Digital Intern

Consistent Approach. Individualized Care.

iVMD for Organ Procurement

Organ Procurement

The Digital Intern is available for use by Organ Procurement Organizations in a beta format.  Contact us to get started today!

The Digital Intern iPad application enables OPCs to take the power of the Digital Intern with them wherever they go. The iPad application requires patient data which can be obtained through manual data entry or an interface with your medical record software.

The Digital Intern includes a web interface for administrators to configure the application to fit the needs of their organization.  The web interface also provides access to administrative reports and historical patient information.

In addition to the Digital Intern software, there is a comprehensive order set available to ensure all necessary labs, procedures, and medications have been ordered functioning as a comprehensive checklist. For DCD patients, pain and agitation management is included in the order set. Use of the order set with the Digital Intern software ensures that everything the Digital Intern recommends has been authorized by an order signed by the appropriate provider (OPC or physician, per your policies).

Flowchart

The physician determines when use of the Digital Intern is appropriate and decides which aspects of patient care the Digital Intern should help manage. The physician can exclude certain medications from the Digital Intern’s toolbox or tell the Digital Intern to use certain drugs only as a last resort. The physician can set and change goals for patient metrics. The Digital Intern considers every change in the patient’s condition and recommends the next steps to bring the patient’s metrics in line with goals set by the physician. The Digital Intern adapts its recommendations based on the patient’s response to treatment, tailoring each recommendation to the patient’s individual physiology. This approach is consistent and thus will permit retrospective analysis of patient populations for quality improvement initiatives. The care team works together with the Digital Intern as their partner. Nursing and Respiratory Care staff can carry out the recommendations of the Digital Intern without consulting a physician for each decision, dose change, or lab result for those things that the physician has ordered the Digital Intern to manage. Hospital leadership can implement organization wide policies to prioritize use of certain drugs or change the Digital Intern’s default settings to help with cost containment. The Digital Intern will make suggestions accordingly but will abide by the physician’s treatment plan. The EMR can supply data to the Digital Intern about the patient. Nurses, doctors, and other caregivers will continue to document in the EMR and should consider it the source of truth for all patient data. The Digital Intern will interface seamlessly with the EMR where possible so that workflow is minimally altered thereby improving efficiency rather than promoting discontinuity.

Evaluation Methods

Our initial algorithms were developed specifically for organ donors and organ procurement organizations. The measurement for success was the number of organs recovered and the cost to recover them (from the standpoint of critical care time billed), compared between the control year and the treatment year when the Digital Intern was operational.

Results

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The organs recovered per donor (excluding research) were 2.83 in the control year and 3.54 in the treatment year. The results were statistically significant (p<0.0359).  In the control year the critical care hours billed averaged 5.9 per donor and 2.3 in the treatment year.  These results are statistically significant (p<0.001). and produced cost savings that averaged $2685 per donor.

Conclusions

The Digital Intern is designed to manage complex patients with adaptive algorithms that respond to the patient’s physiology. It is fast, effective, and efficient. Future iterations are in development to extend care to other patient populations where defined metrics can be used to optimize medical management. In the meantime, the critical care physician has no worry of being sidelined and is certain that all of the patients are receiving appropriate levels of care reflecting the known best practices.