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Cloud software predicts patient needs at Mercy

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New artificial intelligence software is empowering caregivers at Mercy Hospital Springfield to pre-emptively combat patient bottlenecks hours before they occur.

The St. Louis-based health system has rolled out cloud-based software by Qventus Inc. across its 44 hospitals.

“We have developed an artificial intelligence system that acts like an air traffic control, in the background,” said Mudit Garg, CEO of California-based software company Qventus.

Garg said with most of Qventus’ clients, those in charge of managing hospital services are so busy overseeing patient care, they don’t have time to study analytics and develop efficiency improvements.

“That kind of plagues our entire health system,” he said. “Most emergency departments, when they get really busy, start backing up. That’s terrible for a variety of reasons: Their patients are waiting and they have a bad experience; there are patients who deteriorate while they are waiting; … and there have been cases of people even dying – and that’s absolutely terrible.”

The 60-person team at Qventus designed a cloud-based program – now being used by about 50 health care clients – that not only collects and analyzes hospital data but also makes real-time recommendations for improvements. “It sort of starts developing intuition,” Garg said.

Since practitioners already have a long list of hospital procedures to follow, the software does not require any direct input throughout the day, Garg said, but collects data from resources already in place. Qventus mines information from Mercy’s existing Epic health records software – as well as other systems, such as patient records, staff time clocks and lab testing requests – to get a sense of how many patients are in each part of the building, wait times, staff shortages and other backlogs.

When a possible logjam is identified – such as not having enough rooms to admit incoming patients – Garg said the mobile-friendly software starts making suggestions to solve a problem.

“It will actually proactively message the charge nurse, the nurse manager, the house supervisor, different people in the hospital, who can do something about it,” Garg said of the text messages, emails, faxes and phone calls that go out to key decision makers, based on the situation.

Key communication
Local practitioners have been using the software in the emergency department for about a year and a half, said Brent Hubbard, chief operating officer of Mercy Hospital Springfield.

“The Qventus software can factor in everything from historical patient volumes to the weather outside and even how long a particular doctor tends to spend with patients to predict when wait times may start to rise,” Hubbard said via email. “Then, it alerts our staff and suggests adjustments to help manage a possible increase in patients.”

For example, he said Mercy may need to move emergency department patients to inpatient rooms.

“That could mean our environmental services team needs to quickly clean some rooms because other patients were recently discharged,” he added. “The software provides a way for everyone to easily connect with each other in real-time so they can work together to take action.”

In a nine-month period, he noted the Springfield hospital reduced by half the number of patients who left before treatment was complete.

In 2015, 8 percent of patients left Mercy Hospital Springfield’s emergency department without being seen, according to data from the Centers for Medicare & Medicaid Services.

“Our goal is less than 4 percent,” said Lisa Hallam, a registered nurse and interim director of the emergency department the last few months. “This is so much more organized. Before, there were multiple phone calls that needed to be made to managers and directors of departments, just to get extra help.”

Based on the frequency and number of emergency patients arriving, the program predicts how many X-ray technicians, phlebotomists and doctors are needed, and it alerts Hallam, Hubbard and others throughout the hospital, via a mobile app, to position resources in optimal places.

Alternatives
CoxHealth has considered third-party vendors such as Qventus, but have opted to continue to develop their own in-house software, said Amanda Hedgpeth, vice president of clinical services. Referred to as the “through-put dashboard,” the analytics software tracks patient flow through various hospital departments including the emergency room, surgery, nursing and environmental services.

“We have our own home-grown analytics,” she said, noting the dashboard is monitored by managers and administers from mobile devices and on computer screens throughout the hospital.

It may not have artificial intelligence or automatic alerts, but Hedgpeth said CoxHealth is satisfied with the system.

“I probably check it 15 times a day. And most of us have dual screens in our offices, so on one screen it stays up all the time,” she said. “It’s called visual management – it allows us to quickly see where patients are in the process and where we may need to tweak things to be able to provide better patient care.”

Data driven
About 25 hospitals use Qventus, Garg said, and another 25 are now in the deployment process.

Garg declined to disclose the cost to each hospital but said the subscription model is based on facility size.

In its home state, Qventus officials cite results from four clients. Natividad Medical Center decreased the number of patients who left without being seen by 42 percent, decreased the time patients wait to be seen by a doctor by 20 percent, and decreased patients total length of stay by 8 percent. The outcome at Natividad is an estimated 850 additional visits yearly and an estimated $425,000 in additional annual revenue, according to Qventus officials.

Stanford Children’s Health decreased operating room delays by 11 percent, saving a total of 520 hours, and El Camino Hospital recorded a 39 percent reduction in patient falls within six months.

Although the program started out as an emergency department solution, Garg said the methodology is now being applied to other areas, including clinics and pharmacies.

“Most of health care delivery consists of a whole bunch of complex processes that are intertwining,” Garg said. “If we can make a reliable, sustainable way of realizing problems before they happen, and solving them before they happen, we can have really good impact.”

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