Dynamic PracticeGuidance Module DPG

Dynamic PracticeGuidance Module (DPG)

Regulatory mandates such as Core Measures and SCIP are increasing, placing significant tracking, trending and reporting obligations upon the US health care system as it strives to improve clinical performance, consistency and outcomes. At the same time, the market is rapidly moving to a pay-for-performance model, with the ability to automate the real time monitoring of clinical guidelines and best practices becoming an operational necessity. Health care managers are finding that retrospective analysis of hospital practices is no longer clinically appropriate nor financially sufficient in today's demanding environment. We do not want to simply learn from our mistakes-we need to prevent them from occurring at all.

The Dynamic PracticeGuidance Module (DPG) is an automated, real time monitoring and alerting solution that supports patient care compliance based upon your hospital's clinical best practices and established guidelines, such as Core Measures. DPG sends real time warnings, then alerts, to the clinical staff. Since this like all our other rule engines functions only on an exception basis, warnings and alerts only persist when the hospital's clinical guidelines are not being met. Thus, the system provides valuable time for corrective actions, if indicated, to be taken before the warning turns into an alert However, the DPG is also sensitive to the time constraints of the clinicians and enables alerting sensitivity to be adjusted rule by rule down to the level of the individual patient's needs, ensuring that the right information is received when it is required for the clinician to intervene.

The same features that give the Dynamic PharmacoVigilance® Module (DPV) its flexibility, clarity and ease of use are embedded in DPG. The core component of DPG is a real time rule engine that is activated by a wide range of clinical data inputs. A DPG rule is a set of clinical parameters. Each rule has an initiating event, and looks for a solution event to occur within a time frame, specified by the customer, embedded within each rule. Numerous other filters may be added to the rule to add additional specificity and depth. A simple example of this is a blood culture received with sensitivity data, with the solution to place the patient on an appropriate, cost-effective antibiotic within a specific time frame. The guidance built into the rule creates first a warning then followed if the time for action has expired by an alert via electronic notification and, as with all of the VigiLanz solutions, the ability to monitor and receive warnings and alerts on your mobile devices such as iPads.. The DPG rules are engineered to be defined and tailored to meet the specific needs of each hospital and its clinicians.

Key Features of DPG

• Continuous monitoring of a wide range of clinical inputs: drugs, labs (wet and microbiology), vital signs, diagnoses, procedures, EKG, cardiology, radiology, documentation, etc. Effectively, any and all data that can be accessed electronically directly, through your EMR or via your enterprise data warehouse, such as the Oracle Healthcare Enterprise Healthcare Analytics® system
• DPG operates out of the VigiLanz Data Center, continuously monitoring 24/7 for clinical events. There is no operational overhead nor performance impact on your existing HIT systems.
• DPG operates out of the VigiLanz Data Center, continuously monitoring 24/7 for clinical events. There is no operational overhead nor performance impact on your existing HIT systems.
• All inputs come from the hospital's current clinical systems via a one way feed, so there is no required manual data entry. In addition, the rules themselves are designed, built and maintained by the clinicians who will be using them, not IT. This minimizes the time demand on IT and provides greater flexibility for the hospital's clinical and administrative staff.
• Alerting on exceptions to clinical guidelines is based upon optimal, evidence-based practice norms. A library of rules built by clinicians is provided 'out of the box' along with the ability to build your own unique rules specific to your own needs
• A unique Good Medical Practice interval, unique to each rule, enables you to set the time for the correct action (the 'solution event') specified within the rule. This gives clinicians the time to deliver appropriate medical care within their normal workflow. Once that care is delivered the rule activation is marked as averted and disappears from the clinical workflow. This patented feature was specifically designed to address the Achilles heel of most notification systems: over alerting and subsequent alert fatigue, and yields an industry high percentage of actionable alerts.
• Ability to quickly build sets of clinical rules with filters that adjust for variations in patient and hospital parameters such as age, gender, and weight, down to the level of the individual physician and unit.
• DPG assigns a low, medium or high priority to each alert that is issued based upon the criticality of the situation. This can be used for reporting purposes, as well as to determine the optimal method of notification (pager, email, iPad, PDA, etc.). Guidelines are easily tailored by the clinician, risk manager or patient safety director to the specific best practices of the individual hospital.
• Appropriate labs and their time intervals can be recommended based upon a medication order.
• Conversely, a lab result can trigger a recommendation of a specific medication order.
• IV to PO: Based on clinical inputs from the patient record such as meals being ordered, discontinuation of TPN, or the administration of other oral medications, the optimal time to migrate the patient from IV to PO can be recommended.
• Clinical inputs, such as vital signs, EKG, invasive cardiac monitoring, etc. can result in specific recommendations. For example, post-operatively, a low body temperature might trigger a recommendation to the nursing staff to take the appropriate steps to raise body temperature (additional blankets, raise room temperature, etc.).
• An essential tool in Disease Management: Diagnosis Codes (ICD-9) can be activating events. For example, a rule might require that patients older than 60 years of age who are admitted to the hospital with a diagnosis of community acquired pneumonia(CAP) be administered some form of antibiotics within a Good Medical Practice interval of eight hours and that a blood culture be taken before medication administration.
• Procedure Codes (CPTs) can be activating events. For example, a rule might require that all patients that have suffered a myocardial infarction, before being discharged from the hospital, be prescribed a beta blocker, if not contraindicated

Download DPG Brochure