Academic research

Massachusetts General Hospital performed a prospective observational assessment to compare relay and retention of critical patient information between the outgoing and incoming anaesthesiologist before and after introduction of an electronic handoff checklist. The goal of the checklist, which was implemented via MetaVision, was to prompt discussion and improve communication at the transfer of care. The checklist contained the minimum amount of essential information required at handoff, and access to the checklist was designed to fit into the standard handoff process. The authors found that relay and retention of specific information improved with use of the checklist, with major improvements occurring in the areas of intraoperative medications and fluid balance, and communication. Use of the checklist, which was voluntary, was sustained at nearly 75%, and clinicians felt that quality of communication and identification of perioperative concerns at the end-of-shift handoff were significantly better after the introduction of the checklist. The study found that retention of information was also improved with use of the checklist. The study authors assess that “It is likely that some of the items on the checklist showed significant increase in transfer as a result of being brought forward from other parts of the anesthesia record, a unique benefit of an AIMS-based checklist…With use of the electronic checklist, information for patient weight, airway management, IV access, estimated blood loss, urine output, and antibiotic administration was displayed from previous entries in the record, and several of these items showed statistically significant improvements in information transfer with use of the checklist.” Data on checklist usage were collected from MetaVision.

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A study performed at Hôpital Pitié-Salpétrière in France examined the objectives, conception and expected benefits of electronic medical records (EMR) in the Intensive Care Unit. The study discusses how the right EMR can help address the complexity of managing ICU patients, and focuses on MetaVision as its primary example. Using two studies of patient outcomes based on paper records compared to the MetaVision EMR, the authors point out that while the impact of EMRs on mortality, ICU length of stay and duration of mechanical ventilation varies from study to study, the data suggest that the use of EMRs is advantageous. Due to the difficulty of designing multi-centre randomised controlled studies, the authors recommend retrospective case-control studies with a tight matching between patients as a next step.

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A study conducted at Paul Brousse Hospital in France evaluated the impact of implementing MetaVision upon standard ICU patient outcomes, and found a 20% reduction in length of stay. MetaVision was customised in order to trace the model followed before implementation by creating screens for various clinical, biological and radiological parameters, and for guidelines, procedures and policies such as blood glucose control, enteral and parenteral feeding, insulin infusion rate, and antibiotics administration. According to the study, “We believe that the clinically relevant differences concerning the length of stay in our ICU resulted from an improved quality of care following the implementation of ICIS [sic].”

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With the goal of making residents more involved with meeting their educational needs, Massachusetts General Hospital developed a program where residents choose their preferred OR case assignments. The system creates resident profiles, based on MetaVision records and Accreditation Council for Graduate Medical Education (ACGME) case logs, to facilitate attending review of case experience. MGH also developed an ACGME case-log visualisation tool in order to easily compare each resident’s experience to both case minimums and peer group averages. The study found that these decision support systems successfully distributed responsibility between residents and attending for creating appropriate assignments.

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Massachusetts General Hospital performed a study which developed and internally validated an intraoperative predictive model for unplanned postoperative ICU use based on MetaVision data. The authors conclude, “Our study has demonstrated that it is feasible to use near real-time AIMS data to reliably identify patients who may require postoperative ICU care from those who do not.”

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A study done by The Johns Hopkins Hospital concludes that data provided by MetaVision can help optimise blood management, and has the potential to “enhance patient safety, reduce costs, and conserve blood, a valuable and scarce resource.” An analysis of data acquired by MetaVision revealed significant variation in blood usage among surgical services and surgical procedures, and among individual anaesthesiologists and surgeons. This data may be used for standardising transfusion practices and as the basis of a quality improvement program. Additionally, these findings can be used to predict intraoperative requirements, preventing the costly mistake of ordering more blood products than necessary.

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Macquarie University Hospital conducted an online survey examining how the ICU nurses feel about MetaVision, and the results were overwhelmingly positive. Specifically, the nurses’ perception is that the system enhances time management, increases time with patients as a result of less time spent charting, and reduces medication errors.

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A study at Barnes-Jewish Hospital examined the value of AIMS for facilitating handoffs between anaesthesiologists providers. The hospital embedded an intraoperative anaesthesia provider handoff checklist into MetaVision, which displays minute to minute information regarding the patient’s status. This integrated checklist provides accurate and comprehensive patient data and improves communication, satisfying the Joint Commission’s requirements for standardised handoff procedures.

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A study done by Paul Brousse Hospital in France shows that using MetaVision in their ICU cut clinician coding time in half, reduced billing errors by 72% and increased charge capture by nearly $300,000 per annum. The study evaluated the effects of using an Intensive Care Information System (ICIS) on the incidence of coding errors and its impact on the ICU budget allocated versus manual coding.

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