The Impact of Real-Time Decision Support
Jeff Dunn DO
During high-stress health care events, providers of all levels (doctors, nurses, and paramedics) need to navigate the steps of evidence-based care and make the right decisions under pressure. When every second counts, having instant access to step-by-step decision support helps providers deliver the best care possible.
A point-of-care solution for medical providers
Redivus Health developed a cloud-based, software application that provides clinical guidance for providers during high-mortality emergent events like cardiac arrest, stroke, and sepsis. Redivus was piloted by five Kansas hospitals in 2017,and has expanded to 14 facilities with about 500 end users.
“The software is like a GPS for time-critical medical events, providing turn-by-turn guidance and time-stamped documentation of each step,” explains Jeff Dunn, D.O., Redivus Health founder and CEO. “Redivus helps providers make critical decisions quickly and accurately while providing digital documentation.”
Redivus is the newest tool used by the Kansas Heart and Stroke Collaborative and The University of Kansas Health System to improve health care throughout the state of Kansas. The Kansas Heart and Stroke Collaborative is a grant-funded program of The University of Kansas Health System that aims to bring systemic change to heart disease and stroke care in rural populations while reducing the total cost of care.
Multiple uses for Kansas hospitals
Health care providers across Kansas are using Redivus in a variety of ways. “We have 26 critical access hospitals in our rural health network,” says Brian Pfannenstiel, Director of Critical Care at HaysMed, part of The University of Kansas Health System. “With the application, they can transfer a patient directly into our care with all of the documentation. Additionally, providers can share 12-lead EKGs via the app, which speeds up the process significantly.”
Sheridan County Hospital has had measurable success identifying and treating patients with sepsis. “Having real-time decision support is key when you’re dealing with sepsis. Before we were using Redivus, we identified three sepsis patients in one year. After implementing Redivus and adding it to our protocols, we diagnosed and treated three sepsis patients in just a few months. Now we’re better equipped to identify sepsis and treat patients quickly instead of transferring them to another facility,” explains Hannah Schoendaler, Chief Nursing Officer at Sheridan County Hospital.
“It’s common for someone to have to travel for an hour to get to our hospital,” she adds. “Redivus helps us identify symptoms quicker so we can treat sooner and get people back home.”
“What’s unique about Redivus is that it can used by providers with a variety of clinical skill levels, from physicians and nurses to techs, and it’s used not only in the moment, but also to help with training for some of these events. Some rural locations might not see a large volume of acute events on a regular basis and walking through the steps in Redivus can make staff members more comfortable,” says Chris Wilson, Executive Director for Innovation at The University of Kansas Health System.
Schoendaler agrees that the extra support helps her team. “There are so many emotions that go along with responding and treating someone who has a time-sensitive diagnosis,” she notes. “Any opportunity we have to peel back those emotions of anxiety or uncertainty and deliver the care in a prompt manner is helpful for our team. Redivus has helped with alleviating anxiety and frustration so we’re confident in giving the diagnosis.”
Dunn is also pleased to see Redivus being used extensively for training purposes. “This is a hidden insight that we didn’t necessarily expect — people are using our solution to run through mock scenarios in the mobile platform,” he says.
The value for rural hospitals is increased when it’s used for education. For hospitals in need of training and those that don’t have sim labs, Redivus can augment training. For example, providers can run through a code blue scenario or the stroke or sepsis module. “We’re rolling Redivus into our advanced cardiovascular life support (ACLS) courses that are available through HaysMed,” Pfannenstiel adds.
Solving problems in rural health
Diagnosis and treatment for these medical events can be complex, particularly for rural clinicians who see lower volumes of patients with cardiac arrest, stroke, and sepsis. Through use of Redivus and other efforts, the Kansas Heart and Stroke Collaborative is striving for progress in the following areas:
1. Increase sepsis identification and bundle compliance.
2. Improve stroke diagnosis and help increase the treatment compliance for tPA-eligible candidates.
3. Increase return of spontaneous circulation (ROSC) of cardiac arrest patients through close adherence to the American Heart Association guidelines.
Improving standards of care and compliance is an enormous opportunity for critical access hospitals. Rural patients and communities can benefit from lower mortality rates and improved outcomes, and continue receiving care close to home versus traveling to a larger facility away from home and their support system. Providers benefit by having more confidence to diagnose and treat patients, and the organizations benefit financially through proper diagnoses and reimbursements.
“Rural health care needs a solution that is intuitive and helps guide the clinician through time-sensitive guidelines. There is also a need to facilitate communication between facilities, and Redivus enables that. We selected Redivus as an application to meet our goal of improving patient care across the continuum,” says Terry Siek, Vice President of Patient Care and Chief Nursing Officer at HaysMed, part of The University of Kansas Health System.
Redivus is quick and easy to set up and start making an impact the same day. Having this tool available helps raise the level of care whether in an urban or rural setting. “We are dedicated to helping advance digital health and get digital tools into the hands of rural clinicians,” Wilson says.
Ultimately, the increased use of technology and adoption of Redivus at various health facilities in Kansas helps build a stronger network of rural health care with improved care, communication, and documentation across the care collaborative.
“When we use technology to improve patient care and nursing efficiency, it has a positive effect on patient outcomes, the organization, and health care in general. Redivus ensures the patient receives the same quality of care for Kansans wherever they go for health care,” says Pfannenstiel.
Redivus is available for smartphones and tablets on iOS and Android through a subscription model. For more information, visit Redivus.com or follow on LinkedIn, Twitter or Facebook.
NRHA commissioned the above piece from Redivus Health, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.