From Data to Decision One Patient at a Time

Many data-driven solutions are able to identify patient populations and treatment modalities with the greatest variability and financial impact. Missing, however, is a practical means to assess and stratify risk for an individual patient — in real time at the point of care.

ePRISM® from Health Outcomes Sciences is uniquely positioned to fill this void, providing fully automated access to predictive models wherever and whenever clinical decisions are most critical.

Using validated, evidence-based outcome determinants, ePRISM® is a powerful force for personalized precision medicine, directly influencing the clinical transformation organizations desire in this new era of value-based care.

ePRISM® is specialty agnostic and scalable across an enterprise, to any number of sites, departments, computing devices and users.

Facilitating the Intersection of Research and Practice

Myriad scientific models have been developed by researchers around the world, but existing enterprise solutions for EHR, population health, business intelligence, EDW and analytics are not structured to deploy them. ePRISM® is unique in its ability to translate scientific models into automated evidence-based decision support tools that are both actionable and predictive.

ePRISM® for Cardiac Medicine

Harold has been diagnosed with coronary artery disease and his cardiologist is proposing an angioplasty procedure. Although the procedure is performed on more than a million patients nationwide every year, it is not without risk.

With ePRISM®, Harold’s cardiologist has access to real-time automated calculations that reflect Harold’s individualized risk of bleeding, acute kidney injury, mortality, restenosis and unplanned readmission within 30 days. All of these adverse events are associated with poor outcomes, higher-than-average costs and potential reimbursement penalties, and all are preventable.   

The calculations rendered by ePRISM® are unique to Harold, based on a specific, pre-defined set of validated patient determinants. They are garnered from predictive models authored by the American College of Cardiology through its NCDR programs, and licensed exclusively to Health Outcomes Sciences. Access to this data peri-procedure allows Harold’s cardiologist to mitigate the probability of these adverse events and avoid unnecessary costs through better, more informed decisions, such as:

  • bivalirudin or heparin
  • inpatient or outpatient
  • bare metal stent or drug-eluting stent
  • use of a closure device
  • level of contrast
  • radial or femoral entry
  • optimal sheath size
  • hydration therapy
  • procedure staging
  • postponement of non-cardiac therapies

Additionally, Harold is able to participate in a meaningful process of shared decision-making through review of a specially-constructed, personalized consent form generated by ePRISM®. Graphically rich, written at an 8th-grade reading level and void of legalese, the consent form is proven to foster a deeper understanding of the procedure and its risks while enhancing overall patient satisfaction and peace of mind.

With ePRISM®, Harold’s cardiologist is also able to determine whether the angioplasty procedure is classified as ‘appropriate,’ ‘may be appropriate’ or ‘rarely appropriate’ according to criteria published and sanctioned by the American College of Cardiology Foundation in collaboration with seven other medical associations.

It’s The New [Computable] Vital Sign!

ePRISM® for Emergency Medicine

Dorothy is taken by ambulance to the local community hospital near her residence. Based on signs, symptoms and the results of a brain CT scan, the emergency medicine physician determines that Dorothy is having an acute ischemic stroke. He must decide whether to administer a drug referred to as tissue plasminogen activator, or tPA.

The drug is potentially life-saving, but for some patients, there is substantially increased risk of death or disability. With ePRISM®, the emergency medicine physician has access to Dorothy’s individualized probability of a good outcome or bad outcome, both with and without tPA.   

As each minute passes from Dorothy’s time of arrival, ePRISM® displays to the emergency medicine physician the real-time percent probability of mRS 0-2 (no symptoms or slight disability) and mRS 5-6 (severe disability or death) at 90 days. The calculations rendered by ePRISM® are unique to Dorothy, based on a specific, pre-defined set of validated patient determinants.

To receive care from a neurosciences team with stroke expertise, Dorothy needs to be transferred to a Comprehensive Stroke Center 40 miles away. However, her chances of survival and recovery are dependent in large part on the actions of the emergency medicine physician, who in this instance has been granted access to the ePRISM® solution through an outreach program run by the Comprehensive Stroke Center.

Supported by ePRISM®, the emergency medicine physician is better equipped to confidently decide whether to administer tPA. The calculations are garnered from a predictive model developed by Tufts University in collaboration with Saint Luke’s Marion Bloch Neuroscience Institute. The model is consistent with guidelines published by the American Heart Association/American Stroke Association for primary prevention of stroke, and it directly addresses the 2015 policy authored by the American College of Emergency Physicians and American Academy of Neurology on use of tPA for management of acute ischemic stroke in the emergency department.

Barnes Jewish Hospital Dramatically Improves Outcomes with ePRISM®

ePRISM® is Specialty Agnostic and Scalable Across a Healthcare Enterprise

Using ePRISM® has helped us improve the safety and quality of care for our cardiac patients undergoing PCI, and it has also helped lower costs. Knowing a patient’s risk in advance means clinicians are in a much better position to make decisions that will produce good outcomes, like choosing the right bleeding avoidance strategies.

Jeptha Curtis, MD

Yale-New Haven Hospital | New Haven, Connecticut

Personalized precision medicine is the future of healthcare. Physician intuition is important, but a technology platform like ePRISM® can help hospitals reduce variability in care. The fact is, all physicians overtreat and undertreat, no matter how much experience they have. Automated predictive modeling provides insights physicians cannot compute on their own.

Charles Bethea, MD, CMO

Integris Health | Oklahoma City, Oklahoma

ePRISM® helped us reduce our incidence of PCI-related acute kidney injury by more than 70%. We could not have achieved such extraordinary results without it. We have fully operationalized the use of these predictive tools, and we do not proceed with a PCI without first considering a patient’s individualized risk.

Amit Amin, MD, MSc

Barnes Jewish Hospital  |  St. Louis, Missouri