Open App Challenge

webECG - a complete and integrated cardiac

solution

Brock Heinz Spaulding Clinical

February 2013

Solution Overview

High Level Solution Description: The webECG solution is a complete and compelling answer to the burning questions regarding preventing, diagnosing, and treating some of health care's most expensive chronic diseases. By leveraging flexible and dynamic analytics, providers can easily identify their highest risk cardiac patients through a powerful modular data mining risk solution. Then, with a fully integrated ECG device and platform, cardiac results are automatically saved to the EHR regardless of whether the patient is in a physician office or in their home.

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Problems Addressed: Reduces cost and improves outcomes for a variety of diseases including, but not limited to heart disease, hypertension, and pulmonary conditions.

Empowers providers to enhance patient engagement by supporting remote cardiac monitoring, thus reducing 30-day readmissions for some of the most relevant chronic conditions. With customizable data mining capabilities, the solution is a powerful way to address population health.

… improving the management of high cost chronic disease while also addressing value-based care imperatives

Usability and Design - Setup

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… how our application will be used by a healthcare provider and patients to improve outcomes

•  Sites are configured via browser in cloud-based system

•  Unlike traditional ECG solutions, there are no associated capital costs

•  Sites receive a hand-held, FDA approved 12 lead ECG device (http://bit.ly/WdVtYk)

•  Acquires up to 5 minutes of 12 lead ECG; can optionally collect 30 seconds of

patient / caregiver voice

•  Client software is installed at the site – either via launcher buttons in the EHR or in

stand-alone mode

Usability and Design – Data Mining / Analytics

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… how our application will be used by a healthcare provider and patients to improve outcomes

•  Modular framework allows providers to classify risk levels based on custom

criterion and population health analytics

•  By default, system offers the clinically validated Framingham Risk Score

(http://bit.ly/11u4VvR) to estimate the 10-year cardiac risk of patients

•  On a timed basis, data mining framework queries EHR for past and future

appointments (24 months in the past, and three months into the future)

•  With each distinct patient, a clinical summary is pulled from the EHR, risk levels are

calculated by the algorithm, and the results are stored in a database

•  Providers can visualize the risk scores via a web interface

•  A color coded system that cross references appointments for a given day

(where EHR Tasks can be created directly from the web interface)

•  A macro view that shows entire patient population – also exportable in Excel

Usability and Design – Risk Mining … how our application will be used by a healthcare provider and patients to improve outcomes

Usability and Design – Visualizing Risk

* simulated schedules and patients were used to make user interface more realistic

… how our application will be used by a healthcare provider and patients to improve outcomes

Usability and Design – Acting on Risk

* simulated schedules and patients were used to make user interface more realistic

… how our application will be used by a healthcare provider and patients to improve outcomes

Usability and Design – Client Software Interaction … how our application will be used by a healthcare provider and patients to improve outcomes

•  Launches natively in EHR: demographics and authentication are automatic via UAI integration and launcher button framework

Usability and Design – Saving an ECG … how our application will be used by a healthcare provider and patients to improve outcomes

•  Both waveform and order / result (with proper 12 lead ECG billing code) is seamlessly saved to EHR

Usability and Design – Over-Reading ECG … how our application will be used by a healthcare provider and patients to improve outcomes

•  Cardiologist measures / interpretations integrated with EHR

Usability and Design – Remote Patient Monitoring

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… how our application will be used by a healthcare provider and patients to improve outcomes

•  Key piece of the puzzle in managing transitions of care to reduce

readmissions

•  System can easily be extended to the patient home

•  Small size of device is ideal for caregivers and patients

•  Client software is delivered via the browser; typically installs with only a

single click after entering an authentication code

•  Authentication based on patient preferences – typically email address and

assigned password

•  Demographics and patient picture are automatically obtained via UAI

•  At upload time, ECG can optionally be saved directly to EHR

* mobile client software, including Windows 8, still in active development

Development Stage / Integration Description

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Code is complete and ready for Allscripts testing and approval (Enterprise EHR)

Data Mining / Analytics •  GetSchedule() •  GetPatient() •  GetClinicalSummary() •  GetPatientsByICD9() •  SaveTask() •  GetProviders()

Client Software Interaction – Physician Office and Remote •  GetUserAuthentication() •  GetPatient() •  SearchPatient() •  GetPatientByMRN()

Saving / Over-Reading ECG •  SaveDocumentImage() •  SaveOrderAndResult() •  GetOrderResultSets()

Go to Market Plans

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How will solution be brought to market?

•  The solution will be offered as a stand-alone product or packaged with the Spaulding webECG cloud-based electrocardiography system and integrated with Allscripts EHR

Which Allscripts customer segments will be targeted? •  Clinics, physician offices, and hospitals, both independent and part of larger

integrated delivery networks (IDNs) using Allscripts electronic health records •  Accountable Care Organizations (ACOs) with the objective to improve clinical

outcomes, reduce readmission rates, and improve patient satisfaction

What is the proposed price point for the solution? •  Nominal one-time device fee, $7/ECG (based on volume) •  Access to Risk Calculation and Management: TBD

Video Demonstration

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•  http://www.youtube.com/watch?v=ix49xDIeqok •  Available in 720p HD

Video Overview •  Introduction – framing of the problem and proposition of a solution •  System Setup – simple, browser-based, sites are configured in seconds •  Data Mining and Analytics – modular framework helps providers manage risk •  Client Software Interaction – tightly integrated with EHR •  Saving ECG – seamlessly append ECG to patient record (waveform and result) •  Over-Read ECG – cardiologist collaboration, updates to EHR are automatic •  Remote Patient Monitoring – simple install, extends care, integrated with EHR •  Summary

Why Select this Solution?

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•  Complete cardiac system addresses management of high cost chronic conditions

•  Through data mining / analytics, empowers providers to be proactive about addressing cardiac issues via population health

•  Tightly integrated with the EHR, opportunities for error in data collection and transcription are eliminated

•  Collaborative system allows for seamless cardiologist interaction •  With integrated remote patient monitoring, providers can effectively reduce

30-day readmissions •  Addresses most relevant and costly challenges facing Allscripts’ customers