SAN FRANCISCO, June 1, 2022 /PRNewswire/ — Today InsightRX, a healthcare technology company which provides cloud-based precision dosing support to guide treatment decisions, announced that Boone County Hospital, a 25-bed critical access hospital in Iowa, implemented model-informed precision dosing via its point-of-care InsightRX Nova platform to reduce acute kidney infections resulting in zero nephrotoxicity events. The hospital has also improved the number of patients achieving the desired therapeutic range for their antibiotic regimen by 27% in one year.
In May 2019, Boone County Hospital implemented InsightRX Nova, a precision dosing platform that uses pharmacokinetic model-informed Bayesian forecasting, to standardize its therapeutic drug monitoring for four key antibiotics, including vancomycin. Although the platform is only being used for approximately 50 patients per year, Boone Hospital has realized an annual $16,000 cost avoidance from reduced blood draws in addition to $7,000 in pharmacist time through efficiency improvements.
“In addition to saving money and time, we’re also saving our patients from too many blood draws, which improves the patient experience,” said Kimberly Askren, clinical pharmacist and antimicrobial stewardship champion at Boone County Hospital. “Previously, patients needed to have two blood samples taken at precise times, and then we needed to run the manual calculation using a pharmacokinetic equation. Now, we measure the vancomycin level in the regular morning blood draw, and it takes me a tenth of the time to get the correct dose. That extra clinical time is really valuable.”
With five clinics, including a walk-in urgent care, Boone County Hospital serves a large rural population from across central Iowa, treating an average of 800 emergency patients every month. Nearby infectious disease physicians also refer patients to Boone Hospital’s outpatient infusion center, which conducts long-term antibiotic dosing for patients with serious infections. In the past few years, the center identified a need to prevent adverse effects, including tinnitus and acute kidney injury (AKI), for patients who were receiving a triple therapy of gentamicin, vancomycin, and a broad-spectrum antibiotic.
Vancomycin is an antibiotic used to treat bacterial infections. Inadequate dosages can be ineffective and lead to possible resistance, while excessive dosages frequently cause AKIs. Affecting nearly 500,000 patients in the U.S. each year, AKIs add up to $81,000 in additional per-patient hospital costs, according to a recent literature review in the Journal of Pharmacy Practice.
In 2020, several national organizations issued a new consensus guideline for the therapeutic monitoring of vancomycin, which included a switch from the typical peak/trough dosing strategy to one that optimizes the area under the curve to the minimum inhibitory concentration (AUC/MIC) ratio. The guidelines also recommend the use of Bayesian modeling software, rather than manual calculations, to determine accurate dosing levels. While many smaller hospitals assumed they would be unable to meet the new standard of treatment, Boone Hospital was already practicing next-generation precision dosing with its patients.
“Now that we have InsightRX for precision dosing, our patients are at much lower risk of under or overtreatment, and we feel confident that we’re giving them the right dose from the start,” said Sondra Donald, director of pharmacy at Boone County Hospital. “Critical access hospitals tend to assume this kind of software is cost-prohibitive for them, but we’re proof that precision dosing can be a viable option for small facilities. The software pays for itself in a short period of time, and our patients are now getting world-class treatment in rural Iowa with much lower risk of adverse events.”
As part of the implementation, InsightRX also provided Boone County Hospital with a review of its current process, offering two methods for improving its outpatient infusion performance. In the past six months, the team was able to achieve its therapeutic target attainment goals based on that guidance. Boone County Hospital is also pleased with the analytics provided by the precision dosing platform, as one of the requirements of a CMS-approved antimicrobial stewardship program is the ability to track performance improvement over time.
“Boone County Hospital is a great example of how even smaller, more rural facilities can leverage model-informed precision dosing to have a significant impact on patient safety,” said Sirj Goswami, PhD, co-founder and CEO of InsightRX. “With the technology we have today, there’s no reason for patients to experience undue risk as they embark on an antibiotic regimen. We look forward to a long partnership with this pioneering facility.”
About InsightRX
InsightRX is a healthcare technology company that has developed a cloud-based platform for precision medicine and clinical analytics designed to individualize treatment at the point of care. The platform leverages patient-specific data, pharmacology models, and machine learning to understand each patient’s unique pharmacological profile and can be integrated seamlessly within a clinical workflow.
- Published June 2, 2022
