STopVTE: A Clinical Decision Support Tool to Accurately Predict and Prevent Postoperative VTE

STopVTE is a clinical decision support (CDS) tool embedded in electronic health records (EHRs) that accurately predicts the risk of perioperative venous thromboembolism (VTE) for surgical patients. The tool updates a patient's risk daily based on real-time changes in their clinical status and recommends the optimal prevention strategy, helping to significantly reduce VTE rates.

Description

The STopVTE tool addresses the critical need for a VTE risk-assessment tool that accurately reflects the dynamic nature of a patient's condition during and after surgery. Existing systems often underestimate risk by only considering static factors before an operation, leading to ineffective prevention strategies. STopVTE overcomes this by daily assessing risk factors reflected in the EHR, such as a new central line or the onset of sepsis, to predict the chronology and subtypes of VTE events (e.g., pulmonary embolus or deep vein thrombosis). This allows for distinguishing between early VTE (while a patient is an inpatient) and late VTE (after discharge). Based on these daily risk predictions, the application recommends changes to the dose and type of thromboprophylaxis and can also suggest extended prophylaxis and post-discharge VTE screening.

Applications

- Integration into hospital EHR systems to guide VTE prophylaxis for surgical patients.
- Application in surgical sub-populations where existing risk stratification systems are not well-validated.
- Use as a research tool to test the efficacy of different VTE prevention strategies.
- Implementation in quality improvement initiatives to reduce VTE rates and associated healthcare costs.

Advantages

- Improved Risk Prediction: Accurately predicts the risk of VTE by considering dynamic changes in a patient's clinical status throughout their recovery, unlike current systems that rely on static factors.
- Reduced VTE and Bleeding Complications: Accurately estimating risk helps guide thromboprophylaxis, reducing overall VTE events. It also helps avoid unnecessary anticoagulation for low-risk patients, preventing costly and devastating bleeding complications.
- Daily, Real-Time Risk Updates: The tool updates risk on a daily basis using real-time EHR data, allowing for timely adjustments to prevention strategies.
- Tailored Prevention Strategies: Recommends optimal prevention strategies and screening based on the calculated risk, including recommendations for extended prophylaxis for post-discharge VTE.
- Widespread Compatibility: The technology is being developed to be compatible with both CERNER and EPIC, allowing for widespread use in various healthcare settings.

Invention Readiness

The innovators have created a prototype, the VTE Prophylaxis Advisor, which has already reduced perioperative VTE. The team is leveraging a large amount of EHR data to design training and test sets for the predictive tool. Code has been developed to query diagnostic imaging using natural language processing to identify the time, type, and clinically relevant details of VTE, which will be used for the machine learning algorithms. Further studies will include validity, sensitivity, and specificity testing using internal data, as well as a clinical trial to compare the tool with existing risk prediction tools.

IP Status

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