HL20: Aurelia Boyer—Analyzing Data, Reducing Costs

Amalga, created by Microsoft and now offered through Caradigm, the company's joint venture with GE Healthcare, supports patient-centric analytics, a unified view of data across disparate systems, and perspectives both from the individual patient and across a population of patients.

Among the surprises: more upper-extremity DVTs than expected. Another analysis with a different group of physicians dealing with congestive heart failure resulted in a savings of $1.5 million, Boyer says.

"We were trying to prove that Amalga could do something for us in real time," she says. Typical analysis of quality measures was more retrospective. The secret to moving the needle on DVT was to catch problems before the patients left the hospital, she says.

"It's a multistep problem," says Boyer. "We had to find advocates who really wanted to say, 'What's in the EHR? How do we collect that data? Do we have the exact right data? Once we have the exact right data, do we make sure all the users fill it out perfectly?' "

Another quality improvement effort looked at external wound infections. "You wanted to look at chest tube drainage," Boyer says. "What became very clear, the nursing notes had to be very well filled out in order to have the right data. So if you said it was this kind of chest tube, everybody had to use the exact same words and the exact same criteria, and then we had to show the doctors the data every week, all the time."

So even when a physician documents a patient as being not at high risk for complications, if the data shows otherwise, the mandate is to "do something about that right now, today, not after the patient's discharged," such as being placed on an anticoagulant, Boyer says.