When the Cleveland Clinic determined in 2008 that its anesthesia information management system wasn’t meeting its needs, the Clinic charged leaders within its own walls with creating a better system. The technology that resulted, and another innovative IT system that’s been used alongside it in Clinic operating rooms since 2010, has now been licensed to a private company that’s turning it into a commercial product for use in the Clinic and other institutions.
Cleveland Clinic Innovations and three private investors launched Talis Clinical last month based on two IT products developed in the clinic’s Anesthesiology Institute. The two technologies – the Anesthesia Automated Record Keeping System (ARKS) and Decision Support System (DSS) – work in tandem and will be packaged as Advanced Clinical Guidance – Anesthesia.
“There is tremendous activity in the operating room, so it’s critical to appropriately document the patient’s known conditions, the procedure being performed and the anesthesia workflows which include anesthetic agents, fluids and specific therapies that are administered at specific times,” said Talis Clinical President and Chief Operating Officer Gary Colister. The system enables anesthesia best practices to be followed and builds a compliant, billable electronic anesthesia record while also supporting the clinical team managing the patient.
The first piece of the technology, ARKS, is an anesthesia information management and documentation system created by George Takla of the General Anesthesiology Department, who was appointed to develop the application with a team of developers in 2008. It gathers and records physiological patient data like heart rate, blood pressure and respiratory rate in real-time during an operation and displays it on one screen. Today, it’s used in more than 270 operating rooms within the Cleveland Clinic network.
The other piece, DSS, provides advanced clinical guidance during general anesthesia procedures. Inspired by the computers and integrated alert systems in planes, Anesthesiology Institute Chairman Dr. David Brown began work on the system in 2008 and was joined by Dr. Wolf Stapelfeldt, chairman of the General Anesthesiology Department.
“It allows them to document everything that they’re doing, and reminds them of the workflows that are important for a targeted outcome,” Colister said. DSS uses the information collected by ARKS and alerts clinicians when those physiological metrics indicate the patient is headed toward a path outside of the targeted clinical outcome. The idea is that, with the use of a computer to process the tremendous amount of data collected during an operation, clinicians may be able to identify problems more rapidly.
“Some operations go on for six, eight or more hours,” Colister added. “As clinicians are relieved, the technology documents what has happened in the case so the next clinician can immediately step in to allow for consistent continuity of care.”
Innovations has been evaluating and refining the technology for commercialization since 2011. When Colister and his business partner and lead investigator, Roger Hungerford, saw the technology during a briefing with Innovations last year, they saw it as a scalable technology with several potential applications beyond anesthesiology. Previously, the pair had honed their expertise in critical care developing and commercializing a smart infusion pump for the company Hungerford previously founded, SIGMA International General Medical Apparatus. That company was being acquired by Baxter International, and the pair was looking for a new business opportunity.
“We see it as a platform that we can take from OR into many other different clinical areas,” Colister said.
But for now, it’s staying focused on the anesthesia product. With the formation of Talis Clinical, the team licensed the technology from the Clinic and is now bringing on the original development team to continue building the company infrastructure and processes needed to both support the Clinic’s use of the product, and make it available to other hospitals.
While other AIS technologies offer decision support, the Clinic has emphasized that its technology takes into account patient-specific conditions and real-time patient data. It sounds a bit similar to work being done by Verdande Technology, a company whose CEO I interviewed last month about its case-based reasoning support applications. The Clinic says its technology can also be scaled for the needs of a small or large hospitals.
[Anesthetist photo from BigStock Photos]