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Smarter Decisions,Better Care
2
Industry Challenges Across the World
1 - http://www.pwc.com/gx/en/healthcare/emerging-trends-pwc-healthcare.jhtml
Although healthcare challenges can vary from region to region, health systems of
every type around the world have the same objective:
to deliver the highest possible quality of care
to the maximum number of people.1
“
”
4
10 500+
Clinical topics
1500+
Patient topics
28 000+
Graphics
160+
Medical calculators
400 000+
Evidence links
What’s New/ Practice Changing
UpDates
22
Specialties
CME/CPD
5 400+
Drug entries
A New Way to Practice Medicine
5 700+
Physician authors
5
A Trusted Resource
21+ yearsFor 21+ years, the most trusted evidence based, peer reviewed editorial content, proven to improve patient care quality
5 700+ authors Expert evidence-based recommendations made by over 5 700+ physician authors from 51 countries
850 000 clinicians29 000 hospitals worldwide rely on UpToDate, including:
95% of medical teaching institutions in Benelux and Germany
90% of medical teaching institutions in Japan 90% of medical teaching institutions in the United States
279 000 000+ searches Clinicians view more than 279 million topics annually in UpToDate, changing 80 million clinical decisions
6
What Clinicians Say
Source: 2012 UpToDate individual subscriber survey
indicated they trust UpToDate as a point of care clinical information resource
In an
17 000 individual subscribers
survey of over
95%
I trust UpToDate as an
authoritative point-of-care
clinical information resource.
“
”
7
National Adoption
UpToDate has national contracts with the governments of Iran, Norway, Saudi Arabia, Jordan, and Spain, Oman. These countries have standardized the use of UpToDate in public healthcare.In countries such as Luxembourg, the Netherlands and Switzerland use of UpToDate is a de facto standard
8
Doctors Have Clinical Questions
Covell, DG. Ann Intern Med 1985; 103:596; Green, ML. AM J Med 2002; 109:218; Osheroff, JA. Ann Intern Med 1991:575; Ely, JW. J Am Med Inform Assoc 2005; 12:217; Gorman, PN. Med Decis Making 1995; 15:113.
Unanswered clinical questions impact patient management decisions Approximately 2 out of 3 clinical encounters generate a questionPhysicians have approximately 11 clinical questions a day
60%
of questions go unanswered
Answering all clinical questions could
change
5to8 patient management
decisions each day
9
Clinicians Save Time with UpToDate
Percentage of users who report that UpToDate saves them time in answering clinical questions
Argentina Germany Taiwan UAE UK USA0%
25%
50%
75%
100%
90% 87%92% 95%
86%91%
Source: 2012 UpToDate individual subscriber survey
10
Research Demonstrates UpToDate Impacts Outcomes
We invite you to review the study data yourself: http://www.uptodate.com/home/research
Over 60 research studies
UpToDate is the most widely studied point of care clinical decision support tool. To date there have been over 60 studies that have looked at UpToDate as a tool to:
Allow more questions to be answered faster
Change decisions
Improve outcomes
11
Clinicians Need Help Making Better Decisions
1Lucas, BP. The impact of evidence on Physicians’ inpatient treatment decisions J Gen Intern Med 2004; 19:402.
Cook County HospitalCook County Hospital, Chicago, IL
Test: Critical decisions assessed before and after providing clinical knowledge support on a random sample of 146 inpatients
Result: Attending physicians changed treatment decisions for 18% of patients
Insight: UpToDate drove most decision changes1
12
UpToDate Changes Clinical Decisions
Phua J, See KC, Khalizah HJ, et al. Utility of the electronic information resource UpToDate for clinical decision-making at bedside rounds. Singapore Med J 2012; 53:116.
Researchers at Singapore’s National University Hospital report that bedside use of UpToDate led to changes in patient care decisions…
37%of the time
62%
29%
9%
This reinforced my planThis modified my plan
What Effect Did the Information from UpToDate Have on My Plan…
Data from CME responses
(n = 2,575,145)
(n = 1,187,150)
(n = 388,305)
UpToDate Impact by Clinician Query Type
Other Prognosis Prevention Treatment Diagnosis Clinical Manifestations0%
25%
50%
75%
100%
48%62% 62% 67% 62%
51%
16%
23% 27%26% 30%
39%
36%
14% 12% 6% 8% 10%
This reinforced my plan This modified my plan I need more information
(n= 4.1 Million CME Responses)
15
Enstinet Usage Feb 2012 – May 2015
16
Enstinet Usage Feb 2012 – May 2015
Enstinet Usage Analysis
17
Series10%
25%
50%
75%
100%
0.620000000000001
0.3
0.08
This reinforced my plan This modified my plan I need more information
This reinforced my plan: 136,400 /year, 11,366/Month, 2,841/Week
This modified my plan: 66,000/year, 5,500/Month, 1,375/Week
I need more information:17,600/year, 1,466/Month, 366/Week
2014 – 2015 Usage = 220,000
18
Top Specialty
Facility Name - ENSTINET
Date Range From 05/01/2014 To 05/01/2015
Rank Topic Specialty Total Topic Hits
1 Drug Information 29,595 2 Obstetrics, Gynecology and Women's Health 21,039
3 Pediatrics 18,837 4 Infectious Diseases 17,862
5 Gastroenterology and Hepatology 15,985 6 Nephrology and Hypertension 13,356
7 Endocrinology and Diabetes 11,967 8 Cardiovascular Medicine 11,642
9 Hematology 11,155 10 Oncology 11,154
11 Pulmonary and Critical Care Medicine 9,491 12 Neurology 7,829
13 Rheumatology 6,266 14 Adult Primary Care and Internal Medicine 5,107
15 Adult and Pediatric Emergency Medicine 4,962 16 Allergy and Immunology 4,932
17 General Surgery 4,171 18 Patient Information 3,054
19 Dermatology 2,340 20 Psychiatry 1,801
19
Use of UpToDate Associated with Improved Outcomes
1. Solucient maintains the nation's largest healthcare database, comprised of more than 26 million discharges per year from 2,900 hospitals.
2. Bonis PA. Association of a clinical knowledge support system with improved patient safety, reduced complications and shorter length ofstay among Medicare beneficiaries in acute care hospitals in the US. Int J Med Inform 2008; 77:745.
Significantlyshortens
lengths of stay
Significantly lowers complication rates
Significantlylowers adverse outcome rates
Solucient1 studied the impact of UpToDate on length of stay,
patient complications and patient safety2
148 403 1096 29800.00000000
0.25000000
0.50000000
0.75000000
20
Quality Indicators Improve with Increased Use of UpToDate
Bonis PA. Association of a clinical knowledge support system with improved patient safety, reduced complications and shorter length of stay among Medicare beneficiaries in acute care hospitals in the United States. Int J Med Inform 2008; 77:745.
Complications
UpToDate Usage Levels and Impact on Patient Complications, Patient Safety and Mortality
Imp
rovem
en
t in
Ris
k P
erc
en
t
Patient Safety Length of Stay
UpToDate Topic Reviews Per Week
148 403 1096 2980
0%
20%
40%
60%
80%
21
Researchers at Harvard University FindUpToDate Associated with Improved Outcomes
Isaac T, Zheng J, Jha A. Use of UpToDate and outcomes in US hospitals. J Hosp Med 2012; 7:85.
Use of UpToDate Associated with...
Improved Quality Every condition on Hospital Quality Alliance
Metrics
Shorter Lengths of Stay 372 000 days over 1 year
Lower Mortality Rates 11 500 lives over 3 years
Using UpToDate Increases Medical Knowledge
20 Minutes a day
McDonald, F, Zeger, SC, Kolars, JC. Factors Associated with Medical Knowledge Acquisition During Internal Medicine Residency J Gen Intern Med 2007. 22
Equals an Entire Year of Residency
UpToDate is recognized and accredited for CPD American Academy of Family Physicians
American Academy of Nurse Practitioners American Academy of Pediatrics American College of Emergency Physicians American College of Obstetricians and
Gynecologists American Osteopathic Association Australasian College for Emergency Medicine Austrian Academy of Physicians Federación Mexicana de Colegios de
Obstetricia y Ginecología Colegio de Medicina Interna de México College of Family Physicians of Canada Dubai Health Authority Health Professions Council of South Africa Oman Medical Specialty Board Postgraduate Medical Training Bodies in
Ireland Royal College of Physicians and Surgeons of
Canada Royal Australian Australasian College of
Physicians Royal Australasian College of General
Practitioners Royal Australian and New Zealand College of
Obstetricians and Gynecologists Royal New Zealand College of General
Practitioners Singapore Medical Council 23
Accreditation Council for Continuing Medical Education
AMA PRA Category 1 Credit(s)TM
Accreditation with Commendation
24
Economic Impact of UpToDate at Salford Royal NHF Foundation
Source: November 2011, Forrester Research: The Total Economic Impact Of UpToDate’s Clinical Decision Support System For Healthcare Institutions: A Case Study Of Salford Royal NHS Foundation Trust in the UK
Benefits Included: Staff productivity Diagnostic test
efficiencies Improvements in the
quality of care
Forrester Research found Salford Royal NHS Foundation Trust (SRFT)recovered the costs of UpToDate in 90 days
90=
ROI
days
25
For More Information [Presenter to customize for particular audience]
Phone: Institutions outside of the US/Canada+31 172 641440Email: [email protected]
www.linkedin.com/company/uptodate?trk=hb_tab_compy_id_21924
www.twitter.com/UpToDate
www.facebook.com/UpToDateEBM
www.youtube.com/uptodateebm