Diverting from “One Size Fits All”

Victor JohansonBlog

PCI Care Transformed with a Patient Centered Approach

Healthcare, as we know, is in constant motion. New technologies, ideas, and drugs are surfacing daily, making things extremely difficult for hospitals and providers to keep up.  It is imperative that health care organizations have the latest and greatest technology or risk falling by the wayside, but the expenses related to high-quality care alone may subject them to the same fate. There is a constant tug-of-war between cost and quality and the patient is stuck in the middle.

CMS has for years been attempting to stabilize the situation and even the playing field. With the recently released bundled payments in cardiology, CMS is aiming to provide patients with quality care without breaking the bank.  As with any industry, there is a key to balancing the equation, and although it has been a bumpy ride, some organizations are beginning to turn that key and experience some outstanding results.

One such example is Barnes-Jewish Hospital’s approach to precision medicine and patient-centered care. Although the idea of precision medicine isn’t new, it has been difficult to implement and can be expensive and time-consuming. The workflow within the hospital is a complex and often a demanding process that has little room for additional steps. The thought of providing each individual patient precise care based on his or her profile sounds like a bottleneck on a busy highway that would cause traffic jams and unproductivity, when in fact it can be the extra lane of traffic that provides improved outcomes and impactful cost savings that are propelling Barnes-Jewish Hospital to top-decile performance.

“Physicians and the team at Barnes-Jewish recognized that they could in fact influence costs during the case if they could risk stratify their patient populations.”


In preparations for value-based care and other cost saving programs, Barnes-Jewish Hospital recognized that quality in the cath lab was not where it should be, and there was room for improvement within the workflow. In the past, it has been believed to be too difficult to realize cost savings during the procedure, and most savings would be realized during post-procedure operations, but the physicians and the team at Barnes-Jewish recognized that they could in fact influence costs during the case if they could risk stratify their patient populations. In order to achieve this without disrupting current procedures, they implemented ePRISM, a tool that is designed to deliver precision medicine in a seamless, productive way.

By including ePRISM into their workflow, Barnes now had the ability to risk stratify their populations and decide precision treatment pathways to ensure the best outcomes for each patient, but contrary to popular belief, adding ePRISM is not like flipping a switch. I will refer to my highway analogy, in order to improve productivity and flow of traffic you can’t simply put in another lane, it’s going to take some time to redirect things and build off the existing foundation to provide the desired result, and although it can be painful at first, the end results are incredibly rewarding and lasting.

Since it’s implementation ePRISM has assisted Barnes-Jewish Hospital in delivering quality, precision care to countless patients who have seen improved outcomes. Bleeding and AKI rates have decreased by over 50% each, along with improved mortality rates and patient satisfaction. It is estimated that Barnes-Jewish Hospital has achieved a savings of over 3.6 million dollars and are trending towards top decile in AKI and bleeding rates. Barnes also was able to implement a new same-day discharge program that has left patients increasingly more satisfied and since it’s conception, approximately 80% of all elective PCI patients are discharged on the same day of their procedure.

In implementing a proactive approach to care, Barnes-Jewish Hospital has positioned themselves for success in bundled payment environments and have proven that precision medicine can be implemented effectively. Our patients are our most important stakeholders, and we do not have to sacrifice their quality for cost, we just have to find the balance.

To learn more about Barnes-Jewish Hospital’s success with ePRISM and precision medicine click here.