VAT Registration Number: GB 936 4035 26
CONTACT US
Call: UK +44 (0) 208 144 6967
Email: precisia@c2-ai.com
Copyright 2020 - 23 C2-Ai/Precisia All rights reserved.
There is zero integration required between our CRAB retrospective audit systems and EHR/EPR’s. We use patient coding information that hospitals already have for billing/reporting purposes. Ensuring the data is correctly presented can take from 2 to 5 person days. That’s all that’s needed. No API’s, no long delays. The system can be up and running in days from contract.
The workflows in the hospital do not change and no extra work is required to gather data.
We use the same clinical coding the hospital sends to regulators and it’s a simple and quick integration.
For the avoidance of doubt, no long delays, no disruption, no workflow changes, no new people hired, no new tasks for clinicians.. just a data transfer of pseudo-anonymised data to our secure system.
For the retrospecitve reporting system (CRAB), we provide detailed monthly and annual reports that highlight overall performance but then drill down into issues, where they are located and how to resolve them.
We also provide an expert tool to allow clinicians and managers to drill down into results by period, specialty, consultant, type of operation etc. This goes down to the clinical coded record of each individual patient if needed to understand the chronology of their diagnoses and treatment etc.
For the prospective risk assessment tool, the system runs from the cloud so can be accessed at any desktop, tablet or handheld device. The system then links to printers and/or systems like SAP to enable signature of the outputs by the patient/relatives as part of the consent process.
Our estimation of cost savings is based on many hospitals own internal costings for particular triggers of avoidable harm. We agree a cost per trigger and then our monitoring over a period to identify the improvements in terms of harm but also the direct associated costs. That means medications etc. required (things you are taking from a stock room) but doesn’t include extra overtime for staff, bed blocking etc.
Our partners see the results in their bottom line, in the same financial year.
Returns are roughly 30 times what we charge (excluding the reductions in clinical negligence costs that we estimate at 10%).
It is imperative – for patients and surgeons alike – that measures of quality are properly adjusted for the individual conditions of the patients receiving treatment and the complexity of the care involved. CRAB is unique in calculating the risk for every patient as an individual rather than making assumptions about patients from national statistics.
The CRAB Surgery module is the result of thirty years of research and development, and evolves beyond the POSSUM audit methodology, published by our CMO Graham Copeland et al in 1991 and in use around the world. The original POSSUM methodology is recommended by the Royal College of Surgeons and the National Confidential Enquiry into Perioperative Deaths (NCEPOD), but we have developed it significantly.
From our work, even an ‘aviation quality’ hospital was unable to detect up to 87% of preventable morbidity/harm. A typical hospital is likely to be closer to 90% hidden.
If a hospital can’t detect the harms, it can’t establish the root causes, resolve the problems and accrue the care and financial benefits that are possible with our system.
C2-AI measures morbidity and mortality using our unique approach, delivering high accuracy and actionable insights that lead to improvements across the 100%, not the ‘10%’ of harms most hospitals can detect.
Triggers are events during a patient’s hospital stay that may have resulted from hospital-based ‘harm’. The Medical Module assesses every in-patient admission using clinical coding to identify validated surrogates that map to these trigger events.
In many such cases there are direct coding relationships, but in others complex combinations of clinical codes with the process of episodes of care are used to identify the trigger.
The triggers are combined into modules: general, surgical, intensive care, medication and laboratory tests, and investigation is possible by department, specialty and individual consultant.
C2-Ai has built up norms within CRAB for all triggers and combinations of triggers with our knowledge of changes in these indicators. With known individual clinician and institutional-based anomalies it is possible to identify variations in triggers which can be associated with potential deteriorations in practice and hence outcome.
Data can also be interrogated using physiological profiling to understand the inherent state of health of the patients treated and any underlying diagnoses that may be a cause of complications. Reporting can be supplemented, where appropriate, with key audit criteria for effective care.
We have done extensive testing on the accuracy of our mortality and morbidity algorithms and have excellent results for each (the former looking at an 800k patient, 10-year data set and the latter via a study with Karolinska Hospital in Sweden).
Since then, our partner hospitals across 11 countries have used our systems and found our results to direct them to real issues and savings in both financial and harm/mortality terms.
See our references page to read more about what people using our system think of it.
The systems are web hosted but under the strictest data protection and security protocols,
Our amazing IT team keeps us compliant with ISO27001 and ISO13485. We meet GDPR standards and we have also been tested as HIPAA compliant in the USA. It is also our privilege to have been approved by the NHS National authorities in the UK to host and process the national patient dataset – one of only a handful of private companies to be given such permission.
The resulting hosting arrangements are state of the art for information governance and security, and can be cloned into client’s countries as necessary.
Bottom line – integration is not difficult.
We have a unique system that uses Ai-backed algorithms to map the clinical profile of each and every patient. From this, we can:
Patients are individuals. You can’t look at the average illnesses in a country and then use that information to diagnose a patient. So why are hospital information systems trying to improve patient safety and outcomes in this way.
As an example, a hospital we know does the high risk operations for another hospital. Simple average based information systems flag the first hospital up for having a rate of complications per operation that is higher than the average. Of course they do. They are doing harder operations but the inability to do real risk-adjustment for patients means that the results of these systems is no better than a ‘smoke alarm’ with many false positives for issues raised.
This undercuts faith in the systems and wastes time trying to fix things that aren’t broken.
We use our validated approaches to risk-adjust for both operative and medical patients to identify real issues. We don’t stop there. Our systems can drill down to the underlying issues.
Our estimation of cost savings is based on many hospitals own internal costings for particular triggers of avoidable harm. We agree a cost per trigger and then our monitoring over a period to identify the improvements in terms of harm but also the direct associated costs. That means medications etc. required (things you are taking from a stock room) but doesn’t include extra overtime for staff, bed blocking etc.
Our partners see the results in their bottom line, in the same financial year.
Returns are roughly 30 times what we charge (excluding the reductions in clinical negligence costs that we estimate at 10%).
We use hospitals’ own administrative patient coding for all patients. In any given country, this will be their equivalent of ICD9/ICD10 coding for diagnoses and procedures. We are used to interfacing with hospitals to access the data in a secure and professional fashion.
We have easy, templated procedures for capturing the data we need, and skilled engineers well versed in legacy systems so that they can help clients regardless of the age and configuration of the IT they are operating with.
The systems are web hosted but under the strictest data protection and security protocols,
Our amazing IT team keeps us compliant with ISO27001 and ISO13485. We meet GDPR standards and we have also been tested as HIPAA compliant in the USA. It is also our privilege to have been approved by the NHS National authorities in the UK to host and process the national patient dataset – one of only a handful of private companies to be given such permission.
The resulting hosting arrangements are state of the art for information governance and security, and can be cloned into client’s countries as necessary.
Bottom line – integration is not difficult.
We estimate we cover areas that represent 90% of US negligence claims.
We look at 146 surgical complications, 32 triggers, all patients, avoidable harm and mortality in hospital care across all specialty areas. Our Compass module can also be deployed into primary care to support more effective management of referrals and admissions and optimise patients to get the best possible care in the most efficient way.
The data we use is pseudo-anonymised so the hospital can cross reference to patient information from an identified but we cannot. We never hold personal information on patients.
Data is held and managed in an ISO 27001 information security accredited environment.
All staff who could have access to data are properly governance trained and certificated.
Evidenced data destruction in compliance with ISO standards is performed at the end of a job or on demand. This involves the use of approved data destruction software or drive shredding if the drive is non-functional. If a device has to be shredded, the whole process from its removal from the server to 6mm fragments needs to be evidenced.
In the UK, NHS hospitals mandate the use of the NHS private network (N3/HSCN). This requires dedicated fibre connections, government approved firewalls and compliance with NHS IG standards. HSCN systems must be kept completely separate from the internet other than through approved interfaces negotiated with NHS Digital. C2-Ai operate internationally, requiring careful segmentation of systems and networks and maintenance and verification of all access logs.
We are compliant with the top 10 OWASP vulnerabilities evidenced with regular penetration testing to prove compliance. The platform on which new C2-Ai products will be based is OWASP compliant.
The workflows in the hospital do not change and no extra work is required to gather data.
We use the same clinical coding the hospital sends to regulators and it’s a simple and quick integration.
For the avoidance of doubt, no long delays, no disruption, no workflow changes, no new people hired, no new tasks for clinicians.. just a data transfer of pseudo-anonymised data to our secure system.
VAT Registration Number: GB 936 4035 26
CONTACT US
Call: UK +44 (0) 208 144 6967
Email: precisia@c2-ai.com
Copyright 2020 - 23 C2-Ai/Precisia All rights reserved.