Adverse, critical and unanticipated events happen every day in healthcare. The results are increased morbidity and mortality, increased length of stay and unreimbursed cost of care. Simple and intuitive visualization provides an early warning of clinical deterioration so that clinicians can take appropriate action to circumvent an adverse event. COVID-19 has emphasized the need for clinicians to be able to anticipate these events and provide proactive care. In our on-demand webinar, we discuss how predictive analytics monitoring can help clinicians prevent events (such as emergent intubation and sepsis), conserve precious resources, decrease the risk of staff exposures and ultimately improve patient outcomes.View Webinar
To support your surveillance and control efforts, our team has created a custom package of COVID-19 alerts. These alerts are meant to assist in identification of potential persons of interest and track the order of or positive result of a COVID-19 test. These alerts have been in the pilot phase with several hospitals where positive cases have been identified and we feel the current U.S. situation warrants distribution more broadly. Alert descriptions can be found in the TheraDoc Users’ Community on PremierConnect®.
While the risk of the novel coronavirus (COVID-19) remains low for the general public in the United States, as indicated by both the CDC and WHO, the outbreak poses a great threat to the U.S. healthcare supply chain. This risk is increasingly evident when it comes to the masks and respirators that healthcare providers depend on to deliver care. An interruption in the supply chain of these products poses a potential risk to our nation’s patient population and our dedicated caregivers and clinicians as controlling exposures to occupational hazards is a fundamental way to protect personnel.
For the first time in 50 years, the Centers for Disease Control and Prevention mandates quarantine for travelers from China due to an outbreak of respiratory illness caused by a novel (new) coronavirus – COVID-19 – first identified in Wuhan, Hubei Province, China.
Premier® Clinical Surveillance technology and services, powered by TheraDoc®, gives Infection Preventionists back precious time they need to stem the spread of COVID-19.
CHARLOTTE, N.C. -– A recent Premier Inc. (NASDAQ: PINC) analysis found that total care for patients who experienced an opioid overdose resulted in $1.94 billion in annual hospital costs across 647 healthcare facilities nationwide.
Premier®, a healthcare improvement company, found that these costs were concentrated among nearly 100,000 opioid overdose patients with nearly 430,000 total visits across emergency department (ED), inpatient and other care settings. Sixty-six percent of the patients were insured by public programs (33 percent Medicare and 33 percent Medicaid), 16 percent used a commercial payer, 14 percent were uninsured and 3 percent were covered under other programs, such as workers’ compensation.
Annual hospital care for overdose patients represents a significant portion of healthcare expenditures and can be detrimental to providers in regions with high addiction rates. For instance, by extrapolating the cost trends Premier identified in its analysis, the total added costs to the U.S. healthcare system are estimated to amount to $11.3 billion annually, or 1 percent of all hospital expenditures. If the payer mix remained constant, $7.4 billion of the expense would be borne by the federal Medicare and Medicaid programs.
“Opioid addiction has been a public health problem for some time, but we’ve yet to show exactly how hospitals – the entities that treat most of these patients – are financially impacted,” said Roshni Ghosh, MD, MPH, Vice President and Chief Medical Information Officer, Premier. “This analysis shows that on top of losing family members and friends to this epidemic, it’s costing consumers and taxpayers, as well as hospitals. There is an urgent need to provide health systems and emergency caregivers with frontline solutions that they can use to stem the tide of opioid addiction in our communities.”
Leveraging the Premier Healthcare Database, Premier’s analysis of opioid overdose visits, patient progression, and usage and cost patterns was made available to members via individual hospital and system-level reports. These actionable reports are standardized to help health system leaders easily and quickly benchmark internal patterns, relative to opioid overdoses, to measure their performance based on industry trends and pinpoint opportunity areas. The Premier Healthcare Database leverages the PremierConnect® performance improvement platform, which houses data on 45 percent of U.S. patient discharges nationwide.
“The comparative analyses that Premier provides in these reports are key to supporting health system efforts to address this epidemic,” said Ghosh. “These are detailed, evidence-based insights that help providers create focused and customized pain management and addiction reduction initiatives specific to the patients that need them. Our goal is to support our members in every way possible in reducing overuse and misuse, and improving health outcomes, safety and costs at the same time.”
Opioid overdose patients that present to the ED are at a high risk for multiple organ failure, hospitalization, increased costs due to ICU stays and unplanned readmissions following discharge. According to the Premier analysis, caring for all overdose patients treated in the ED alone amounted to more than $632 million in costs to hospitals. Approximately 47 percent of patients were treated and released, and 53 percent were treated and admitted. Of those that were admitted, nearly 40 percent experienced organ failure. The average cost for an overdose patient who was treated and released totaled $504, but the average cost rose to $11,731 for those that were treated and admitted and to $20,500 for those that required ICU care. Adding these costs – ED, inpatient and ICU – totaled the $1.94 billion in annual hospital charges.
While the analysis used the data from 647 facilities to estimate a national aggregate rate (40.9 per 10,000 visits), there was wide state-to-state variation, ranging from a low of 6.1 per 10,000 visits to a high of 87.5 per 10,000 visits. Of those receiving treatment, 34 percent were treated for heroin poisoning and 8 percent were treated for synthetic opioid poisoning, such as methadone. Likewise, 58 percent of those treated were for undetermined opioid poisoning, including prescription opioids and overlapping or unspecified use, such as if the patient used heroin that was laced with synthetics, e.g., fentanyl.
In addition to the added expense of providing care for overdose patients, Premier’s analysis found that three of every 10,000 overdose patients die in the ED, while another 366 per 10,000 patients die in inpatient settings. The impact of an overdose can often be reversed quickly in the ED or by emergency responders. However, overdose patients admitted to the hospital can experience extended lengths of stay and are at risk of mortality depending on the amount and type of drug they took, as well as their current health status. Moreover, of those who were treated and released from the ED, about 24 percent were readmitted for additional emergency care within 30 days of discharge. Therefore, opioid overdose patients are being readmitted at a higher rate than the 17.5 percent national average for 30-day readmissions for Medicare patients, as calculated by the Centers for Medicare & Medicaid Services (CMS).
Premier’s outstanding research and clinical expertise has helped the company build and offer solutions to further aide providers on the frontlines in addressing the opioid epidemic. Premier partners with professional associations and federal agencies to help its members better manage these patients, as well as advocates for changes to regulations and policies that limit care coordination. For example, 30 Premier member health systems recently participated in a national safer post-operative pain management pilot program as part of Premier’s Hospital Improvement Innovation Network, which tested and designed new care delivery processes to better manage pain and the potential for opioid drug addiction. Based on learnings from its members, Premier developed a Safer Pain Management Toolkit, which provides easy-to-access information and an aggregated inventory of products, solutions and resources that support pain management methods to improve patient safety for its members. Additionally, Premier uses its data-driven reports, such as the opioids analysis, to help members pinpoint areas of opportunity and works with them on care transformation strategies to improve performance. Premier’s clinical surveillance solution, powered by TheraDoc®, also provides real-time alerts for pharmacy team interventions on high-risk drugs and potentially dangerous drug combination interactions, as well as monitors patients prescribed high-dose long-acting/extended release opioids.
More information on efforts to address the opioid epidemic can be found on the Premier Safety Institute® website.
The analysis of opioid overdoses and related costs was conducted in October 2018 using the most recent 12 months of data from 647 facilities contained within a database maintained by Premier. In contrast to recent CDC and CMS findings, Premier’s analysis used ICD-10 coded opioid overdoses and clinical presentation in the ED (with subsequent admission for treatment or “treat and release”) and excluded patients who were administered opioid medication by the hospitals themselves. While Premier’s calculated rate (40.9 per 10,000) is significantly higher than some previously reported rates, it better reflects the overall burden on healthcare facilities and private and public payers. The extrapolation analysis leveraged data from the Healthcare Cost and Utilization Project, which estimates 143 million annual ED visits nationwide and applied the 40.9 per 10,000 rate in Premier’s analysis to estimate the number of opioid overdose ED visits annually (584,870 visits nationwide or 5.8 times more). Premier then multiplied the $1.94 billion in annual costs in its analysis by 5.8 to get an estimated $11.3 billion in annual ED costs.
About Premier, Inc.
Premier Inc. (NASDAQ: PINC) is a leading healthcare improvement company, uniting an alliance of more than 4,000 U.S. hospitals and health systems and approximately 165,000 other providers and organizations to transform healthcare. With integrated data and analytics, collaboratives, supply chain solutions, and consulting and other services, Premier enables better care and outcomes at a lower cost. Premier plays a critical role in the rapidly evolving healthcare industry, collaborating with members to co-develop long-term innovations that reinvent and improve the way care is delivered to patients nationwide. Headquartered in Charlotte, N.C., Premier is passionate about transforming American healthcare. Please visit Premier’s news and investor sites on www.premierinc.com; as well as Twitter, Facebook, LinkedIn, YouTube, Instagram and Premier’s blog for more information about the company.
Florida-based health system to employ PremierConnect® pharmacy clinical surveillance and analytics across 40 hospitals to enhance medication management, antibiotic stewardship
CHARLOTTE, N.C. (March 9, 2017) — Adventist Health System, a faith-based healthcare organization headquartered in Altamonte Springs, Florida, has expanded its partnership with Premier Inc. (NASDAQ: PINC), a leading healthcare improvement company, to use pharmacy clinical surveillance and analytics in its effort to better treat diseases.
A member of Premier for more than 20 years, Adventist Health System uses clinical, operational and supply chain analytics in the PremierConnect® performance improvement platform. By expanding its partnership in 40 hospitals across nine states, Adventist Health System will integrate Premier’s pharmacy clinical surveillance and analytics with existing PremierConnect analytics to enhance medication management and antibiotic stewardship.
“Patient safety has always been a top priority at Adventist Health System,” said Loran D. Hauck, MD, chief clinical officer for Adventist Health System. “Premier’s pharmacy clinical surveillance and analytics solution will help our pharmacists forecast and identify opportunity areas, prioritize next steps, document interventions and benchmark progress across the continuum. This is particularly important as we enhance our antimicrobial stewardship program with capabilities to quickly identify situations where antibiotics have no clinical benefit and reduce the emergence of antibiotic resistance.”
PremierConnect pharmacy clinical surveillance and analytics, powered by TheraDoc®, streamline data for pharmacists to target clinical intervention opportunities, track performance with customizable departmental reports and alerts, and optimize drug therapies in real-time. Providers use the solution to create or enhance antimicrobial stewardship programs by identifying cases of antibiotic overuse, reducing time-to-appropriate therapy and enhancing treatments for difficult-to-treat pathogens. Additionally, the solution helps providers adhere to the Centers for Disease Control and Prevention’s National Healthcare Safety Network reporting requirements.
“Adventist Health System is a leading organization that is committed to fostering an environment where patient safety and the efficacious use of life-saving drug therapies is a top priority,” said Leigh Anderson, chief information officer, Premier. “We’re thrilled they chose to build on their relationship with Premier to improve disease treatments and reduce the administrative burden on pharmacists whose time is better spent focusing on delivering safe and effective care.”
The financial terms of the agreement were not disclosed, and are not expected to materially affect Premier’s fiscal 2017 financial results.
About Premier Inc.
Premier Inc. (NASDAQ: PINC) is a leading healthcare improvement company, uniting an alliance of approximately 3,750 U.S. hospitals and more than 130,000 other provider organizations. With integrated data and analytics, collaboratives, supply chain solutions, and advisory and other services, Premier enables better care and outcomes at a lower cost. Premier, a Malcolm Baldrige National Quality Award recipient, plays a critical role in the rapidly evolving healthcare industry, collaborating with members to co-develop long-term innovations that reinvent and improve the way care is delivered to patients nationwide. Headquartered in Charlotte, N.C., Premier is passionate about transforming American healthcare. Please visit Premier’s news and investor sites on www.premierinc.com; as well as Twitter, Facebook, LinkedIn, YouTube, Instagram and Premier’s blog for more information about the company.
Matters discussed in this release that are not statements of historical or current facts, such as Adventist Health System’s anticipated use of Premier’s performance services at expected levels, as discussed herein, are “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements may involve known and unknown risks, uncertainties and other factors that may cause the actual results, performance or achievements of Premier to be materially different from historical results or from any future results or projections expressed or implied by such forward-looking statements. Accordingly, readers should not place undue reliance on any forward looking statements. In addition to statements that explicitly describe such risks and uncertainties, readers are urged to consider statements in the conditional or future tenses or that include terms such as “believes,” “belief,” “expects,” “estimates,” “intends,” “anticipates” or “plans” to be uncertain and forward-looking. Forward-looking statements may include comments as to Premier’s beliefs and expectations as to future events and trends affecting its business and are necessarily subject to uncertainties, many of which are outside Premier’s control. More information on potential factors that could affect Premier’s financial results is included from time to time in the “Forward Looking Statements,” “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” sections of Premier’s periodic and current filings with the SEC and available on Premier’s website at investors.premierinc.com. Forward looking statements speak only as of the date they are made. Premier undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise that occur after that date
Morgan Rae Guthrie
Director, Public Relations
P: 704.816.4152; C: 704.425.3056
13034 Ballantyne Corporate Place Charlotte, NC 28277
Today, an urgently needed tool was introduced to help US hospitals implement strategies to promote the appropriate, safe use of antibiotics. The National Quality Forum (NQF) and the Centers for Disease Control and Prevention (CDC), alongside a team of more than 25 experts, including Premier Inc., convened to create the Antibiotic Stewardship in Acute Care: A Practical Playbook.
Examples of strategies in the Playbook include team-wide, systematic approaches to: assessing when patients need antibiotics and when treatment should be adjusted; educating staff, family, and patients about appropriate antibiotic use; and, tracking and reporting antibiotic prescribing, use, and resistance.
Premier hospital members have been taking steps to combat antibiotic-resistant bacteria. In fact, since the launch of Premier’s nationwide collaborative initiative to improve antibiotic overuse, more hospitals are adopting antibiotic stewardship programs. Premier’s spring Economic Outlook survey suggests 97 percent of health system C-Suite feel that developing/enhancing an antimicrobial stewardship program is a top priority – this is up from 81 percent in the fall.
It has been estimated that up to half of antibiotic use in hospitals is unnecessary and inappropriate. In fact, Premier/CDC research found that 78% of hospitals were overprescribing redundant combinations of intravenous (IV) antibiotics for two or more days. In addition, antibiotic overuse and misuse have spurred the spread of Clostridium difficile infections that can cause life-threatening colitis. In a recent study on the impact of C.difficile, Premier found that the majority of cases analyzed were associated with concomitant antibiotic use.
In preparation for the release of TheraDoc® v4.6.1, we have the following important information to communicate.
Client Workstation Browser Requirements
Due to performance related issues, the use of Microsoft Internet Explorer 8 (IE 8) will not be officially supported with TheraDoc v4.6.1; however, IE 9, IE 10 and IE 11 will be supported. Be aware if your facility chooses to continue using IE 8, your facility may experience performance problems:
- If the same browser session is left open indefinitely. To help avoid this issue, end-users should close and restart their browsers at least once a day.
- Unusual, long “load” time for a browser page that contains a script; such as a large query or report in the TheraDoc application. When this occurs, the following error message displays:A script on this page is causing Internet Explorer to run slowly. If it continues to run, your computer may become unresponsive. Do you want to abort the script?
To help avoid this issue, Microsoft has released a fix that can be used to change the script timeout value by modifying a registry entry. This fix should be made on each workstation where IE 8 is used to run the TheraDoc application. For more information and instructions, see the following entry on the Microsoft Support Web site:
NOTE: Microsoft has announced that after January 12, 2016 it will provide technical support and security updates for only the most recent version of Internet Explorer (currently IE 11). Microsoft is encouraging all users to upgrade to the most current version to ensure ongoing technical support and security updates.
Browser Setting Requirements
Please be aware of the following browser setting requirements for using TheraDoc v4.6.1:
- Compatibility mode should not be enabled
- Zoom should be set to 100%
- Quirks should not be enabled
TheraDoc Application Hardware and Software Requirements
Disclaimer: The following hardware and software specifications are the minimum acceptable for a baseline TheraDoc application installation. Depending on the facility size, user count, and data volume, additional hardware may be required. Failure to meet or exceed these requirements will invalidate any and all performance expectations and TheraDoc support’s ability to remediate any performance based issues that may arise.
Server Hardware Requirements
- Recommendations are based on Intel 64-bit architecture.
- The recommendation below should support 200 named users. If more than 200 named users are going to use the system, additional hardware and third-party software may be required.
- Disk space requirements for 3 years of storage for a growth rate of 120 MB / BE / year.
- Disk space requirements assume raw HL7 messages are stored for 12 months
- Disk space requirements assume vital signs data is being sent hourly
- Vital signs sent more than 1/hour could negatively impact system performance
- The STAGE server should be separate environment from the PROD servers.
- If multiple application/web servers are deployed (>4000BE), the member will have to install and configure a load balancer capable of maintaining persistent (aka sticky) connections.
- TheraDoc support recognizes the benefits of VM environments and that VMs are a good use for STAGE/TEST environments and also potentially for PROD APP servers. The best performing implementations are those that have one or more application servers placed on a VM and the database server placed on its own dedicated hardware.
- Provisioning of virtual machines is the responsibility of the member. Failure to appropriately provision and monitor virtual machines to comply with the minimum hardware specifications below will invalidate any and all performance expectations and TheraDoc support’s ability to remediate any performance based issues that may arise.
- TheraDoc support recommends that the PROD environment is run on a dedicated database server. Custom consultation is required for placing the database server in a VM environment.
- NOTE: Having a PROD server on a VM may increase database licensing costs.
- For > 30 concurrent users, additional memory may provide performance benefits
- Memory allocation (single server setup): DB (1GB), ColdFusion (2GB), JasperReports Server (2GB), TESA/KNET (1GB), OS (2GB)
- Memory allocation (two server setup): ColdFusion (3GB), JasperReports Server (2GB), TESA/KNET (1.5GB), OS (1.5GB), DB (8GB) on a separate server
Client Hardware and Software Requirements
- Intel dual core processor or better
- 4 GB Memory
- 1024×768 Display Resolution
- 10/100Mbps network interface
- Keyboard and Mouse
- Browsers: IE 9, IE 10, IE 11
- Windows operating system running a compatible version of IE
- Software enables exporting data to MS Excel 2010 or greater
- Alpha-numeric pager
- Service provider must support WCTP
v4.6.1 Upgrading Recommendations / Requirements
Windows Server 2003 will not be supported with v4.6.1. Windows Server 2012 R2 is supported with v4.6.1.
If upgrading from Windows Server 2003, it is recommended to install TheraDoc v4.6.1 on Windows Server 2012 R2.
We appreciate your choice in TheraDoc for clinical surveillance and look forward to the release of this new version. To assist with any questions or concerns surrounding this update, please have your Authorized User reach out to TheraDoc Support at firstname.lastname@example.org or 877-TDOC-FIX (877-836-2349).
Premier, Inc. (NASDAQ: PINC) has reached a definitive agreement to acquire TheraDoc, a market leading provider of clinical surveillance software, for $117 million in cash, subject to potential purchase price adjustments regarding TheraDoc’s actual working capital, cash and indebtedness at closing. The transaction is expected to close in Premier’s fiscal 2015 first quarter ending September 30, 2014, subject to customary closing conditions.
TheraDoc is a wholly-owned subsidiary of Hospira (NYSE: HSP). Premier’s board of directors unanimously approved the transaction, and applicable antitrust approvals have already been obtained. Based on the trailing twelve months operating earnings provided by TheraDoc, the $117 million represents a purchase price multiple in the 10-11 times range.