Risk Management Each year in the United States, over seven million patients present to emergency departments (EDs) with chest pain or other possibly cardiac complaints. For such patients, unnecessary hospitalizations of those truly do not have cardiac problems results in $3 billion in avoidable costs in this country each year. Yet, among these patients, still on the order of 26,000 patients are mistakenly discharged from the ED with acute cardiac ischemia (either heart attack or unstable angina pectoris, which can lead to heart attack), which doubles their chances of death. Not only are these problems of a national scale, over- and under-hospitalization is a problem in each community and in each hospital's ED. It is estimated that greater than 70% of all healthcare providers are insured for malpractice liability risk through non-traditional coverage methods. Various forms of non-traditional coverage exist including trusts, reciprocals and risk retention groups; however, the most predominant form of non-traditional malpractice liability coverage in healthcare is the healthcare captive insurance company. There are approximately 200 such companies incorporated by US healthcare entities to support the malpractice and general liability insurance needs of the majority of academic medical centers and integrated delivery systems. Generally these companies have a single parent owner (the medical center or integrated delivery system parent) but are designed to respond to and provide coverage for a myriad of customers, most notably employed and non-employed physicians aligned with the system. The companies have a vested interest in minimizing losses due to allegations of professional negligence, as the captive insurance company essentially is a form of self-insurance. The customers pay premiums to the healthcare captive insurance companies and those dollars and resultant investment income are the only sources of payment for malpractice settlements and verdicts. The Risk Management solution assist healthcare organizations in taking advantage of existing products with real-time TIPIs and adding TIPI-IS quality improvement and error-reduction system to further minimize the risk of errors in the ED triage of patients with possible cardiac complaints and to facilitate their most cost-effective care. As demonstrated in clinical trials, through decision support to improve care, and through specific medical error reduction applications, TIPI Technology addresses the great need to reduce the billions of dollars spent on unnecessary or inappropriate care, while enhancing care quality and reducing errors. Risk Management Features   Benefit Diagnosis Related Problems (e.g., Failure to diagnose, delay in diagnosis, missed diagnosis)   Provides reports on patients discharged home at risk of having an MI (patients discharged with high ACI TIPI probability > 55 %) Identifies patients readmitted within 3 days for retrospective review & quality improvement Provides decision support in real time to help ED physicians identify patients with ACS (including myocardial infarction (AMI) and unstable angina) Physician specific reports that show you average ACI/TIPI probabilities for groups of patients admitted or discharged. Key lab tests, ECGs, and diagnosis information provided for each patient. Insert line about disparities (i.e., women) Failure to follow up on abnormal lab values   Communicates critical test results to the ED physician of record & tracks follow up Alerts the physician electronically when a patient is sent home from the ED with positive Cardiac Bio markers (e.g., abnormal Troponin and abnormal CK-MB) Provides a back-up mechanism for follow-up on abnormal lab results Delay in Treatment   Tracks time to treatment for patients where time is critical to patient outcome Provides time to treatment reports for use in retrospective quality improvement activities Inadequate Documentation   Generates a form to guide clinicians through the documentation of decision-making process and actions taken, including differential diagnosis, treatment plan, and patient instructions. ED Diversion & Hospital Capacity   Provides real-time decision-support to help identify patients in need of ICU/CCU bed Provides reports on patients sent to the ICU/CCU with a low ACI-TIPI Probability Provides reports on patients admitted to ICU/CCU without an AMI diagnosis For more information see: Example 12-lead Electrocardiograph Risk Management Form [PDF] Electrocardiograph-based emergency department risk management tool based on the ACI-TIPI: potential impact on care and malpractice claims [PDF]

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