COReAPPClinical Outcomes Registry

Specification:

o Functional• Point of care input (smart-phone/mini-tablet)• Capture outcomes (adverse events)• Capture provider performance metrics • Provide clinical decision support (CDS)• Configurable menus/functions by admin• Compliant error checking

Postop note; documentation• Efficient data entry

• minimize redundant data entry• nested menus

• Independent of hospital IT/AIMS• Provide pre-care clinical RISK ALERTS

o Technical• Native iOS, Android*, Windows 8• WiFi or 3G/4G, Cloud based• asynchronous/offline operation• HIPAA/PHI compliant encryption• SQL compatible DB and reports• Bar code compatible

M Jacques1 BS, X Fu1, PhD, FJ Overdyk2, MSEE, MD1. Hofstra University Department of Computer Science2. Hofstra North Shore-School of Medicine; North American Partners in Anesthesia* Current demo platform

Smart-phone

COReAPP

Risk Alerts: Difficult Airway AICD/Pacemaker PCI Stent

PONV OSA BMI Aspiration Risk Clinical Decision

Support:

Level 1 Level2 Level 3

Aspiration

Suspected

Confirmed

Use of difficult airway equipment

Planned use of difficult airway equipmentUnplanned use of difficult airway equipment

Unable to intubateSurgical airway required

Airway/RespiratoryLaryngospasm w

intervention(1) on induction (2) upon emergence

Airway/RespiratoryBronchospasm w

interventionrelieved by a) postive pressue b) sux c)pt intubated

Airway/Respiratory Pulmonary Edema

Airway/RespiratoryNegative Pressure Pulmonary Edema before ETT removal

Airway/Respiratory Pulmonary Embolus

Airway/RespiratoryUnplanned

reintubation

Airway/RespiratoryPost Op Mechanical

Ventilation

Airway/RespiratoryNM block reversal in

PACUAirway/Respiratory Naloxone given

Airway/Respiratory

Patient SatisfactionAntiemetic(s) in

PACU

Patient Satisfaction Vomiting in PACU

Patient SatisfactionNausea/Vomiting-

prolonged/resistant

Patient SafetyUnintended

Awareness under GA

Patient SafetyPostoperative

hypothermia <36Patient Safety Medication error

Patient SafetyEquipment

malfunctionPatient Safety Patient Fall

OR fire/burnSurface burnAirway fireOR fire

Patient SafetyAgitation requiring restraint/treatment

Patient Safety

Incorrect surgical site, side, patient,

procedure, implant

Patient Safety

Incorrect regional block site, side,

patient, procedure

Airway/Respiratory

Airway/Respiratory

Patient Safety

Outcomes/Adverse events*

Printer Logistics;

Smart-phone

CardioVascular Cardiac Arrest (w CPR) CardioVascular CardioVascular

CardioVascularACS: Myocardial Ischemia

req intervention

CardioVascular ACS: Myocardial Infarction

CardioVascularDysrhythmia requiring

intervention

Discharge/Planning

Case Cancelled Day of Surgery

System Reasons Medical Reasons Patient Reasons

Discharge/Planning Unplanned return to OR

Discharge/PlanningUnplanned Hospital

Admission (and 23 hr stays)

Discharge/Planning Unplanned ICU Admission

Neurologic; Procedural

Brain Injury

CVA

Hypoxemic brain Injury/Coma

Other brain injury

Neurologic; Procedural

Spinal cord Event

Epidural abscess following regional

Epidural hematoma following regional

Other spinal cord injury

Neurologic; Procedural Visual Loss

Neurologic; Procedural

Peripheral Nerve Injury: in distribution of or absence of

regional anesthesia

Neurologic; ProceduralFailed Regional Block as

primary anesthetic

Neurologic;ProceduralPneumothorax

After perithoracic vascular or regional procedures

Other

Neurologic/ProceduralPost-Dural Puncture

Headache

Neurologic/Procedural Vascular Access Event

Neurologic/Procedural Wet tap

Neurologic/Procedural Local anesthetic toxicity

Neurologic/ProceduralInfection after peripheral

nerve block

Neurologic/ProceduralExcessive block requiring

airway support

Pharmacy/Blood Bank Malignant Hyperthermia

Pharmacy/Blood Bank Anaphylaxis

Head/Neck Trauma Dental injury

Head/Neck Trauma Corneal Abrasion

Head/Neck TraumaNondental Upper Airway

Trauma

Other Major Morbidity/Mortality Death

*Anesthesia Business Group Criteria

SCIP Abx: