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HOW TO LEVERAGE DATA TO MANAGE AND SAVE
LIVES? - A WORLDWIDE AWARD WINNING SOLUTION
José Pedro Almeida
@jpedroalmeida_
José Pedro Almeida
913709072
[email protected] 18th, 2013
• 5300 employees / 60 Dep.
• 336 million euros/Year
• 1100 Beds (60 ICU beds)
• Ranked #1 Since 2008
• Opened since 1959
São João Hospital Center – Porto, Portugal
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ProductionPharmacy
FinancialQuality
Laboratory
EMR
Supply Chain
HR
• Information is spread out in
dozens of heterogeneous systems
• Millions of records are stored but
there is no solution to analyze &
correlate them in a fast manner
• No holistic view of how treatments
& costs are related
• Lack of Data Quality
How Information Systems impact Management in Healthcare…
Pharmacy
FinancialQuality
Laboratory
EMR
Supply Chain
HR
EDW / OLAP
Production
What have we done differently?
Patient
Episodes
Diagnosis
Medical Procedures
Surgical Procedures
Analysis &
Exams
Medicines
&
MaterialCost ofTreatment
Nursing Procedures
Geography and
Demography
Healthcare Providers
Infections
Clinical Result
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?
…
BigData Patient Centric Model - Preparing the future
Some Figures
300 millionRecords/ day
650 Indicators
100.000 questions
answered/ year
500 analysisfields
560 Billion PreCalculatedAnswers
(….)
1 billion dollarsin medicines and material
1.5 millionPatients
Working 24h/7h
since
January 2012
What drugs were consumed in 2015,related with the General Surgeryinpatient,by patients between 35 and 65 years old,female gender,from outside the district of OPorto,with hipertensionhaving a “Gastric Bypass” procedure?
Who performed the operation?Did this population caught anosocomial infection?
Powerfull Clinical Studies Capability
Strategic Management
Operational Management
OperationTheatre Live Perfomance
Indicator Before HVITAL After HVITAL
Decisions sustained on validated
numbers30% 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 & Control5 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’S5-10 500-1000
Business Gains – Phase I
We had a Bunch of KPIs - But do they really transform an Organization?
You need to help those who are on the field…
Antibiotic Stewardship
Infection Control
Clinical Deterioration
Risk
Clinical challenges – Top Priorities
Infections – How HVITAL helps in Infection Control?
What is our infectionrate?
How do we control the spread of infection?
What kind of infectionsmost concerns us?
How is it spreadingamong our patients?
What is an infection?
Infections – São João Spacial Mapping
Where is my Hospital Infection? How is it spreading?
Methicillin-resistant Staphylococcus aureus (2014)
Where is my Hospital Infection? How is it spreading?
Vascular Surgery
Infections – São João Spacial Mapping
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…
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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.
Clinical deterioration –An Avoidable Phenomenon?
Thursday, 16h30: admission to the ED, dx “respiratory infection”
Sat, 8h: BP 110/60mmHg, HR 100/min, RR 22/min
11h30 – blood collected
12h30 – blood enters lab for analysis
14h30 – analysis result released
19h00 – patient found in shock
19h45 – CARDIORESPIRATORY ARREST
Patient dies
Saturday, 3rd inpatient day
Friday: 1st evaluation by inpatient medical team• History HTN, …. BP 160/100mmHg, HR 86bpm, RR 20cpm
• Blood Analysis where requested in the morning
Fri: Hg 9g/dl (4g/dl), WBC 30x109/l (3x), CRP 364mg/l (4x),
creatinine 1,7mg/dl (0,6mg/dl)
Clinical deterioration example
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.
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HVITAL was warning
about potassium level
decreasing rapidly 2
days before
How do you convince doctors to use HVITAL?
A simple text message that might save your live….
InternationalAwards & Recognitions
1st prize – Big Data & Analytics
Solution of the Year, London (UK),
March 2014
1st prize – MSHUG Innovation Award,
HIMSS 2014 Florida (E.U.A),
February 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)
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