August 24, 2007

CareEngine revs evidence-based decisions

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Jim Jirjis, M.D., M.B.A.

CareEngine revs evidence-based decisions

Through its partnership with ActiveHealth Manage-ment, Vanderbilt's Primary Care clinics have successfully integrated a new clinical decision support technology called CareEngine for faster adherence to evidence-based clinical guidelines.

Since its implementation in March, CareEngine has provided more than 2,000 evidence-based clinical alerts, called “Care Considerations,” to Vanderbilt's clinicians.

Vanderbilt Primary Care credits these alerts with helping to promote more rapid adoption of new evidence-based guidelines, and to better serve the 17,727 employees covered by Vanderbilt University's health plan.

Vanderbilt Adult Primary Care (VAPC) employs more than 150 physicians and residents, and provides primary care services for about 30 percent of Vanderbilt employees and their families.

The CareEngine system works by scanning Vanderbilt members' medical, pharmacy and laboratory claims data, then comparing it against the latest findings in evidence-based clinical literature. ActiveHealth customized CareEngine specifically for Vanderbilt to integrate into its workflow.

“It is impossible to expect doctors to read and memorize every page of every study published in every medical journal,” said Jim Jirjis, M.D., M.B.A., medical director of VAPC.

“This is why ActiveHealth's clinical decision support technology is so helpful. The CareEngine system enables our physicians to have patient-specific information, derived from the latest medical literature, delivered right to them within their practice.”

When a Care Consideration comes in, a team of VUMC nurses compares it with each patient's records to determine if there may be a reason why the Care Consideration would not apply, such as an allergy to a recommended medication.

If there is no obvious reason why a Care Consideration would not apply, nurses communicate the Care Consideration to the treating physician, who then determines whether the recommended treatment is appropriate for the patient.

“Physician feedback to the CareEngine system has been extremely positive,” said Jirjis. “Our physicians have responded to approximately 98.7 percent of ActiveHealth's 786 different Care Considerations.

“Of note, our physicians now prescribe statins for heart health to certain patients who would not have previously received them.

“We credit this new practice to ActiveHealth's Clinical Development Center, which constantly identifies the most pertinent medical information and updates CareEngine to provide us with accurate and timely alerts.

“ActiveHealth's cutting edge technology strengthens our position as a leader and innovator in medical education, research and patient care.”

“Studies show it can take up to 15 years for physicians to learn and adhere to new medical standards,” said Greg Steinberg, M.D., chief medical officer of ActiveHealth.

“Vanderbilt's Primary Care group is a shining example of how an evidence-based clinical alert system, when integrated into the physician's workflow, can be helpful in identifying opportunities to improve care and lead to faster adoption of new evidence-based guidelines.”