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BACKGROUND

Implementation of Electronic Medical Records (EMRs) have overloaded Emergency Department (ED) doctors with data on the patient. There is not always time to review multiple screens of data and/or to sort through multiple past patient encounters to find pertinent information. Mentally collating sequential trends in labs or studies to define chronic conditions is even more difficult.

Pertinent information is often missed. Underreporting of preexisting conditions occurs, which can result in higher than expected mortality rates, longer lengths of stay, greater costs per patient and inaccurate reporting of hospital quality ratings. There is a critical need to implement a technology to automate proper identification and documentation of major complications and/or comorbidities that were present on admission to ensure the proper diagnoses are communicated throughout the continuum of the patient’s care.

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PATIENT INFORMATION

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UNDER REPORTING

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TECHNOLOGY

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AUTOMATION

Enter Stony Brook University Hospital in Long Island. Stony Brook University Hospital needed a solution to quickly combine and search the EMR’s from all of the areas in the hospital (diagnostic imaging, hospital laboratories, etc.), including the information taken in the ED, and present it quickly and efficiently in one, easy to access and use format. The hospital IT group designed a software platform to do just this and Retrieve Dx was established. Retrieve Dx produced a 61% increase in the number of properly diagnosed comorbid conditions. 44% of the comorbid conditions were pre-existing.

What did this mean for Stony Brook?

  • Improved quality of patient care

  • Higher provider satisfaction

  • Higher quality measure scores

  • Increased reimbursements

By the numbers:

  • When judged against standard clinical documentation improvement programs, Retrieve Dx reduced the number of missed diagnoses per case from 4.3 to .03
  • Improved Observed-to-Expected mortality index (O/E): 1.55 in 2012, 1.13 in 2014, 0.80 in 2015
  • Added an average of 1.09 comorbidities per patient thus improving patient care 
  • Reduced average time to document comorbidities from 9 minutes to seconds 
  • Eliminated two Full Time Employee (FTE) Clinical Documentation Specialist positions for a savings of $280,000 per year 
  • Produced $4.2 million in annual cost avoidance
  • Increased CMI by 0.1 resulting in $10 million in additional annual revenue
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RETRIEVE Dx

Why Current Documentation Methods Cost Providers and Hospitals Revenue

While CMS revises the reimbursement payment structure from a fee-for-service to a pay-for-performance model, the risk-standardized mortality rate is heavily assessed to measure the quality of patient care. This measure, along with other quality measures, are the center focus for all healthcare organizations. Without the appropriate and accurate diagnoses documented, the information within the EMR will not reflect the patient’s true severity of illness and predicted risk of mortality leading to a cascading set of effects that will ultimately affecting patient outcomes, decrease revenues and decrease quality ratings for both physicians and the hospital.

Retrieve Medical’s proprietary real-time software called Retrieve Dx, is a decision support application. It brings past and potential diagnoses to the forefront, allowing physicians to provide the highest quality of care from a holistic point of view. Evidence-based results are available to the provider in one location allowing for seamless and uninterrupted documentation of all relevant diagnoses. Data points, both historical and recent, are available for review at the time of initial documentation, decreasing the provider spent on the computer while increasing time available for patient:

  • Lab results
  • Radiology reports
  • EKG reports
  • Echocardiogram reports
  • Other clinical data

Retrieve Dx automatically searches a patient’s EMR throughout the hospital databases in less than 30 seconds, and pulls major complications and possible co-morbid conditions from data fields such as vital signs, laboratory values, medication lists, and radiography reports prior to and during the patient’s admission to the hospital.

The system then sends present diagnoses, complications, and comorbidities to the doctor for a decision about inclusion or exclusion of the admission diagnosis.  The process is easy and remains totally under the control of the admitting physician. This software saves the ED staff considerable time, results in 75% more diagnoses made at the time of admission, increases hospital revenue, reduces hospital liability, results in better outcomes for the patient, and improves hospital and physician reportable ratings.

Retrieve Dx reduces manual processes where:

  • Physicians identify issues and manually enter information into the EMR system. This process is very time consuming and may generate errors of omission 
  • Utilization of standard notes, cut and paste techniques, or previously saved notes increases the risk of missed and/or erroneous diagnoses
  • Patients may not report every illness or symptom in the hospital and/or they may not know the extent of their chronic problems
  • Medical records may not “connect the dots,” leaving pre-existing symptoms undocumented in current documentation which in turn could lead to allegations of hospital negligence

Benefit Realization

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  • Improved recognition of comorbidities and severity of illnesses
  • Decrease in readmission rates
  • Increase in CMI
  • Increased CDI
  • Increases in quality of care
  • Promotion of effective communication and care coordination
  • Reduced liability
  • Promotion of effective prevention and treatment of chronic diseases
  • Improved patient outcomes
  • Increased patient satisfaction
  • Increases in revenue
  • Increased hospital ratings
  • Increased physician quality scores

Retrieve Dx: Real-Time Dx: Accurate and Efficient

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  • Accurate diagnoses on admission are essential to operations:
  • Multiple internal processes depend on accurate diagnoses:
  • Patient placement on a unit
  • Staffing
  • Expected complications
  • Billing Metrics are directly affected:
  • Case Mix Index (CMI)
  • O/E calculations
  • Real-Time Dx easily provides the accuracy and efficiency all physicians desire in a decision support application.
  • Physicians:
    • Want to do the right thing without the extra time
    • Will not “buy-in” to a process or system that increases their workload or time spent on documentation
    • Desire greater accuracy to increase their ratings and revenue

Diagnoses Supported by Evidence-Based Findings and Results

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Retrieve Dx is not a stand-alone system. It is easily integrated with any major EHR system already in use by a hospital:

  • Cerner/Siemens
  • Epic
  • Meditech
  • Allscripts
  • McKesson
  • Next Gen
  • Athena

Hospitals may customize the weight given to specific clinical data points as well as which data the software accesses. This flexibility makes it easier for each hospital to adjust the tool to their unique needs and presentation.

There are currently no other applications in healthcare IT space that are like Retrieve Dx, a real time decision support application. Retrieve Dx allows for accurate and efficient documentation of diagnoses upon the initial assessment or admission. Other applications and methods rely on the analysis of physician documentation only. They require additional research and documentation by the physician.

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RETRIEVE Dx – PROBLEM SOLVING

Suggests Possible Comorbid Conditions

  1. Automatically identifies key indicators for comorbid conditions that contribute to a patient’s risk of mortality.
  2. Automatically fetches historical patient data to aid in complete medical coding.

Physician Selects Suggested Comorbidities

  1. All suggested comorbidities can be justified based on a custom set of rules and keyword searches through patient records.
  2. Comorbidities are added to patient record only with Physician approval

Omission of Comorbid Conditions

  1. Automatically search a patient’s electronic medical record (EMR) and generates possible comorbid conditions based on vital signs, laboratory values, medication lists and radiology reports. 
  2. Algorithms are used to assist in identifying some of the top comorbid conditions that have the greatest impact on mortality risk

Conditions Erroneously Categorized as “Hospital Acquired”

  1. Generates suggested comorbidities based on patient data from previous and current encounters which are documented prior to admission to hospital.

Too Much Time Searching Through Data

  1. Automatically gathers patients’ medical data in seconds
  2. Suggests possible comorbidities and complications
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THE TEAM

Retrieve Medical Team 

Our cohesive team works together to build a quality product and support our clients. We are leading experts in the IT and hospital industries. We speak the language of our clients. Sound and experienced business strategists plan and execute each step from start-up to easy interface with major industry end users.

IconDr. Mark Rosenberg, DO, MBA, FACEP, FAAHPM

Chairman of the Board

Chair of Emergency Medicine at St Joseph’s Health in Paterson and Wayne, New Jersey overseeing the care of more than 200,000 adult and child visits annually.  He is board certified in Emergency Medicine as well as Hospice and Palliative Medicine.  Dr. Rosenberg also serves as Chief Innovations Officer (CINO) at the same institution.  

Dr. Rosenberg is past Chairman of the Geriatric Emergency Medicine Section of the American College of Emergency Medicine (ACEP); Past Chairman and Founder of the Palliative Medicine Section of ACEP; responsible for the development of the Pain and addiction Section for the College; and serves as Secretary-treasurer for ACEP and secretary-treasurer for the Emergency Medicine Foundation.  

Dr. Rosenberg is principle author of the Geriatric Emergency Department Guidelines.  He has written many articles and chapters on Geriatrics, Palliative Care, Pain Management and Emergency Department Innovations and has lectured internationally.  He has developed many innovative programs including the acclaimed Palliative Medicine program called LSMA Life Sustaining Management and Alternatives and the ALTO (Alternatives to Opioids) program which is a Multidisciplinary Acute pain management program that not only helps patients with painful conditions without using opioids but also helps those patient with drug dependency and addiction. 

IconKaren Chase MS, BSN, RNC, CCDS

President

Karen joined the Retrieve Medical team in April 2019.  She has over 35 years of varied clinical healthcare and leadership experience and extensive knowledge in healthcare quality management, performance improvement and comparative data analysis. She holds a master’s degree in Healthcare Administration as well as advanced certification in Healthcare Policy and Management. 

Prior to her engagement with Retrieve Medical, Karen led all clinical and operational facets at Accuity Delivery Systems’ CDI and Appeals programs. Karen has also been recognized as one of the Association of Clinical Documentation Improvement Specialists top 30 leaders in the nation and was invited to the newly established Leadership Convention for 2016.

Karen was the Director of CDI and the Associate Director of Revenue Integrity at Stony Brook Medical Center. There she worked closely with the HIM, Coding, and Quality Departments to develop a robust CDI program that ensured accurate, compliant documentation as well as accurate reportable outcomes data.  She also serves as a nurse legal consultant to an Emergency Medicine consulting firm where she evaluates and defends medical legal cases.  

IconDr. Donald Thomas III

Chief Medical Officer

Dr. Thomas has created or reshaped clinical care delivery systems in 30+ healthcare organizations in the northern hemisphere, including healthcare systems, hospitals, clinics, group practices and an insurance provider medical bureau, while delivering increased quality, patient satisfaction and metrics, in addition to significant new dollars to the organizational bottom lines. He is a relentless problem solver and is especially suited to working in situations that are not functioning at their peak.  Dr. Thomas graduated from Howard University College of Medicine with an M.D. in Medicine and earned his A.B. in Physical Science and Genetics at Harvard University.

  • CMO for L.A. County Health Dept. (.8B budget, 22,000 employees, 3,500 MDs, 6 hospitals, 6 urgent care centers and 126 clinics)
  • U.S. Dept. of Heath COGME councilor from 1998-2003
  • Led clinical design teams for 2 hospitals and 2 emergency centers
  • Restructured Medicaid medical division for a major health insurer
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Jerry E. Swon

Chief
Executive Officer

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Neil Mendoza

Chief
Technology Officer

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Joerg Klaube

Chief
Financial Officer

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Harriet L. Donnelly

Chief
Marketing Officer

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James J. Noonan

Director
Operations & Training

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Thomas Swon

Director
Business Development

CONTACT US

Please contact us with any questions or for a demonstration of this powerful tool. We welcome your inquiries regarding the Retrieve Dx software technology and business opportunities. Let Retrieve Medical improve your hospital metrics, your doctor ratings and your quality of patient care.

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