|
Return on Investment ( ROI ): Costs saved using Isabel
|
|
Karen S. Cosby, Rebecca Roberts, Lisa Palivos et al. Characteristics of Patient Care Management Problems Identified in Emergency Department Morbidity and Mortality Investigations During 15 Years. Ann Emerg Med. 2008;51:251-261. |
|
|
Gordon D. Schiff, Seijeoung Kim, Richard Abrams et al. Diagnosing Diagnosis Errors: Lessons from a Multi-institutional Collaborative Project. Advances in Patient Safety 2005; 2:255-278 |
|
|
Mark Graber, MD. Diagnostic error in internal medicine. Arch Intern Med. 2005 Jul 11; 165(13):1493-9 |
|
|
Charles P. Friedman, PhD et al. Do Physicians Know When Their Diagnoses Are Correct? Implications for Decision Support and Error Reduction. J Gen Intern Med 2005; 20:334-9. |
|
|
Kaveh G. Shojania, Elizabeth C. Burton et al Changes in Rates of Autopsy-Detected Diagnostic Errors Over Time. JAMA 2003; 289 (21):2849-2856 |
|
The existing figures in red in this ROI calculator are indicative figures and are alterable. You can enter your own institution's clinical activity data, costs and your estimate of percentages to work out how much the Isabel Diagnosis Reminder and Knowledge Mobilizing System will save your institution. |
|
Most medical error studies find that 10-30% of errors are diagnosis errors. The rate of diagnosis error has been estimated to be approximately 15%, in reasonable agreement with the 10% - 24% diagnosis error rate determined in autopsy studies. We assume that 10% of inpatient episodes are subject to medical error of which 15 % are due to diagnosis error. Further, we assume that 10% of these are serious and need an additional 3 days in hospital. |
|
From empirical evidence we assume that physicians have a diagnosis doubt 1 in 10 outpatients they see. Of the 10% where doubt exists, let us assume that 15% of these ER cases would be missed if Isabel system had not been used. In the resulting cases of diagnosis error, we assume that these would result in an additional 3 days in hospital. |
|
From empirical evidence we assume that physicians have a diagnosis doubt 1 in 10 outpatients they see. Of the 10% where doubt exists, let us assume that 15% of these outpatient cases would be missed if the Isabel diagnosis reminder system had not been used. In the resulting outpatient cases of diagnosis error, we assume that these would result in an additional 3 visits to the outpatient department. |
|
Many inpatients are appropriately admitted based on complexity and/or severity and can pose a diagnosis conundrum. We assume that of the total number of inpatients admitted annually 2% are complex/atypical and diagnostically challenging cases. Without the use of Isabel, half of these cases would need an additional 3 days in hospital. |
|
The hospital wide use of Isabel as a risk management tool could result in a 5% reduction in insurance premiums. |
|
Isabel could enable your hospital to make more flexible use of nurse practitioners instead of resident physicians. The use of Isabel diagnosis reminder system could facilitate nurse practitioners performing the initial workup of patients. |
|
The Isabel diagnosis reminder & knowledge mobilizing system has also been procured for its strong educational benefit. We postulate that training in differential diagnosis and the provision of corroborative knowledge in the workflow could result in a further reduction in the hospitals overall error rate. We assume a reduction of 0.5% of total episodes (saving the cost of an additional bed / day). |