Variances in Care Across Clinicians and Sites

Variances in care across clinicians and sites have long been documented. Patients with the same or similar clinical presentation receive varying types and levels of care, sometimes no care, which leads to varying costs and outcomes.

Certainly, the clinical decision-making process must account for the preferences of individual patients as well as the judgment and skill of individual clinicians, and some variances in care will always be warranted. However, the most effective care is not a binary decision of right versus wrong, but rather, a weighing of risks and benefits against scientific evidence.

By providing a means to compute risk, appropriate use and other predictive measurements for individual patients, in conjunction with guideline-recommended treatments and protocols, our ePRISM® content enablement platform can eliminate unwarranted variances in care.

Undertreatment and Overtreatment

Numerous observational studies articulate a phenomenon referred to as the risk-treatment paradox. Patients at high risk for poor outcomes, yet with the most to gain, are less likely to receive guideline-recommended treatments than patients at comparatively low risk.

Said otherwise, the level of care is not commensurate with the level of risk. Patients at high risk are often undertreated and patients at low risk are often overtreated. Outcomes and costs are resultantly askew. Although the reasons for this paradox are not entirely understood, it can be overcome.

Using ePRISM® predictive content solutions, clinicians can formulate treatment plans consistent with individual patient risk and preference, ensuring that low risk does not result in overtreatment and high risk does not result in undertreatment.

Avoidable Deaths, Complications and Extended Lengths of Stay

Many treatments have known risks that can lead to adverse events, including mortality, and can result in extended lengths of stay. Informing patients of these risks, and requiring their consent, may offer protections against legal recourse, but does little to prevent the occurrence of adverse events.

It is neither reasonable nor prudent to expect that clinicians take action to prevent the occurrence of all possible adverse events, when for some patients, if not most, doing so may be futile and entirely unnecessary, and may cause more harm than good.

Our ePRISM® content enablement platform arms clinicians with evidence-based risk, appropriate use and other predictive measurements for individual patients, allowing them to make the kinds of clinical decisions best positioned to prevent the occurrence of adverse events.

Unfavorable Readmission Rates for Populations Such as Heart Failure

Every year, nearly one-fifth of Medicare beneficiaries discharged from a hospital — roughly two million — return within 30 days. Some readmissions are planned, some are unplanned and others are unrelated to the initial reason a patient was hospitalized.

Unplanned readmissions are in the line of fire, specifically for heart failure, COPD, pneumonia, CABG, stroke, AMI and hip/knee replacement populations, but also hospital-wide. Revenue preservation is reliant on reducing unplanned readmissions and keeping them under control. For many healthcare organizations, hundreds of millions if not billions of dollars are at stake, yet pinpointing the causes of unplanned readmissions is extremely difficult.

With ePRISM® predictive content solutions, hospitals are able to proactively, in a fully automated fashion, identify individual patients most at risk of readmission and take action to ensure discharge plans and associated follow-up care adequately address their needs.