Large Hospital Study
IllumiCare®, in partnership with the Texas Hospital Association, provided a large, academic hospital with the THA Smart Ribbon®. It is an EMR-agnostic “ribbon of information” that displays patient-specific, real-time hospital wholesale costs of medications, costs of labs and imaging as well as iatrogenic risks concurrent with the electronic medical record (Epic Systems, Madison, WI). The hospital engaged in a rigorous pilot study to compare physicians who used the THA Smart Ribbon against their historical behavior and then versus non-user physicians at the same hospital as a control group at go-live. While using the THA Smart Ribbon, just 55 pilot cohort providers in 71 days produced savings of $430,444 (Medication: $304,274, Laboratory: $67,901, Radiology: $58,269).
A group of 55 hospitalists and internal medicine physicians were randomly selected and provided access to the THA Smart Ribbon to form a pilot cohort. The pilot cohort provided care to 5,186 patients. Over the same time frame, other physicians in the same subspecialty were not given access to the THA Smart Ribbon, and thus comprised the control group.
There was intentionally no in-person training provided; only a brief 4:40 video was sent to the pilot cohort for self-paced instruction. Only 4 of the 55 providers reported watching the training video.
All orders for medications, labs and radiology were attributed to the ordering provider. In the case of medication orders that spanned multiple days, the total cost for the duration of the therapy was attributed back to the provider who wrote the medication order.
Medication costs were based on actual inpatient wholesale acquisition cost. For each medication order, the THA Smart Ribbon determined, in real-time, the actual cost to supply that amount of medication to the patient based on the dose/route/frequency/duration of the order. For labs and radiology, Medicare allowable costs were used as a proxy for actual costs. These costs were vetted and considered accurate estimates of true costs for these orders by the institution.
THA Smart Ribbon users both reduced their average spend per patient and also reduced the variance among providers. During the same period, the same type of providers in the same hospital without the THA Smart Ribbon had no change. [See Figures 2 and 3.]
“This is one of the better projects I have been a part of as far as actually capturing ROI, measured in an incredibly rigorous manner. A tool like this will be very helpful as we train the next generation of providers.”CHIEF MEDICAL INFORMATION OFFICER