the Premier Cardiovascular Information System for Improving Patient

…the Premier Cardiovascular Information System for Improving Patient Healthcare Prognostic Risk Algorithm Presented by Nick Gawrit June 27, 2008 SIR Conference 2008 - Dublin

Sequence of Events • Risk Algorithm provided by Society of Thoracic Surgeons for use in retrospective risk scoring • Need identified that surgeons would like to use this tool ahead of surgery to evaluate the risks they are presented • heartbase saw potential of decreasing risks of surgery by developing a module that allows risk to be analyzed prognostically, and be reassessed as the patient approaches surgery SIR Conference 2008 - Dublin

Prognostic Risk Scoring Tool Features: • Score patients on any PC, anywhere! • Procedure based field completion • Score Report • Patient Score history • Integration into heartbase • STS 2. 6 risk scoring model (future-Euro Risk Score) SIR Conference 2008 - Dublin

Needs • • • Integration into heartbase event management Schema creation to allow assessments to look at variables used in relational structure in one record type Interpretation of the retrospective model into a prognostic model Risk algorithm verification Screen design to reflect risk variables related to procedure performed Continual risk adjustment of variables as they change Print functionality for medical records and surgeons outlining the assessment Training on system use and impacts on medical records documentation On-line history of assessments Risk management instruction Reports Future SIR Conference 2008 - Dublin

Integration into heartbase event management SIR Conference 2008 - Dublin

Integration into heartbase event management • Locmenu. pql • Dvmnusys. Menu_ifs SIR Conference 2008 - Dublin

Assessment History SIR Conference 2008 - Dublin

Schema creation • STS record type • Identify all variables used in risk model and copy them to new record type TASK NAME Record Definition for STS Record Number RECORD SCHEMA 96 STS KEY FIELDS SURGDATE(A) MAX REC COUNT 100 DATA LIST (3) SSNUM SURGDATE DIAB COPDSTAT PRWCPBNM PRWOCPBN HCVA PRCBVDIS 4 - 14 15 - 24 25 26 27 - 28 29 30 31 32 96 (A 11) (DATE'MMIDDIYYYY') (A 1) (I 2) (I 1) (A 1) SIR Conference 2008 - Dublin

Beta Coefficients • Create a schema to handle downloadable data records • Create PQL programs to download data records SIR Conference 2008 - Dublin

Screen Painting • New STS prognostic score screen SIR Conference 2008 - Dublin

retrospective > prognostic • Interpretation of the retrospective model into a prognostic model STS RISK MODELS FOR MORTALITY, MORBIDITY, AND LENGTH OF STAY MODEL SPECIFICATIONS MODEL VERSION 2007. 1. 2 FOR STS v 2. 61 FEBRUARY 22, 2008 SIR Conference 2008 - Dublin

Risk algorithm verification • Risk algorithm verification by hand entering 2000 test cases that had scores generated by the STS SIR Conference 2008 - Dublin

risk variables and procedures performed • Screen design to reflect risk variables related to procedure performed SIR Conference 2008 - Dublin

Continual risk adjustment • Continual risk adjustment of variables as they change SIR Conference 2008 - Dublin

Print functionality • Print functionality for medical records and surgeons outlining the assessment SIR Conference 2008 - Dublin

Training • Training on system use and impacts on medical records documentation SIR Conference 2008 - Dublin

Risk management • Risk management instruction – – – – Get Weight Down (seems to be an exception for females) Exercise Eat Healthy Get diabetes in check Take meds to treat areas like hypertension Younger is better. Get a great physician SIR Conference 2008 - Dublin

Reports • In the evaluation of what is needed phase SIR Conference 2008 - Dublin

Future • • Euro Score Flash Drives Cell Phone Web Site SIR Conference 2008 - Dublin

Demonstration SIR Conference 2008 - Dublin

Thank You! by Nick Gawrit SIR Conference 2008 - Dublin

SIR Conference 2008 - Dublin