SBIR Phase I: Hyper-Personalized Clinical Evidence-based Blood Transfusion Decision Support Tool to Drive Value-Based Care

这个小型企业创新研究(SBIR)第一阶段项目的更广泛的影响/商业潜力是开发一个高度个性化的、临床的和基于证据的输血决策支持工具，以减少不必要的输血、与输血相关的并发症和与输血相关的支出。输血是美国最常见的处方医疗程序，每年花费我们的医疗系统300亿美元。据估计，每年不必要的输血成本不低于150亿美元。如果包括治疗输血相关并发症的费用，这些数字会翻一番。在循证医学时代，输血实践仍然具有高度的主观性和显著的临床差异。拟议的项目旨在通过开发一个全面的临床证据驱动的决策支持系统，使医生能够在一个可用的界面中集成近乎实时的实验室、临床、诊断和预后信息，从而解决医院中与输血有关的关键需求。该项目的长期目标是将不必要的输血发生率降至最低，以改善患者结局并减少医疗支出。该项目的目标是开发一套全面的患者血液管理工具，该工具可在所有临床领域实施，并可轻松部署到几乎任何医院。将追求以下具体目标：a)开发和实施可扩展的符合HIPAA标准的方法，用于从电子病历系统中提取、存储和管理与输血相关的数据；以及b)推导以患者为中心的算法，为电子病历系统创建临床决策支持工具，并推动高度个性化的输血实践。拟议工作的成功完成可能会彻底改变医生做出输血决定的方式，并最终改变和消除过度输血的文化。随后在美国各地广泛实施，每年可以挽救数以千计的生命，与医学研究所S倡议的目标不相上下，该倡议旨在减少不当抗生素处方和与药物相关的不良药物事件。

The broader impact/commercial potential of this Small Business Innovation Research (SBIR) Phase I project is to develop a hyper-personalized, clinical, and evidence-based blood transfusion decision support tool to reduce unnecessary transfusions, transfusion-related complications, and transfusion related expenditures. Blood transfusions are the most commonly prescribed medical procedure in the US, and cost our healthcare system $30 billion annually. The cost of unnecessary transfusions is estimated at no less than $15 billion each year. These figures double when including the cost of treating transfusion-related complications. In the era of evidence-based medicine, transfusion practices remain highly subjective with significant clinical variation. The proposed project aims to address a critical un-met need in the hospitals related to blood transfusion by developing a comprehensive clinical evidence-driven decision support system that would empower the physician with a near real-time laboratory, clinical, diagnostic and prognostic information, integrated within a usable interface. The long-term goal of the project is to minimize the incidence of unnecessary blood transfusions to improve patient outcomes and reduce healthcare expenditures. The goal of this project is to develop a comprehensive patient blood-management suite of tools that can be implemented across all clinical fields and can be easily deployed in most any hospital. The following specific aims will be pursued: a) To develop and implement scalable HIPAA-compliant methodologies for the extraction, storage, and management of blood transfusion-related data from electronic medical record systems; and b) to derive patient-centered algorithms to create clinical decision support tools for the electronic medical record system and drive hyper-personalized blood transfusion practice.Successful completion of the proposed work may revolutionize the way physicians approach the decision to order a blood transfusion and ultimately change and eliminate the culture of over-transfusion. Subsequent widespread implementation throughout the US could save thousands of lives each year, on par with the goals of the Institute of Medicine?s initiative to reduce inappropriate antibiotic prescribing and medication related adverse drug events.