Academic research

Mechanical ventilation is often essential for patient care in the ICU, but can be associated with serious complications. Ventilator-associated lung injury is related to increased mortality and morbidity and should be prevented by applying lower tidal volumes (V_T). Academic Medical Center in the Netherlands developed and implemented an active computerised decision support system (CDSS) using MetaVision that worked in two different ways: a consulting style that always shows the preferred V_T, and in a critiquing style that shows the preferred V_T only if V_T is above the desired threshold. The hospital performed a prospective, off-on-off-on study to measure the effect of an active CDSS for these two communication styles, consulting and critiquing, on adherence to V_T recommendations. The study found that the use of a CDSS in both communication styles improved the use of lower V_Ts for ventilated patients. When decision support was not sustained, adherence to low V_T fell back to its original value. The consulting style was found to be slightly more effective than the critiquing style, which the study authors postulate may stem from the high frequency of showing reminders in this style and the relatively simple underlying guideline whereby display of the reminder prompts the clinician to check the V_T and adjust it if required.

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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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In order to comply with new Joint Commission physician credentialing and privileging standards, Massachusetts General Hospital in Boston created an evaluation system based on electronic anaesthesia data automatically captured by the MetaVision AIMS (Anaesthesia Information Management System). MetaVision provided “reliable and extensive documentation of clinical monitoring and physician practice patterns” which was used to assess clinical performance.

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A study done at Sheffield Teaching Hospitals National Health Service Foundation Trust (STH), UK, found that using MetaVision, critical care pharmacists made a significant number of medication recommendations, and these recommendations had a high acceptance rate (>90%) by medical staff. According to the study, “This system improves communication between both professional groups within the critical care team, and supports clinical practice including remote review of patients over multiple sites.”

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A study done at Hadassah-Hebrew University Medical Center in Israel found that using context-sensitive mandatory fields in MetaVision was associated with high record completeness rate and data concordance, enabling complete anaesthesia records for 99.6% cases. Implementation of MetaVision was deemed successful by 98% of the anaesthesiologists, who found using MetaVision to be more comfortable than paper-based records. MetaVision’s usability was rated as high, and the forms’ design as comfortable.

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Clinicians at the University Hospital of Lausanne (CHUV) report that MetaVision improves patient safety and treatment accuracy and has a significant impact on their daily workload. Using MetaVision, CHUV was able to reduce malnutrition, minimise ICU patient weight loss, and identify potentially dangerous conditions in newborns. MetaVision shortened the time required for computations and clerical reporting by 30 minutes per shift, enabling clinicians to spend more time on patient care.

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Research published in Anesthesia and Analgesia shows that MetaVision decision support tools increased compliance with SCIP indicators and improved outcomes at Lehigh Valley Health Network (Allentown, PA). After implementation, compliance with documentation and administration of antibiotics within 60 minutes of surgical incision increased from 62% to 92%, and was associated with a decrease in the incidence of SSI from 1.1% to 0.7%.

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Massachusetts General Hospital customised the MetaVision Anaesthesia Information Management System (AIMS) to ensure that anaesthesia providers complete a separate quality assurance data collection program. As a result, the hospital increased their ability to capture adverse events by 92%.

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A study from Anesthesiology Clinics reviews the impact of AIMS with decision support at various hospitals, including a clinical improvement at Massachusetts General Hospital using MetaVision.

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