InsightRX

Opportunity

In caring for the most critical patients, dosing prescription medication within a narrow therapeutic index can be a matter of life and death. The Federal Drug Administration estimates over 2 million serious adverse drug reactions (ADR) occur every year in the United States leading to over 100,000 deaths. Conventional methods for calculating patient dosages rely on offline tables and formulas fashioned with an average, adult patient in mind. Generalized data may be effective for dosing low-risk drugs, but when dealing with high-risk medications a greater degree of precision is necessary to yield greater patient outcomes.

Intravenous Medication

Solution

InsightRX is a data-driven workflow system that enables care teams to calculate specific dosing based on patient data gathered and updated in real time from the electronic medical record (EMR). Using this new cloud-based application, clinical teams at OSF HealthCare will be able to prescribe and monitor doses of high-risk medication that are measured specifically for the individual patient.

Impact

Beginning in 2018, OSF HealthCare Pharmacy Services piloted InsightRX for precision dosing of vancomycin for bacterial infections in pediatric patients. Following a 90-day trial, the performance of InsightRX will be compared to a three-year time period when the software was not being used for evaluation towards further implementation. Based on past administration rates, more than 1,000 patients could stand to benefit from the InsightRX trial.

“InsightRX provides a system of Quantitative Pharmacology to our care teams. The system calculates specific, individualized dosing based off information gathered in real time from the electronic medical record.”

- Rob Jennetten, Director of Innovation Partnerships, OSF Innovation

Using precise quantitative pharmacology to yield better patient outcomes

Recognizing an opportunity to improve patient outcomes and reduce medical costs, OSF Innovation is linking comprehensive data and adaptive learning to calculate precise, patient-specific medication dosing through InsightRX.

In the most critical cases, administering the right, therapeutic amount of vital medications has a drastic effect on patient outcomes. Prescribing too much of a highly specialized drug can result in toxicity and adverse side effects. Receiving too little of a medication will not be beneficial for the patient and could result in ineffective care and prolonged hospital stays.

According to the Patient Safety Network, adverse drug reactions (ADR) are the most common form of inpatient error with nearly 5percent of hospitalized patients experiencing negative reactions to medication. ADRs account for nearly 700,000 emergency department visits and 100,000 hospitalizations each year.

Historically, pharmacists have calculated prescription measures working offline with tables or formulas created based on the ‘average’ patient. Many conventional dosing formulas determine the therapeutic range for medication based primarily off patient age and weight alone – leaving out factors like lifestyle, genetics and other data relevant to high-risk medicine. While these methods may be effective for prescribing a wide variety of low-risk medications, OSF Innovation recognized an opportunity to improve care and outcomes for the most sensitive patients.

InsightRX is a data-driven workflow system that enables care teams to calculate specific dosing based on patient data gathered and updated in real time from the electronic medical record (EMR). Using this new cloud-based application, clinical teams at OSF HealthCare will be able to prescribe and monitor doses of high-risk medication that are measured in real time for each individual patient.

Created to serve the most specialized cases like pediatric oncology and leukemia, InsightRX draws from data gathered from similar medical cases around the world to help fill the gap in precise patient care. Integrated with the patient EMR, the platform’s algorithms continuously update dosing levels based on incoming patient vitals. InsightRX uses adaptive learning to streamline patients into the therapeutic range for their medicine, a process that would normally take follow-up appointments from the clinical team.

Beginning in 2018, OSF HealthCare Pharmacy Services piloted InsightRX for precision dosing as a continuation of a care transformation initiative to expand access to care for patients. In the initial pilot, clinicians began using InsightRX to prescribe vancomycin for pediatric bacterial infections, verified against traditional dosing methods. Following a 90-day trial, the performance of InsightRX will be compared to a three-year time period when the software was not being used for evaluation toward further implementation.

Results

Based on past vancomycin administration rates, over 1,000 patients could stand to benefit from just the InsightRX trial alone. It is expected that InsightRX will allow clinical teams to more rapidly administer the therapeutic range for patients and thereby benefit patient health and reduce treatment times compared to the previous three years. In the future, OSF HealthCare is making plans to research and deploy new InsightRX modules that can benefit patients worldwide.

“InsightRx will allow pharmacists to efficiently and safely dose patients prescribed high-risk drugs, leading to shortened hospitalization stays and improved outcomes.”

- Jerry Storm, Senior Vice President of Pharmacy Services, OSF HealthCare