8/7/2019 Applying Innovation Science to Medicine by Joel French,
Robert Weathersby
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Applying Science to Medicine Joel French, Robert Weathersby
AbstractOnly 55% of patients receive recommended care, with
little difference found betweencare recommended for prevention, to
address acute episodes, or to treat chronicconditions ( McGlynn et
al, 2003 ). The lag time between the discovery of more
effectiveforms of medical treatment and their incorporation into
routine patient care averagesseventeen (17) years ( IOM ).
Computerized provider order entry (CPOE) has been widelydocumented
as a necessary tool to reduce preventable medication and other
related errorsbut only 7.4% of acute care hospitals in the United
States utilize CPOE with appropriaterules and evidence ( HIMSS
Analytics ). The most fundamental building block for CPOEis the
evidence based order set, but complexities associated with
creating, managing andupdating order sets have introduced major
obstacles to CPOE implementation efforts.Chronic conditions such as
heart disease, diabetes or arthritis affect more than 130million
Americans directly, and account for 7 in 10 deaths. Further, these
chronicconditions consume 75% of all healthcare spending, and
account for nearly two-thirds of the growth in health spending over
the past 20 years -costing the U.S. economy $1 trillionannually (
Almanac of Chronic Conditions, 2008 Edition ). Estimates suggest
the averagepatient upon hospitalization has 2.75 diagnoses -
meaning "appropriate care" must spanand synthesize multiple
morbidity-specific best practices to effectively administer care
tothat "average" patient. The traditional approach to treating
patients with evidence basedprotocols requires a physician to
perform an ad hoc exercise of "mental merging" -reconciling
duplicate candidate orders across multiple order sets to treat a
patient withco-morbidities (today's norm). A more clinically
effective, productive, and patientsafety-centric alternative is to
employ a proprietary software merging algorithm. These
advanced algorithms remove duplicate orders, resolve conflicts,
completes validation of the appropriate medical evidence and
organizes the resulting merged order set so thephysician can
succinctly address the patientsoften complicated treatment by
focusing onthe unique combination of labs, medications, etc.
appropriate for the specific presentingconditions. This article
describes a patent-pending propriety method of
algorithmicallymerging multiple independent order sets for patients
with co-morbid and chronicconditions into a single, maintenance
free and evidence-based order set that can beimmediately
implemented into physician workflow to satisfy "Meaningful
Use"guidelines for incremental provider reimbursement based on the
American Recovery andReinvestment Act (ARRA) legislation.
SECTION 1. THE U.S. HEALTH INDUSTRY AND THE NEED FOR
INNOVATIONThe U.S. health industry is the largest and most
complicated industry in the world. It is known for itsrunaway cost
increases, abject inefficiencies, adversarial relationships between
health plans andproviders (hospitals and physicians) and stringent
regulatory and accreditation obligations. The properintegration of
information technology is widely viewed as being essential to
improve efficiency,introduce controls required to reduce
preventable errors and the associated costs as well as to
helprealign incentives for improving the performance and
satisfaction of its various participants. Accordingto data combined
by Hoovers business research from the U.S. Census, the healthcare
industry consistsof 340,650 separate establishments employing
5,508,926 people with 2.2 million nurses andapproximately 650,000
physicians (36% of which are in individual physician offices).
Health systems, insurance plans, and policymakers alike are
committed to the goal of creating aninterconnected heath care
system in which health information can be securely exchanged
electronically.The health insurance plan often has a unique set of
information as it relates to the patient. Healthcareprovider and
insurance plans alike share priorities, among them 1) facilitating
how consumers and
8/7/2019 Applying Innovation Science to Medicine by Joel French,
Robert Weathersby
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