1. SIR Conference 2008 - Dublin Prognostic Risk Algorithm Presented by Nick Gawrit June 27, 2008 …the Premier Cardiovascular Information System for Improving Patient Healthcare

2. SIR Conference 2008 - Dublin Sequence of Events Risk Algorithm provided by Society of Thoracic Surgeons for use in retrospective risk scoring Need identified that surgeons would like to use this tool ahead of surgery to evaluate the risks they are presented heartbase saw potential of decreasing risks of surgery by developing a module that allows risk to be analyzed prognostically, and be reassessed as the patient approaches surgery

3. SIR Conference 2008 - Dublin Prognostic Risk Scoring Tool Features: Score patients on any PC, anywhere! Procedure based field completion Score Report Patient Score history Integration into heartbase STS 2.6 risk scoring model (future -Euro Risk Score )

4. SIR Conference 2008 - Dublin Needs Integration into heartbase event management Schema creation to allow assessments to look at variables used in relational structure in one record type Interpretation of the retrospective model into a prognostic model Risk algorithm verification Screen design to reflect risk variables related to procedure performed Continual risk adjustment of variables as they change Print functionality for medical records and surgeons outlining the assessment Training on system use and impacts on medical records documentation On-line history of assessments Risk management instruction Reports Future

5. SIR Conference 2008 - Dublin Integration into heartbase event management

6. SIR Conference 2008 - Dublin Integration into heartbase event management Locmenu.pql Dvmnusys.Menu_ifs

7. SIR Conference 2008 - Dublin Assessment History

8. SIR Conference 2008 - Dublin Schema creation STS record type Identify all variables used in risk model and copy them to new record type TASK NAME Record Definition for STS Record Number 96 RECORD SCHEMA 96 STS KEY FIELDS SURGDATE(A) MAX REC COUNT 100 DATA LIST (3) SSNUM 4 - 14 (A11) SURGDATE 15 - 24 (DATE'MMIDDIYYYY') DIAB 25 (A1) COPD 26 (A1) COPDSTAT 27 - 28 (I2) PRWCPBNM 29 (I1) PRWOCPBN 30 (I1) HCVA 31 (A1) PRCBVDIS 32 (A1)

9. SIR Conference 2008 - Dublin Beta Coefficients Create a schema to handle downloadable data records Create PQL programs to download data records

10. SIR Conference 2008 - Dublin Screen Painting New STS prognostic score screen

11. SIR Conference 2008 - Dublin retrospective > prognostic Interpretation of the retrospective model into a prognostic model STS RISK MODELS FOR MORTALITY, MORBIDITY, AND LENGTH OF STAY MODEL SPECIFICATIONS MODEL VERSION 2007.1.2 FOR STS v2.61 FEBRUARY 22, 2008

12. SIR Conference 2008 - Dublin Risk algorithm verification Risk algorithm verification by hand entering 2000 test cases that had scores generated by the STS

13. SIR Conference 2008 - Dublin risk variables and procedures performed Screen design to reflect risk variables related to procedure performed

14. SIR Conference 2008 - Dublin Continual risk adjustment Continual risk adjustment of variables as they change

15. SIR Conference 2008 - Dublin Print functionality Print functionality for medical records and surgeons outlining the assessment

16. SIR Conference 2008 - Dublin Training Training on system use and impacts on medical records documentation

17. SIR Conference 2008 - Dublin Risk management Risk management instruction –Get Weight Down (seems to be an exception for females) –Exercise –Eat Healthy –Get diabetes in check –Take meds to treat areas like hypertension –Younger is better. –Get a great physician

18. SIR Conference 2008 - Dublin Reports In the evaluation of what is needed phase

19. SIR Conference 2008 - Dublin Future Euro Score Flash Drives Cell Phone Web Site

20. SIR Conference 2008 - Dublin Demonstration

21. SIR Conference 2008 - Dublin Thank You! by Nick Gawrit

22. SIR Conference 2008 - Dublin