“Bringing Clinical Practice Guidelines to the Point of Care”

1. “Bringing Clinical Practice Guidelines to the Point of Care”

2. Health Solutions International, LLC Health Solutions International, LLC (HSI) is a software development company and designer/owner of Physician Empowerment Technology (PET). The management team of HSI owned and operated CAPP CARE in the early 1980s. In 2000, CAPP CARE merged with Beech Street Corporation to become the largest managed care organization in the USA. After the merger and sale of CAPP CARE, the management team incorporated HSI to exclusively focus on the development of Internet based technology solutions for improving the delivery and quality of healthcare. Since 2003, HSI has dedicated its financial resources to the development of software to automate Clinical Practice Guidelines (CPGs) in order to provide health care professionals with acknowledged “best practices” at the point of care.

3. Physician Empowerment Technology (PET) PET is a software application designed to automate approved and published Clinical Practice Guidelines (CPGs). The automated CPGs are accessible via an interface to any Electronic Health Record (EHR) application. The medical outcomes data gathered using PET is stored as aggregated data for query and creation of reports to meet Meaningful Use (i.e. Clinical Quality Measures) and other medical outcomes research for private and public initiatives.

4. What has HSI accomplished with PET to date? PET is now a completely operational application. As a result, PET has now automated 8 of Veterans Affairs 23 approved and published CPGs as follows. Asthma Chronic Kidney Disease (management) Chronic Kidney Disease (screening) Dyslipidemia Heart Failure Major Depressive Disorder Pregnancy Tobacco Use

5. What has HSI accomplished with PET to date? (continued) PET has also automated 28 of the 38 Clinical Quality Measures required by HHS for Meaningful Use by 2013. PET has automated 160 of the most common diagnoses approved and published CPGs with the goal of automating all 518 approved and published CPRs. Finally, PET is in the process of interfacing with several EHR vendors.

6. Linkage to CRPS CPRS PET Patient ID Physician ID Assumes VA/DoD are hosts. If Cloud, then CPRS transmit prescription data to PET for outcomes research, MU

7. ATTRIBUTES OF PET Standardization of care All physician members of a group provide best quality care through the use of peer reviewed andupdated clinical practice guidelines.

8. ATTRIBUTES OF PET Proscriptive v Prescriptive Well authored CPGs allow the user to deviate from a CPG recommendation by providing an option for deviation. In this way, outcomes measurement can then determine the better way of treatment/diagnoses, thus facilitating the advancement of medical knowledge.

9. ATTRIBUTES OF PET Convenience of use By interfacing PET to an eHR, CPGs are readily accessible during the time of greatest need – during the patient encounter – the appropriate information at the appropriate time.

10. ATTRIBUTES OF PET Reduction of documentation time Although CPGs contain several hundred pages, through the use of branching logic, the longest CPG is navigated in a few minutes.

11. ATTRIBUTES OF PET Bookmarking Through the bookmarking option, the user can exit a CPG at any point to obtain recommended laboratory tests, or return to the CPG at the exit screen at the return visit. PET will reopen at the exited screen to allow for results to be entered, branching logic to direct the navigation to the appropriate pathway.

12. ATTRIBUTES OF PET Continuing Medical Education By automating the CPG, PET provides the physician with a comprehensive assessment of the diagnosis with references and footnotes therefore effectively and efficiently increasing the physician’s medical knowledge.

13. ATTRIBUTES OF PET Referral request Indications for referral are part of the branching logic. Should the CPG logic recommend a referral, the required form with indication(s) is presented to the user.

14. ATTRIBUTES OF PET Facilitating electronic transfer of patient info A summary of the physician’s navigation through PET, can be electronically sent to other participants in the patient’s care.

15. ATTRIBUTES OF PET Confidentiality Complete confidentiality is maintained. Patient identification data is never transmitted unless encryption is utilized on both ends.

16. ATTRIBUTES OF PET Liability Medical malpractice is defined as care below community standards. CPGs represent community standards. Users of CPGs can avoid allegations of medical malpractice.

17. ATTRIBUTES OF PET Source, Authors, References PET allows the user to obtain a high comfort level regarding the recommendations contained in the CPGs as the source, authors, and references are clearly shown.

18. ATTRIBUTES OF PET Meaningful use/Outcomes Research Every option in a CPG is recorded in machine readable format, allowing for unlimited queries regarding out- comes, comparison of outcomes with other users, entities, or similar compositions.

19. Outcomes Research – Sample flow chart ATTRIBUTES OF PET Graphic visualization of pathway As the user navigates through the selected CPG, the ability to view the pathway one has taken or view the pathway to be followed is graphically displayed through the chart module, part of PET.

20. AHRQ Lab Drug Side Effects CPG Developers Pre-certification criteria Radiology Hospital Electronic Medical Record Clinical Practice Guidelines Outcomes Research Researchers Healthcare Mgmt Co. Referral Criteria Prescription Writer Pharmaceutical Industry Allied Health Drug Interactions Links C1995 EMR PET Patent Pending