Hospitals harness big data to help improve outcomes in the operating room
We live in a digital world, and hospitals are no exception. Take for example the machines in an operating room. They generate thousands of data points, and yet only a fraction is typically harvested and saved in hospitals’ electronic medical record systems. Hospitals know this data contains the answers to many questions, including keys that might help to improve quality of care, increase efficiency and find ways to save on costs.
While they are eager to tap into the data being generated, many feel they need a dedicated team of data analysts to interpret the information.
But two anesthesiologists, Dr. Richard French and Associate Professor Ross Kennedy, at Christchurch Hospital in New Zealand found a practical solution.
Christchurch maintains a strong focus on low flow anesthesia and is already considered to be a low flow institution. The hospital has about 650 beds in its acute care wing and performs 32,000 surgical episodes a year – approximately 88 per day.
Dr. French and Professor Kennedy expected to confirm their use of low flow with GE Healthcare’s Carestation Insights – a suite of cloud-based applications, powered by algorithms, that pull data directly from anesthesia machines and give clinicians an easy view of their practice – both at the individual OR level and across the hospital. One of the first apps focuses on helping institutions drive low flow initiatives to improve care and reduce anesthetic waste.
“Low flow anesthesia” is often misinterpreted as diminishing the “dose” of anesthetic agent delivered to the patient. Rather, it focuses on minimizing and avoiding drug waste. With low flow practice, hospitals benefit from cost savings and do their part to minimize greenhouse-type effects on the environment. In fact, a busy midsize hospital purchasing 1,000 liters of inhaled anesthetic per year is equivalent to 1,200 passenger car emissions.
“We honestly weren’t expecting to learn anything new around our practice from these apps,” notes Dr. French. “However, the data was incredibly eye-opening.”
While they were correct in thinking they were practicing with low flow, there were several outliers where high flow was being used, and there was also a dramatic variation between cases even with the same practitioner.
[caption id="attachment_9661" align="aligncentre" width="690"] Associate Professor Ross Kennedy and Dr. Richard French, Christchurch Hospital in New Zealand
“We realized we needed to focus on the first few minutes of the operation, when high flow tends to happen,” says Dr. French. “By leaving the high flow rate on for the first five or six minutes, you’ve consumed the same dollar amount as the next ninety minutes or more – costing money and expelling unnecessary drug waste.”
With Carestation Insights, Christchurch Hospital altered its practice and, by doing so, decreased its fresh gas flow rates an additional 13%. This correlated to a significant reduction in agent usage, cutting anesthesia cost by 12% and emitting fewer greenhouse gases.
Not only are they seeing financial and environmental benefits, but they gain time they otherwise would have spent on collecting and processing the data to focus on patient care.
“Before Carestation Insights, we suffered through an incredibly laborious process of exporting data from the anesthesia machines, processing the data ourselves, and then attempting to draw conclusions,” explains Professor Kennedy. “Now the data is readily available, and we can look at it from different perspectives.”
Dr. French compared the learnings to an athlete trying to obtain their personal best without a stopwatch.
“We’ve been sincerely trying to get as good as we can, but we’ve lacked real-time information on how we’re performing. Carestation Insights is giving us the actionable data we need.”
Low flow anesthesia is just one example of how Carestation Insights can help clinicians and care teams drive clinical, operational and economic outcomes. The platform extracts more than 300 data points per patient breath from the Aisys CS2 anesthesia machine. Clinicians are already looking to use the data to streamline perioperative workflow, improve proactive fleet service management and help increase the practice of lung protective ventilation.
Other apps from GE Healthcare
include a Checkout Dashboard, which provides visibility to the completion of daily checkouts to help clinicians ensure life support equipment is properly functioning, and a Lung Protective Ventilation Dashboard, which helps clinicians identify opportunities and provide data used to support lung protection initiatives.
GE Healthcare will be sharing results from these applications and other technologies at HIMSS 2018.