THE PREOPERATIVE CONTINUUM OF CAREA CLOUD-BASED SOLUTION

THAT SPANS SUBSPECIALTIES

Ira H. Kirschenbaum, MDSridhar Chilimuri, MD

Gabriela Allen, MDEva Kitlen

Gabriela de Campos QuierosNatasha Richmond

Noshin NushatGabirla Batista

Anesthesia, and it’s concerns run preoperative assessments

Centralized data?

Everyone involved?

WHAT WE DID…

• Isolated key data points of specific interest to all parties in the preop process• Programmed tables on low code, open API, cloud system• Interviewed key stakeholders to assess views they would need to see• Integrated Anesthesia, Surgeon, and Pre-op Internist in the patient’s interests• Developed data entry plan• Extended database to mobile environment

Low-code, open API databases allow point-of-care development of IT solutions by caretakers with the ability to make rapid, real-time

changes and customize to each party involved.

2017

Surgery Indicated

CoM Screen (+) CoM Screen (-)

Labs

Pre-Op ClinicInternal Medicine

Issues No Issues

Fix Issues

CancelMove Ahead with

Issues

Labs

Pre-Op ClinicInternal Medicine

No Issues Issues

Fix Issues

CancelMove Ahead with

Issues

Anesthesia Review

20-30D5D

Surgeon Issues

YOUR PREOPERATIVE JOURNEY PLACES THE PATIENT ON A SHIP WITH THE PRE-OP INTERNIST, SURGEON, AND

ANESTHESIOLOGIST. THERE ARE NO PCP’S AROUND TO HELP-DECISIONS NEED TO BE MADE RAPIDLY, ALMOST REAL-TIME.

VISIBILITY TO KEY INFORMATION FOR ALL

PARTIES IS THE KEY!

• 3 DISCIPLINES• CLOUD VISIBILITY• DATASET

• DEFINE DATASET- LITERATURE• PROGRAM DATABASE• RECRUIT TEAM

• PRE-OPERTATIVE INTERNIST• ORTHOPAEDIC SURGEON• ANESTHESIOLOGIST

• CASE INDICATED, PAT 20-30 D• PAT OWNS PATIENT- OPTIMIZE• ANESTHESIA REVIEWS

• CASE COMPLETED• NO COMPLICATIONS• HIGH PATIENT SATISFACTION

POPUATE THE FIELDS BASED ON EVIDENCE DATASETS. PRODUCE MULITPLE VIEWS. PRODUCE MULTIPLE FORMS. ALLOW FOR WEBMERGE OUTPUT. LAPTOP OR MOBILE.

Key Barriers-BMI-A1C-CD4-Dental-UtoxMetalSteroidsGeneral health

Safety for the entire perioperative process

ICU RecsCardiac Recs

Tasked with F/U and completion

Bringing it all home!

Safety for Anesthesia

ASA Level

Fluids perioperatively

Intraoperative safety

• PATIENT- FOCUSED• 3-PRONG COLLBORATION

INTERNIST (PCP PROXY)SURGEONANESTHESIOLOGIST

• VISIBILITY• CLOUD-BASED

COMPUTERMOBILEPRINT

• EVIDENCE-BASED DATASET• OPEN ACCESS, LOW CODE DATABASE

TRACKVIAALWAYS MODIFIABLECONNECTIVITY