How clinical decision support is offering personalised pathology to Australian patients

Around the world we are seeing a shortage of healthcare professionals, and health systems globally are under increased pressure brought on by the COVID-19 pandemic. One area of innovation that has been ramped up over recent years to support healthcare services and staff is clinical decision support (CDS).

In pathology, CDS is used to help pathologists sort through the barrage of patients to focus their attention where it is needed most, on complex or high-risk cases.

For years, Beamtree, an Australian Healthcare Technology Company has worked with healthcare organisations around the world to better capture, manage and leverage their human expertise to improve the performance of their business. In doing so, Beamtree have purpose built a CDS software (RippleDown) aimed at helping pathologists create an environment of continuous learning and awareness from existing, untapped data. Abbott, one of the largest healthcare companies in the world, with a vision to help communities live the best life they can, has seen the potential for CDS to help pathologists in healthcare organisations globally to provide patient focused outcomes.

It is this shared vision of improving care pathways for patients, that brought together the Beamtree and Abbott organisations, partnering under a global distribution agreement which has been in place since 2017. Distributing the Beamtree software (RippleDown) under the AlinIQ® CDS brand enables Beamtree access to global healthcare organisations (currently over 250 pathology and hospital organisations serviced by Abbott worldwide) while strengthening Abbott’s Digital Health portfolio to provide improvements to patient outcomes via clinical decision support. This model has enabled Abbott to further increase the value of the software through our medical liaison team. This team’s consultation engagement with our customers and pathologists helps further extend on the capability of the software, customising for specific disease-state recommendations and test appropriateness. AlinIQ® CDS, achieves this by providing accurate, reliable, and incisive decision support for pathology results and in turn, the requesting doctors.  Data is gathered from disparate sources, including results from LIS and instrumentation, clinical documentations patient characteristics, geographical and/or environmental determinants.

AlinIQ® CDS then combines this data with rules-based insights built by clinical experts, to address dynamic changes occurring with the patient, while delivering consistent personalised reports in a timely manner. While the intended use is not to replace clinical judgement of a health professional, AlinIQ® CDS enhances laboratory reporting consistency and quality, delivering recommendations to a health professional - ultimately providing better healthcare outcomes.

Clinical expert users also have access to the system without a need to engage the IT team to alter rules through a feedback loop, therefore increasing and enhancing the expert scientific knowledge held in the system – while rapidly moving new evidence to practice.

 

Tim Kelsey, Beamtree CEO, said; “This Australian invention, RippleDown, has been remarkably successful, and is now used in more than 24 countries around the world, supporting pathologists to be able to focus on complex cases. RippleDown is automating more routine pathology and freeing up the time of the expert clinician to focus on more difficult cases, transforming not just the outcomes of the labs using it, but also the economics of those labs.”

One such laboratory is ACT Pathology in Canberra, that has led the way in utilising this technology. Executive Director, Dr Glenn Edwards has been interested in examining the potential of CDS for decades and was involved in the early commercialisation of RippleDown.

Dr Edwards said; “RippleDown can look at a patient across time, through multiple tests and data elements including demographics. It can reason with that information and provide support to clinicians, that’s the real value. That knowledge is otherwise locked away, sitting in the heads of experts and in IT systems. They have the knowledge, but they are overwhelmed by the volume and scale of pathology testing. This technology unlocks that and allows it to be deployed across the patient journey regardless of scale. It’s tremendously exciting.”

Dr Edwards and colleagues recently published work that shows patient outcomes such as LDL cholesterol levels can be improved through utilisation of CDS in pathology.1.

He also noted that pathology data can empower patients, and the importance of patient-centred care is becoming better understood.

“Change is being fuelled in part by the increasing voice of the consumer in healthcare. We are also seeing silos and barriers breaking down, and pathology being seen as part of the broader healthcare system,” Dr Edwards explained.

Mr Kelsey noted the importance of CDS technology when looking at the global context; “We forecast in our most recent literature a deficit of more than 10 million doctors by 2050 2. globally. It’s an astonishing shortfall. These platforms for clinical decision support offer a very meaningful contribution to resolution of that crisis.”

According to Mr Kelsey there is an increasing appetite for ‘virtual wards’ where patients can have hospital care administered at home, with clear benefits for patients and hospitals; “There is congestion in hospitals because of the COVID pandemic, so the more people can be treated in their home, the better it is for them, the less likely they are to contract illness in the hospital itself, but also they're freeing up beds in the hospital.”

Novel approaches to care such as this are highly dependent on accurate and timely monitoring via pathology data. Mr Kelsey added; “Integration of pathology into the broader care pathway has to be the future direction of travel, it's extremely exciting, there's a lot of innovation that we can already start seeing in the development of new care models.”

Looking to the future, Dr Edwards is excited by the potential of CDS: “We like to consider ourselves an early adopter and value a close ongoing relationship with Beamtree. There’s a lot of potential here for further innovation and development, and we value that relationship.”

Mr Kelsey cited Abbott’s reputation as being fundamental to the ongoing success of RippleDown. He said; “Abbott has a world-class reputation in customer service and technology innovation. The strong credentials of the Abbott brand help us to communicate the benefits of CDS to labs around the world. We are beginning to take this remarkable Australian technology to the rest of the world.”

References:

1. Clinica Chemica Acta 422;  (2013) 21 -25  Bell DA, Bender D, et al

2. QUALITY IN RETREAT A REPORT BY THE BEAMTREE GLOBAL IMPACT COMMITTEE; © Beamtree Holdings Limited June 2022