By Janice Staber, MD
“Great ideas need landing gear as well as wings.” — Charles Douglas Jackson
In the Special-Interest Session, Systems-Based Hematology: How to Implement Evidence-Based Programs for Virtual Hematology Consults and Anticoagulation Stewardship, Michal Rose, MD, and Jean Connors, MD, will provide insights into how their ideas became success stories. Taking place Sunday at 4:30 p.m. (Tangerine 1 [WF1], Level 2, Orange County Convention Center – map it ), the session will be moderated by Nathan Connell, MD, MPH.
Dr. Rose, who is a professor of medicine at Yale School of Medicine and the chair of the Data and Safety Monitoring Committee at the Yale Cancer Center, will present the talk titled How I Setup a Virtual Hematology Consult Service. Virtual hematology consult services (e-consults) are a way to provide health care without seeing a patient face-to-face and are being developed to decrease costs and prevent unnecessary visits. Virtual hematology visits allow for the hematology consultants to review a case and decide if they need to give advice to be carried out by the local provider or triaged to be seen in-person by the hematologist.
Before initiating an e-consult, multiple steps need to be considered, including the accuracy and thoroughness of the electronic medical records, order panels, pre-populated templates, consistency of practice among specialists, and the potential for billing. Dr. Rose’s group (Cecchini M, et al. Blood. 2016;127:1610-1611) and others (Pai A, et al. Blood 2019;133:993-995) revealed that the majority of the consults are triaged electronically, and the rest are seen face-to-face. Dr. Rose will share her knowledge on how to develop this service and provide insights into the nuts and bolts of practically implementing such a program.
Chief of Hematology at Brigham and Women’s Faulkner Hospital, Dr. Connell will moderate the session. He states that “the most exciting part [of virtual consults] is how the field of hematology is leveraging the use of technology to optimize and streamline patient care. The hematology workforce is spread thin, and many institutions don’t have easy access to hematologists, particularly those with expertise in classical hematology, so the use of technology to connect patients and hematologists across distance is an exciting development in our specialty. E-consults in particular help facilitate communication between hematologists and primary care physicians, and I’ve personally benefitted from stronger relationships with other physicians in my network as we communicate more regularly.”
Dr. Connors, who is an associate professor of medicine at Harvard Medical School and the medical director of the Anticoagulation Management Service at Brigham and Women’s Hospital and the Dana-Farber Cancer Institute, will present How I Setup an Anticoagulation Management and Stewardship Program. Anticoagulation stewardship embodies the “coordinated, efficient, and sustainable system-level initiatives designed to achieve optimal anticoagulant-related health outcomes and minimize avoidable adverse drug events through 1) the application of optimal evidence-based care, 2) appropriate prescribing, dispensing, and administration of anticoagulants and related agents, and 3) provision of appropriate patient monitoring and clinical responsiveness.” Core elements of an anticoagulation stewardship program include leadership commitment, professional accountability and expertise, multidisciplinary approach, data collection/tracking, systematic care, and education. Dr. Connors will discuss the importance of risk-stratification to target anticoagulation to the appropriate patients.
Dr. Connell would like to highlight that “anticoagulation management and stewardship programs help institutions improve the quality of care for patients receiving anticoagulant therapy and they also allow institutions to appropriately manage high-cost resources so that inappropriate use is minimized.”
The scheduled lectures will be followed by time specifically designed to foster networking with the speakers and others interested in systems-based hematology (hors d’oeuvres and drinks will be provided).
From these interactions will come ideas. Make sure yours have wings and landing gear.
Dr. Staber indicated no relevant conflicts of interest.