par8o and IRCDA team to automate clinical assessment with SCAMPS

par80 and the Institute for Relevant Clinical Data Analytics (IRCDA) have teamed up to enable sophisticated clinical decision support at the point of care using SCAMPS. I asked Dr. Adam Sharp,  par80's cofounder, president and chief medical officer to explain.

1. What are SCAMPs? How do they differ from evidence-based protocols?
   • SCAMPs are Standardized Clinical Assessment and Management Plans. SCAMPs outline a data-backed, consensus-based, care pathway for a diverse patient population with a particular diagnosis or condition. Data is collected on the treatment and outcomes of that population, analyzed, and then used to improve the care pathway
   • While evidence based protocols can answer highly specific medical questions, the traditional methods are inadequate to address the interdependent questions related to defining effective care
   • SCAMPs aim to bridge the gap with a method that is integrally linked to continuous improvement
   • Additionally, SCAMPs aim to reduce the cost of delivering care to patients while improving quality by focusing on standardization of care and reduction of unnecessary utilization
2. What are some examples of SCAMPs? What value do they provide?
   • There are a wide variety of SCAMPs, ranging from the inpatient to outpatient to ER settings. Some examples of SCAMPs are the Congestive Heart Failure SCAMP (inpatient) Distal Radius Fracture (outpatient), and Acute Kidney Injury (ICU)
   • They reduce variability in care. The algorithm drives consistency among participating providers. In addition to providing a layer of liability protection, organizations want to drive towards best practice guidelines. SCAMPs do so from the grassroots level
   • SCAMPs gain support from providers because in spite of a foundational algorithm driving decisions, providers are free to diverge from the SCAMP recommendation, so long as they provide a reason. This empowers providers to use their own intelligence alongside the best practice guidelines laid out by the SCAMP
   • Finally, a SCAMP is never perfect. After using it in the field for a given amount of time, the data is collected and analyzed by IRCDA’s analytics team. The output is then used to reevaluate the SCAMP and to change the algorithm to account for the decisions doctors made. These iterations ensure care pathways are constantly improving based on the latest empiric evidence
3. And what is IRCDA? How does it relate to SCAMPs?
   • IRCDA is the Institute for Relevant Clinical Data Analysis. In 2006, clinicians in the Cardiology Department at Boston Children’s Hospital began to toy with a new methodology. This methodology would ultimately create SCAMPs
   • As success grew and institutions around the world became interested, IRCDA was created in 2010 to spread and promote SCAMPs to interested institutions
4. You’re a founder of par8o, which you describe as a healthcare operating system. You’re partnering with IRCDA to implement SCAMPs. How does all of this fit together? If par8o is the operating system, what does that make IRCDA, SCAMPs, and hospitals?
   • IRCDA, SCAMPs, and hospitals in many ways represent a microcosm of the healthcare system as a whole. A major benefit of working with IRCDA is that it touches so many major components of the healthcare industry
   • It ranges across healthcare settings (inpatient, outpatient, ER) in addition to focusing on the most important players in the industry – the providers
   • As healthcare’s operating system, par8o wants to layer itself onto as many aspects of care as possible. Doing so will allow us to bring efficiency to all parts of the industry
   • Finally, pathways in healthcare are manifold. From taking a patient through the right care pathway, to following a pathway created by an insurance company for specialty pharma, to finding eligible patients for clinical trials, the foundation par8o builds with care pathways will have many implications for driving efficiencies in other aspects of healthcare
5. How are EMRs involved in this initiative?
   • par8o integrates with all EMRs via the Direct protocol developed by HHS Office of the National Coordinator (ONC). SCAMPs can be initiated out of an EMR using a direct message – the direct message will trigger a draft SCAMP to be created in par8o and will notify the provider that they must complete the SCAMP
   • Therefore, so long as the EMR supports Direct messaging, par8o can use that functionality to integrate
6. What impact will this partnership have for patients?
   • Patients will benefit because par8o’s technology will address two key pain points currently in the SCAMP process. The first is unwieldy data entry – par8o will enable providers to complete SCAMPs from their mobile phone. Using decision support, the forms will seem less onerous
   • Additionally, by leveraging form versioning technology, par8o will enable faster iterations on SCAMPs. Faster iterations means the data gathered during SCAMP collection can be leveraged sooner, resulting in enhanced care for affected patient populations
7. This is clearly a first step. How do you see development rolling out over the next few years?
   • Over the next few years, par8o has a big vision. To start, our aim is to successfully launch a pilot program at a single institution. We hope to ease data entry issues and therefore increase adoption. Additionally, we hope to see faster iterations between SCAMP versions
   • In the future, in addition to expanding to more member institutions, we would like to see a social element brought to SCAMPs where providers are able to participate in chat forums and share the latest literature concerning that area of care
   • par8o also plans to build a SCAMPs “Editor”, which would enable the IRCDA team to build and version their own SCAMPs, greatly increasing the iteration process

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By healthcare business consultant David E. Williams, president of Health Business Group.