In the last 12 months, Lowell Satler, MD, medical director of MedStar Washington Hospital Center’s Cath Lab, and Eileen Searson, MHVI regional manager of Transformational Technology, have been working behind the scenes with IT professionals to create two software programs. One gives physicians a tool to help assess patient risk before procedures. The second prepares patients for what happens when they need a catheterization procedure
Taking a cue from new technology in the auto industry, Dr. Satler and Ms. Searson are working with MedStar Institute for Innovations (MI2) to create a Risk Calculator that provides a warning system to physicians before they begin procedures.
Dr. Satler compares the Risk Calculator to newer cars with alarms that alert you if you swerve over the white line or are about to back into a car. “You’re going to stop backing up if you get a warning, and you’ve probably avoided a fender bender,” he says. “Our Risk Calculator works on the same principle. This allows us to determine, on an individual basis, what the risk is before the procedure.”
“In the past, the model has been that we treat patients in the Cath Lab or OR,” says Ms. Searson, “then receive outcomes metrics weeks later. It’s not proactive. The Risk Calculator is a chance to change our methods, allowing us to customize patient care.”
The Risk Calculator looks at four specific areas: mortality, risk of bleeding, dye contrast-induced nephropathy, and readmission. It assesses each patient for his or her potential risk and assigns a color—red, yellow or green—like traffic signals, as high, medium or low risk. “Our physicians,” says Dr. Satler, “already do this in a soft way. They look at the patient’s medical history, and say ‘this is what I need to do.’ The calculator refines the variables much more tightly, based on a variety of statistical projections—factors doctors already know, but can’t quantify. The Risk Calculator does it for them. And it’s in real time. It may help the doctor decide whether to use a different blood thinner, to choose radial over femoral artery for entry, or maybe whether to proceed at all.”
Ms. Searson says they are ironing out a few wrinkles, but hope to launch the Calculator in early fall. She says, “We want to integrate the Calculator with Amalga, [the Hospital Center’s IT platform that houses diverse programs under one roof] so that much of the information will be pre-populated. We’re still refining the ‘traffic lights’ so it will be as seamless and easy to use as possible.”
Patient Education Portal
From watching hospital TV dramas, most people know generally what to expect when they are having surgery, but aren’t so familiar with what happens if they are told they need to undergo a catheterization procedure. “You get chest pain,” says Ms. Searson. “You’re frightened. Your doctor says you need a diagnostic cath. It can be scary.”
To help put patients at ease, the Cath Lab teamed up with the software company Mytonomy and the hospital’s own Simulation Training & Education Lab (SiTEL) to create an engaging Patient Education Portal to dispel fear by explaining the process, from before patients arrive until after they are discharged. The portal, introduced in February, is receiving positive feedback from patients.
The portal also rolled out at MedStar Union Memorial Hospital this summer and is slated to go live at MedStar Franklin Square Medical Center and MedStar Southern Maryland Hospital Center this fall.
The portal consists of short videos—none longer than two minutes—that highlight key portions of the process, including what patients should bring to the hospital, the personnel they will meet, the procedure itself, questions they should ask their doctor, discharge information and resources available.
Dr. Satler says, “Studies show that information is best transmitted and retained through short videos. Mytonomy had developed similar portals for student learning. With their help and SiTEL’s, we created a unique format, through video and animation, to manage the transition from the outpatient setting, to the hospital, and back out again. We even have a virtual tour to show patients how to get from the parking garage to the Cath Lab on the fourth floor.”
About 300 patients have used the portal, and the response has been positive. Many of the patients are older and some are unfamiliar with computers, but Dr. Satler says family members help them navigate. “We’ve had several octogenarians who have given us great feedback,” he says. “They say they wish they had something like this for every visit to the hospital.”