A clinical information systems company last week unveiled a software innovation that automates a now-laborious process of reaching consensus among hospital clinicians on the most efficient and effective management of medical conditions.
The goal of the product, developed by Pace Health Management Systems of West Des Moines, Iowa, is to greatly speed up the creation of care plans that demonstrate the best results and wring out unnecessary clinical interventions.
Those care regimens, called critical pathways, organize the treatment of specific illnesses and conditions during each day of a patient stay to reduce costs and get patients in shape for discharge sooner.
Critical pathways can be adapted from existing standards of care, such as those developed by respected teaching hospitals, or they can be created by consensus of a hospital's own staff, said James Pritchard, a consultant with JDA, a San Francisco-based healthcare information technology management firm.
In either case, the process of generating and approving pathways can take months, Pritchard said. "They don't go anywhere unless the doctors sign on, and that's where you get bogged down in meetings of physicians," he said. "I've seen organizations take a year and a half to adopt a protocol on hip replacement."
The Pace product can reduce the process to a matter of days, said Matt Terstriep, vice president of sales and marketing. It searches through data from a hospital's experience in treating the targeted condition, picking and choosing among the variations and automatically arriving at an "ideal" pathway, Terstriep said.
Physician buy-in is more likely than it would be for pathways adopted from outside the hospital, because the process uses the doctors' own track records, said Mike Vasquez, president of Pace. "You can buy `off-the-shelf' pathways, but as soon as you bring it in, the objection will be that, `We don't practice that way here.' Sometimes hard data (on physicians' practices) take the emotion out of state of mind," Vasquez said.
Internal pathway-creation efforts typically rely on extracting the needed data from patient charts and making one comparison after another until trends are found, Terstriep said. By contrast, the company's method of capturing structured data elements and subjecting them to its automated search technique allows millions of comparisons at one time, he said.
The technique keeps testing interventions against each other for their financial and clinical consequences until it results in the "survival of the fittest" approaches, he said. Those are strung together to create the pathway.
Consultants who examined the product at the Healthcare Information and Management Systems Society exhibition in Atlanta said it broke new ground. "I don't see anything really close to it," said Melony Williams of Superior Consultant Co.'s Vienna, Va., office.
The company is proposing a fee of $2,500 a month for 60 months, or $150,000 total, including installation.