulse Report . 2008

CADTH Symposium

Vancouver, BC

April 4, 2011

Abbott Point of Care Solutions

4/5/2011April 4, 2011CADTH Presentation

Introductions


Abbott Point of Care Agenda

• APOC / i-STAT overview

• Benefits of i-STAT

• i-STAT in Canada


Abbott Point of Care• 1,300+ employees globally

• 2010 Sales ~ $273MM

• Manufacturing and Research and Development headquartered in Ottawa, Ontario

• Plant in Ottawa made 35MM Cartridges in 2010

• Extensive R & D Investment

• Headquarters in Princeton, NJ

• Over 6,000 worldwide i-STAT customers

• Installed base of ~ 38,000 i-STAT analyzers


The i-STAT is…SIMPLICITY

•One Piece Analyzer and Cartridge Comprise Test Syst em

•Designed for use by non-lab personnel

•Nurse, RT, Perfusion, Tech


The i-STAT System ProvidesThe Most Comprehensive Menu of Tests

© 2011 Abbott4/5/2011

One Company…

…One Platform


The many steps involved:

• Slow lab results

• Delay diagnosis and treatment

• Allow ample opportunity for variances and handoffs that can lead to patient errors

Traditional Blood Analysis Process Is Complex and Time-Consuming


The i-STAT System Streamlines the Traditional Blood Analysis Process

• Real-time results help speed diagnosis and disposition of patients1

• Helps reduce potential for error by decreasing the amount of time required to collect, process, and report results with fewer handoffs

References: 1. Ryan RJ et al. Ann Emerg Med. 2008 Aug 6. (Epub ahead of print).


IMPACT OF i-STAT

Accelerate Treatment• Expedite Patient Care• Improved Outcomes• Reduced LOS• More Patient Interaction• Decreased Lab TAT• Process Efficiency

CLINICIANSComplement the Lab• Reduced STAT Workload• Full EMR Integration• Standardized Platform• Facilitates Compliance• Facilitates Training

LAB

Summary of Benefits

Patient Focus• Faster Treatment • Improved Outcomes• Reduced LOS• Reduced Blood Volumes• Reduced Transfusions• Process Efficiency• Improved Satisfaction

PATIENTPositive ROI• Expedite Patient Care• Improved Outcomes• Reduced LOS• Increased Satisfaction• Enhanced Lab Value• Process Efficiency

HOSPITAL


Critical Challenges Facing Canadian Emergency Departments

Emergency Departments (EDs) across the nation are facing unprecedented challenges in maintaining a high level of patient care,

improving department efficiencies, and remaining financially viable.

• Cost

• Overcrowding

• Staff Shortages

• Patient Safety / Satisfaction

• Downstream costs


The 80/20 Rule: ED Visits Admit vs. Non Admit

Non Admit

Admit

MI Trauma

Rapid Response

Chest pain

Abdominal pain

Syncope

Shortness of Breath

Vomiting/Diarrhea

GI

Overdose

Cough & Fever

National Hospital Ambulatory Medical Care Survey: 2007 Emergency Department Summary found electronically: www.cdc.gov/nchs/data/nhsr/nhsr026.pdf


The i-STAT System:A Comprehensive ED Platform

The most common tests for the most common ED patien ts

On One Platform


ED Visits Leading Reasons and i-STAT cartridge to help aid in Dx

0 2000 4000 6000 8000 10000

Shortness of Breath

Back Symptoms

Headache

Cough

Fever

Chest Pain

Stomach Pain

ED Visits (in thousands)

Pitts SR, Niska RW. Xu J, et al. National Hospital Ambulatory Medical Care Survey: 2006 Emergency Department Summary. Natl Health Stat Rep. 2008;7:1-40.

CHEM8+, CG4+

Troponin , CK-MB, BNP

CHEM8+, CG4+

BNP


• ED Arrival to ED Departure (ED length of stay)

• Door to result (ie. Troponin)

• ED Bed to result

• Door to disposition decision

• Disposition to leaves ED

• Door to doctor / Physician Interaction Time

Impact on ED Metrics


The i-STAT System Shortens ED Length of Stay and Door-to-Disposition Times

• In patients randomized to point-of-care testing:

� 38.5 minute decrease in emergency department (ED) length of stay

� 45 minute decrease in time-to-disposition

• Demonstrated in a trial comparing the effect of the i-STAT System versus traditional laboratory testing on length of stay in a pediatric ED

Median ED Length of Stay

0

50

100

150

200

250

Central Lab i-STATM

inut

es

The i-STAT ® Solution

204204

165.5

Reference: Hsiao AL et al. Ped Emer Care. 2007;7:457-462.


i-STAT Helps EDs Comply With Guideline-Recommended Turnaround Times (TATs)

0

10

20

30

40

50

60

70

80

90

100

Proportion of assays with TAT <30minutes

Proportion of assays with TAT <60minutes

.

Across all centers, i-STAT Troponin testing met the recommended TAT

guideline of 60 minutes nearly 100% of the time

Across all centers, i-STAT Troponin testing met the recommended TAT

guideline of 60 minutes nearly 100% of the time

DISPO- ACS: Multicenter Randomized Controlled Trial Comparing Central Laboratory and Point-of-Care Cardiac Marker Testing Strategies in the ED

Proportion of assays (%) i-Stat POC

Laboratory

Ryan RJ, et al. Ann Emerg Med. .2008. Aug 6. 10.1016/j

3

87

53

98

Number of results TAT<30 minutes

Number of results TAT<60 minutes

Ryan RJ, et al. Ann Emerg Med. .2008. Aug 6. 10.1016/j


Increased Length of Stay Reduces Patient Satisfaction

• Patient satisfaction decreased as time spent in the emergency department (ED) increased

– Fell sharply after 2 hours– Fell with each additional

hour• Demonstrated in a survey

of 1.5 million patients treated at 1,656 U.S. EDs nationwide between January 1 and December 31, 2007

•

Patient Satisfaction, Time Spent in the ED

65

70

75

80

85

90

95

<1 1–2 2–3 3–4 4–5 5–6 >6

Time (hours)

Pat

ient

sat

isfa

ctio

n (%

)

Reference: Press Ganey Associates. Emergency Department Pulse Report. 2008.

Critical Challenges Facing the ED


Ross Memorial Hospital - Ontario

• NEW TEST HELPS DIAGNOSE HEART ATTACK PATIENTS IN MIN UTES

• March 23, 2010, LINDSAY, Ont. — Every minute counts when treating heart attack victims, so decreasing the time spent waiting for t est results can be life-saving .

• The i-STAT system involves a hand-held device which measures the troponin level in a patient’s blood with lab-quality results. Troponin is a chemical that is released in the blood when a person is experiencing a heart attack. Using conventional lab tests, it can take up to an hour to get results; with the i-STAT system, the physician gets the result in approximately 7-10 minutes.

• The sooner physicians are able to diagnose that a p atient has had a heart attack, the sooner treatment can begin, reducing the severity o f damage to the patient’s heart muscle.

• “With the i-STAT System, we can offer patients faste r testing and, potentially, faster treatment when every minute counts,” stated Dr. Leo n Lerm, Chief of Emergency Medicine at RMH. “This will not only build on our E mergency department’s efficiency, but also enhance our patient care.”

• RMH is the first hospital in the Central East LHIN to trial this Canadian product. Funding for the trial was provided by the CE LHIN through the P ay for Performance initiative .

• 95% of patients tested with i-STAT met the Pay for Performance benchmark capturing $19,500 of P4R funding over the course of 6 days.


Central East LHIN

• “If a hospital would like to submit a P-4-R request for i-STAT, the CE-LHIN has no problem in supporting that venture. We have supported it once (RMH) and would be happy to do so again.”

• ~ ER / ALC Performance Lead

• CE LHIN


Calgary Rural Lab call back reduction study

• Purpose: To invest the financial impact of utilizing i-STAT to reduce the number of call-backs of laboratory staff during off hours for STAT lab testing.

• Background: 9 sites of a rural health authority is spending nearly $900,000 paying for lab personnel to return off hours to support with lab testing. Paid for 4 hours every time they are called in.

• Study began in late 2010. Nursing staff trained to run the i-STAT in order to aid patient treatment while reducing costs.

• So far an observed reduction of 42% in laboratory call backs.

• 42% of $900,000 is $378,000 saved while providing better more expedient care.


What else can i-STAT do…

• Improve patient outcomes

• Decrease length of stay

• Reduce transfusions

• Improve throughput

• Reduce process costs

• Improve staff satisfaction

• Reduced Laboratory call back costs

• Reduction in inter-facility transport costs

• Reduce AMA and LWOS


Scope of Services – Emergency Department

• Consultation and Collaboration in development of a business case for an ED process improvement

– Detailed (step by step) analysis of flow and throughput

– Financial Impact Analysis linked directly to account’s key metrics

– Tracking and evaluation of metric improvement post implementation

– Assistance in application of most current clinical guidelines

– Outside Consultants on contract for analysis service


Innovations in Menu Expansion

Testing for consideration

ββββ-hCG

hs-cTnI

Mg

Mg/Phos

NGAL

TSH

PSA

dDimer

PTH

aPTT


i-STAT in Canada

• 345 Customers

• $4.0MM in 2010

• Use Models

–Lab back up device

–Rural lab replacement device

–Niche application

• Reasons why…

–Lack of visibility and focus – Abbott

–Lack of Canadian i-STAT Financial Impact

–Laboratory resistance


Q & A

QUESTIONS?

THANK YOU!

Documents

Abbott Point of Care Solutions - CADTH.ca - Improving Health... · CADTH Presentation Abbott Point of Care ... Press Ganey Associates. Emergency Department Pulse Report . 2008