Using practice management dashboards and point-of-care tools, a proof-of-concept program in colorectal surgery at the Mayo Clinic in Rochester, Minn., has cut in half the number of post-operative complications and decreased the average length of stay compared with traditional protocols.
The program, called Enhanced Analytics for Achieving Surgical Excellence (EASE), saved about $10 million net for eight surgeons.
According to Matthew Burton, M.D., associate consultant (faculty) for applied clinical informatics at the Mayo Clinic, the proof-of-concept addressed how to measure, monitor and continuously deliver the standardized clinical best practices, namely the Enhanced Recovery Pathway (ERP)--protocols designed to achieve early recovery after surgical procedures.
Among the major differences between traditional post-operative care after colorectal surgery and ERP: fluids and food are allowed and, in fact, encouraged after surgery on the same day as the operation; early mobilization by sitting in a chair on the evening after surgery and walking the following day are recommended if a patient's condition allows.
Patients in the proof-of-concept went from about a 70 percent compliance rate with the manual process for the protocols to approximately a 96 percent compliance rate with the electronic intervention. The aim of the ERP is to attenuate the stress response to surgery and enable rapid recovery, with a target length of stay of two days for minimally invasive surgery.
We identified a need for two things: one was some clinical dashboards for practice management and a little bit of analytics on measuring compliance with best practices and seeing when patients went off the pathway; and the point-of-care tools which really pulled the same knowledge into point-of-care workflows as patients were being cared for, said Burton.
In particular, he said the practice management dashboard allows providers to drill down into what are the things that took the patient off pathway and whether it happened before or after evidence for a complication.
The Mayo Clinic is working toward moving the proof-of-concept to a layered open architecture across the entire practice, said Burton, who made the comments in a virtual presentation at an Aug. 21 meeting of the Healthcare Services Platform Consortium, an initiative to create a next-generation IT platform supported by providers, vendors, systems integrators and venture-led firms.
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