Erlanger/MDP Hospitalists selected as a Top 15 Research and Innovation Oral Abstract
In April, Agathos was fortunate to have attended The Society of Hospital Medicine Annual Conference where Dr. David Alvarez, Hospitalist Medical Director at Erlanger Health System, presented on the power of mobile tools guiding physician performance, particularly Agathos’ platform. The abstract was selected as a one of the Top 15 Innovations of Hospital Medicine in 2018.
The Society of Hospital Medicine Annual Conference
The SHM Annual Conference is a comprehensive two-day conference for the practicing hospitalist, physician assistant, and nurse practitioner with the latest, evidence-based information in the management of the hospitalized patient.
SHM markets the conference as, “more than a meeting, it’s a movement,” promoting high quality and high-value health care for every hospitalized patient, advancing the state of the art in hospital medicine through education and research, improving hospitals and the health care community through innovation, collaboration and patient-centered care, and supporting and nurturing a vibrant, diverse and multidisciplinary membership to ensure the long-term health of hospital medicine.
Title: Measure and improve hospitalist performance using mobile tools
Authors: Dr. David Alvarez, MD
Background: Hospital reimbursement has become increasingly dependent upon improving key metrics like length of stay and 30-day readmissions. Hospitalists must continually improve these metrics but often lack access to timely, reliable, and actionable data to inform practice. In addition individualized benchmarks, when available, do not consider the patient’s severity, variations in care, or their individual contributions to shared cases.
Purpose: The goal of this proof of concept study was to provide hospitalists access to timely, individualized, and adjusted metrics, show them how they compared against peers in an academic hospitalist group across three different facilities, and evaluate whether giving hospitalists easy, up to date access to this information on their mobile devices improved performance.
Description: A mobile analytics tool that presents up-to-date individualized metrics was introduced to physicians. The analytics engine pulls data on a daily basis via a recurrent feed from the hospital’s electronic medical record system and continuously calculates and adjusts individualized metrics (length of stay, 30-day readmissions, patient satisfaction and mortality) for attribution, discharging facility, and case mix index (CMI). These metrics are securely accessible by each hospitalist on their mobile phone. Features, such as anonymous peer comparison, progress over time graphs, and prioritized cases, offer additional support for personal practice evaluation. Weekly text notifications give physicians new insights on performance specific to disease categories (e.g. congestive heart failure).
Conclusion: Hospitalist were significantly engaged with the mobile platform with approximately 50% engagement per shift. The users specifically stated that they enjoyed the easily accessible data, the adjusted metrics, and the comparison to their peers. They commented on how they previously had difficulty understanding how their actions affected these metrics and therefore had difficulty in understanding how to change their behavior.
Complete analysis of length of stay effects are pending, but preliminary analysis shows a significantly lower length of stay of for patients discharged by users of the tool compared to non users after six months of use. Further studies are needed to determine long term engagement across diverse hospital settings and the impact on CMS benchmarks. Future directions include highlighting the relationship of hospitalist actions and metric improvements as well as encouraging physician engagement with gamification and/or community building activities.
Our takeaway from the conference
Increased specialization and rapid advances in hospital medicine make it difficult for clinicians who provide inpatient care to stay updated on new procedures, treatments, and medication protocols. This struggle contributes to clinical care variation and hinders standardization, behavior change and creating new practice habits.
With that said, a major highlight of the conference was the focus on emerging innovations. Agathos' platform has proven to be useful in advancing value in a handful of the conference's topic of interests: engaging clinicians and empowering the creation of new practice habits, helping clinicians understand the care they provide, and standardizing care, particularly opioid prescribing patterns, and length of stay.