THE 2023 INNOVATOR AWARDS PROGRAM


needed for coaching and guidance on com- plex exams. They have provided coaching and training over 414 times since launching Virtual MRI. The Virtual MRI technologist can pilot up to three scanners at once and can cover call-outs and staffing gaps in the event of an emergency reducing the need for overtime. Plans are in the works for geographic


expansion across Central Florida. The current concept is limited to Siemens MRI scanners, but the future state will open all vendor scanners for virtual scanning. AdventHealth also plans to develop a virtual staffing concept for CT that allows for quicker table turnover without sacrificing quality.


Kaiser Permanente’s Risk Quantification Program Risk quantification is an evolution in risk management that characterizes risks in terms of probability and dollars of loss expectancy. Optimizing technology and cyber risk management in healthcare is a paramount concern because of the potential for spend to divert funds from patient care priorities such as care quality and access. Decision makers need to know how much technology risk Kaiser Permanente is car- rying and if investments are effective in reducing risk in the face of uncertainty. Legacy qualitative risk evaluation


methods (e.g., rating risk as “medium” or “very high”) are unable to provide objec- tive results. Quantitative risk evaluation addresses the problem, but it requires highly specialized capabilities that are not broadly available in industry. To deploy and scale quantitative risk


evaluation capabilities, Kaiser Permanente invested in a broad program using the FAIR standard in a centralized enterprise service model to supply quantified risk results to decision makers. This provides validated, standardized results that are coherent across the enterprise. Since inception, decision makers at Kaiser Permanente have access to templated risk models, using the results to facilitate decision making across various functions, including: • Information Technology – incremental risk of new technology deployment • Cyber Security – cyber insurance coverage, prioritization of cyber security projects • Compliance – control prioritization, prioritization of audit remediation • Business Operations – power resiliency investment, supply chain management


(including Personal Protective Equipment supply and location) With Michael Ruehmkorff, vice presi-


dent of technology risk management, serving as project lead, his organization has engaged with outside departments to apply quantification in decision support. As implemented, the model allows


Kaiser to scale adoption of risk quantifica- tion for business decision making in the form of a service model based on FAIR. Thus far, this approach has brought over $20 million in value to the organization attributed to quantified calculations opti- mizing risk-based decisions.


Mayo Clinic’s Automated Chemotherapy Dose Rounding Rules Mayo Clinic has worked to decrease cancer drug cost and waste through the implementation of automated chemother- apy dose rounding rules in the electronic health record system. Cancer medicine spend has reached


$185 billion worldwide, including the spending of $75 billion just in the United States. In 2021 alone, there were 30 oncol- ogy novel active substances brought into the market. Many of these are packaged in single-dose vials (SDVs) and have a cost of greater than $100,000 annually. Traditionally, the doses for cancer drugs are calculated based on patient’s weight or body surface area (BSA) resulting in a partial vial with drug left over. Since these drugs are packaged as SDVs, and due to regulatory constraints, it creates a system that leads to waste and increases financial burden. According to the find- ings by Peter Bach, the proportion of waste varies from 1 percent to 33 percent. There is a mismatch between the required doses and the doses available based on the SDV. The cost of wasted drug is usually passed on to patients and payers. These rising and unnecessary costs pose a risk of “financial toxicity” for cancer patients. It is clear that more measures need to be taken by hospitals to reduce the waste and burden on our healthcare system. To counter this issue, a team at Mayo


Clinic implemented a system of auto- mated dose rounding rules in their EHR. This system specifically aims to prevent waste and reduce cost by not opening another SDV when the dose is close to the vial size. Dose rounding is an approach where the weight-based or BSA-based dose is rounded to the nearest SDV size to minimize waste. At Mayo Clinic, this


22 hcinnovationgroup.com | MARCH/APRIL 2023


system was implemented to round the calculated dose to the nearest SDV size if the vial size is within 10 percent of the original calculated dose. Rounding of doses to the nearest 10 percent of the SDV is supported by a position state- ment from the Hematology/Oncology Pharmacy Association. To implement


this system, Mayo


Clinic created a workgroup of phar- macists, pharmacist technicians, and pharmacy leaders. This workgroup was tasked with creating a list of all inject- able cancer drugs and develop a set of rounding rules. The rounding rules were approved by multiple committees that included oncology providers, finance, nursing, and pharmacy across all sites. The final step was an approval by the Pharmacy and Therapeutics Committee. Following the implementation, Mayo Clinic collected data for doses adminis- tered in both the inpatient and outpatient settings during the first six months of 2019. In six months, this implementation generated a total cost savings of over $7 million and saved a total of 9,814 SDVs from being wasted.


Northwell Health Physician Partners’ EHR Optimization New York-based Northwell Health Physician Partners (NHPP) had received physician feedback that revealed ongoing dissatisfaction with ease and efficiency within the Ambulatory Electronic Health Record (AEHR). In response, a multidisciplinary


collaborative launched in 2021 and engaged a third-party consultant, EHR Concepts, to perform an AEHR learning needs assessment. They conducted 1:1 interviews and practice site interviews, held service-line focus groups, captured feedback through surveys, and end-user forums. They engaged over 600 end- users to provide the collaborative with recommendations on creating an action plan to improve training, optimization, and stakeholder engagement. To help physicians best navigate the


AEHR, a campaign called “Home for Dinner” launched, offering new train- ing and proficiency services. This goal of Home for Dinner is to offer a person- alized learning and support experience designed to help physicians best navigate the AEHR by delivering personalized services, tools, and training to get more time back for their patients, their families and themselves.


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