How Does Innovaccer Enhance Surgical Care Experience on the Data Activation Platform

Overview

The surge in COVID-19 cases in 2020 brought a delay in the majority of adult elective procedures—non-essential medical, surgical, and dental clinical treatments. A few months later, hospital leaders across the country ramped up the provision of these procedures due to increasing health concerns and to overcome the revenue loss that canceled procedures caused. The annualized U.S. GDP declined 4.8% in the first quarter of 2020 and approximately half of that figure is attributed to healthcare services, and especially to delayed elective procedures.

A recent study predicts that the post-pandemic backlog will exceed one million cases for spinal fusions and joint replacements in the field of orthopedic surgery alone. These delay and restart movements in elective procedures shed light on a few major concerns: what is the right strategy to speed up elective procedures while avoiding unintended repercussions? How can pre-surgical optimization processes be designed to meet clinical, regulatory, and financial objectives? How significant is risk stratification when it comes to elective surgeries?

Though the term “elective” means “optional,” elective surgeries range from preventative and vital measures, such as screening colonoscopy, to essential surgical procedures, like spinal infection or cataract removal. Many studies show that delayed elective procedures lead to worse patient health outcomes and higher costs2. The post-pandemic backlog is likely to follow a similar trend, with decreased capacity of providers and millions of pending procedures.

How can healthcare leaders ensure:

1. Equity in access to care with bias-aware algorithms for surgical prioritization?
2. Better operational efficiency with OR metrics and real-time analytics?
3. Smooth transition of patients to outpatient care?
4. Gapless communication across the care team for coordinated post-surgical care?
5. Consistent patient engagement for a simplified patient surgical care experience?

Let’s understand the surgical experience journey and its challenges in three key stages: preoperative, intraoperative, and postoperative care.

Preoperative Journey

A basic patient health assessment to understand the patient’s medical history and current health status is required before any surgical procedure. This helps providers in assessing surgical risk and making operative procedures safe by mitigating the risk of complications. However, providers need to ensure a well-timed preoperative assessment that doesn’t lead to unnecessary delays or worsened health and increased care costs.

A comprehensive preoperative assessment requires providers to study a patient’s medical history and conduct a physical examination or testing in laboratories to assess surgical risk properly. Depending on the type of surgical procedure to be performed, this assessment requires surgeons to be aware of the following:

1. Medical history
2. Allergies and intolerances to medications or anesthesia
3. Known medical problems and current status of pertinent known medical problems
4. Surgical history
5. Trauma history
6. Current medications, including prescriptions, over-the-counter medications, herbal and dietary supplements
7. Cardiac, pulmonary, and functional status
8. Hemostasis status (personal or family history of abnormal bleeding)
9. Possibility of severe anemia
10. Possibility of pregnancy
11. Smoking, alcohol and illicit drugs history
12. Risk factors for surgical site infection influenced by factors like smoking, diabetes, obesity, and malnutrition
13. Basic nutritional assessment to ensure speedy wound healing and decreased surgical site infections
14. Physical examination including weight, height and body mass index
15. Vital signs such as blood pressure, pulse (rate and regularity), respiratory rate

All these data points are crucial for surgical planning and could be reaching the surgeons from a variety of data sources and sites. Here, it becomes essential to ensure unified patient data and a singular patient profile that provides the surgeons with point-of-care insights in near real-time.

Preoperative testing and evaluation majorly dictate the patient’s risk profile. For example, conditions such as markedly elevated blood pressure or chest pain may require further evaluation to assess the patient’s risk. Abnormal findings in the preoperative phase are likely to push the patient towards the high-risk zone. At this stage, it is important to stratify patients as low-risk or high-risk to prioritize their surgical procedures accordingly. Innovaccer’s risk stratification algorithm assesses a wide range of factors like medical history, patient demographics, allergies, chronic conditions, history, and social determinants of health to assist providers with an efficient stratification and keep patients out of the emergency department (ED).

Innovaccer’s preoperative care module involves three key phases:

1. Integrating and activating complete patient data by analyzing clinical and social factors;
2. Applying machine-learning algorithms to proactively identify high-risk surgical patients;
3. Enabling virtual preoperative interventions and comprehensive engagement for prioritized patients ready to undergo surgery.

Intraoperative Care

While healthcare organizations have all the data necessary stored within electronic medical records (EMRs) and other data sources, the ability to derive meaningful insights from the data and make it actionable within clinician workflows remains limited. To address this challenge, we propose establishing a robust data foundation that will derive meaningful insights about the OR's performance across different dimensions and help care organizations embark on a path of continuous improvement and learning.

To augment the operations with data and insights, surgeons and administrators must have access to real-time actionable insights to enhance their OR efficiency, with daily utilization insights on a surgical workflow dashboard. Innovaccer’s solution helps organizations improve their OR efficiency across four key areas:

1. Optimizing block assignments: Uncertainty in the duration of surgical procedures leads to unpredictability in OR block assignment and overtime staffing. Innovaccer’s solution leverages machine learning (ML) algorithms to study past data across various dimensions, such as type of surgery, surgeon experience, complications, and other factors to assign specialties to ORs and sub-specialties to time blocks. It also helps in determining block duration and surgery sequence, incorporating marginal delays. This leads to reduced costs, accurate staffing, and a seamless surgical flow.
2. Avoiding delays: Delays frequently occur in the OR and majorly impact patient flow and resource utilization. Innovaccer’s solution leverages an ML-model to identify OR delays resulting from various factors such as turnover between surgeries, nonoperative time, and other factors to optimize surgery timings and OR utilization.
3. Avoiding last-minute cancellations: Same-day surgery cancellation in hospitals is a significant problem with far-reaching financial and clinical consequences. Innovaccer’s solution helps overcome all avoidable cancellations with real-time resource allocation and accurate block optimization. The algorithms are capable of allowing decided time for each small (yet significant) step such as OR preparation so that scheduling errors can be successfully avoided.
4. Minimizing variance in care: Variations in surgical care have been generally interpreted as evidence of uncertainty among practitioners regarding optimal care. Innovaccer’s data-driven approach helps providers understand this variance with quantifiable metrics that can be seen changing over insightful time graphs on comprehensive dashboards. It helps providers identify best practices with data-steered medical evidence and understand guidelines and care pathways to streamline quality care.

Postoperative Care

While leveraging data and analytics to identify high-risk patients is a crucial first step, having a standardized and effective care management plan reviewed by care managers is key to realizing the desired return on investment (ROI). Innovaccer’s postoperative care module involves patient follow-ups with pre-built care protocols that significantly reduce the post-surgery readmission rate. It ensures seamless patient-provider communication for postoperative care guides, patient education, and medication adherence. This approach helps healthcare organizations in significantly reducing readmissions and avoiding ED utilization.

Innovaccer’s Patient-Centered Surgical Home is a team-based initiative hosted over the Innovaccer Health Cloud that involves people of varying expertise domains, bringing them together on a remote platform to care as one for patients. It encompasses early patient engagement, preoperative patient evaluation, and intraoperative initiatives leading to enhanced utilization and postoperative care management and transitional care management for reduced postoperative complications.

Learn more about our solution here. To book a demonstration, click here.