Dennis Kogan featured in Hospital News03 Nov 2017
By Dennis Kogan
For most surgeries, the potential for complications is always present, especially for certain high risk patients. Many hospitals are taking advanced measures to counter this possibility, with a focus on preventing undesirable variation at key points during the episode of care. This especially includes critical care transitions such as between prep and surgery, and surgery and recovery.
Specifically, these hospitals use analytics solutions that are embedded directly within perioperative workflows. Such technology converges IoT tools with healthcare analytics to produce actionable data—that is, data which is near real time and relevant to the patient, and can be acted on during the episode of care. Moreover, actionable data’s value can be extended to identify effective training protocols and to standardize best practices.
Three scenarios, in particular, are calling for an intensive effort to deploy actionable data in the operating room—and they are only increasing in urgency.
This spring, news headlines reported that for the first time ever, there are more seniors in Canada than children. Like other developed countries, Canada’s population is aging. This means that Canadian operating rooms are performing surgery on ever frailer, geriatric patient pools. Indeed, it is fair to say that the Canadian health system should be recalibrated to accommodate the imminent influx of aging, high-risk patients. One key point to keep in mind: more can go wrong when operating on today’s higher risk geriatric pool. Thus, surgeons will greatly benefit from having actionable data which alerts when procedures are veering away from best practices during the episode of care.
Consider two common categories of procedures performed on the elderly: cardiac surgery and joint replacement surgery. While the latter now can be performed with minimum invasiveness, elderly patients are still at higher risk of infections and other complications. Meanwhile, geriatrics make up a significant share of patients for cardiac surgeries. For this higher risk pool of patients, it is even more important to adhere to best practices to avoid unnecessary variation that contributes to unacceptably high mortality rates and costs.
Rising patient volume
Also like other developed countries, Canada’s population is increasing, with immigration fueling much of this growth. At the same time, the country’s doctors are aging, which is contributing to a persistent shortage in their numbers. In plain terms, surgeons are handling more cases, which present more chances for errors. Once again, actionable data in the operating room is an effective strategy to mitigate downstream issues. As a regular component of surgery, actionable data enables surgeons to ramp up faster on more procedures, including implants of new devices.
More post-graduate training needed
More broadly, regular use of actionable data instills a culture of continuous learning for residents and other “apprentice” clinicians. An advanced solution should enable surgeons to review episodes, add notation and collect feedback. Now surgeons have a tremendous aid for understanding—and teaching—others, drivers of unnecessary clinical variation in the operating room. This can be particularly impactful for Canada’s cardiac residents, who enter cardiac residency programs directly from medical school. Potential also exists to weave operating room actionable data into Canada’s various continuing medical education programs beyond residency.
The many needs for actionable data in the operating room are clear. Less so may be how to actually access this data. In brief, acquiring actionable data depends on aggregating both structured and unstructured perioperative data, plus smart integration of key systems and devices. Physician leadership and championship also are essential. After all, it is physicians who play the most prominent and certainly most direct role in the patient’s outcome. With actionable data at hand, physicians have an effective means to assure these outcomes are positive.