Last updated: 05/07/2015

Our goal is to create a clinician performance evaluation tool in order to improve the compliance rate of risk-appropriate prophylaxis.

• Students: Stephen Chen, Vamsi Chunduru
• Mentor(s): Michael Cohen, Gorkem Sevinc, Dr. Paul Nagy, Brandyn Lau, and Dr. Elliot Haut

Venous Thromboembolism (VTE) is a disease process that includes both Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). DVT is caused by blood clots forming in the deep vein. ⅓ of the time, DVT may suddenly lead to PE which can be fatal. This is a disease that is difficult to diagnose, with DVT having diffuse symptoms that gets significantly more serious once the disease evolves to PE. The best treatment for this condition is to tackle it before it starts. However, the compliance rate in hospitals for clinicians prescribing risk-appropriate prophylaxis is low due to clinicians not trusting the tool and relying on their past experiences.

We propose to create a clinician performance evaluation tool that will give feedback to clinicians on how well they are compliant as well as allow them to view data on past patient outcomes.

• Minimum: (Expected by mid April)
  1. Webtool ranking clinician adherence

• Expected: (Expected by end of April)
  1. Webtool giving robust history of incorrect prophylaxis treatment
  2. Pass QA testing
  3. Create a manual and troubleshooting documentation

• Maximum:
  1. Incorporate webtool into other clinical areas

We are creating a clinician performance evaluation tool. We will be using Ruby on Rails to create the backend and use HTML/Javascript/CSS to create the GUI. We aim to build a robust tool that reinforces clinician compliance by not only giving each clinician a score based on how appropriate the prescribed prophylaxis was, but also, to give this tool a teaching component where we provide a history of aggregate performance and insight as to the correct prophylaxis treatment.

* Access to prophylaxis data

• Will give us a data set to base our data off of
• We have talked with Senior Engineer Michael Cohen and he will look into getting us access to the data set
• If we are unable to gain data, we will look at other data sets to base our tool off of
• Due: 3/29
• Completed

* Access to Stash

• We need a way to perform version control on our code
• We will ask the senior engineer at the Technology Innovation Center for access.
• If we are unable to gain access, we will use BitBucket for version control
• Due: 4/01
• Completed

* Access to server

• We need a server in which to host the web tool
• We will look into where we can host this as we make our web tool
• If we are unable to gain access to a server, we'll host our web tool through a third party
• Due: 4/18
• Completed

1. Milestone name: Mock up of web tool
   • Planned Date: 3/22/15
   • Expected Date: 3/24/15
   • Status: Completed
2. Milestone name: Create Ruby on Rails algorithm for web tool
   • Planned Date: 4/24
   • Expected Date: 4/24
   • Status: Completed
3. Milestone name: Create Bootstrap GUI for web tool
   • Planned Date: 4/24
   • Expected Date: 4/24
   • Status: Completed
4. Milestone name: Quality Assurance Test
   • Planned Date: 4/30
   • Expected Date: 4/30
   • Status: Pending
5. Milestone name: Go-live documentation
   • Planned Date: 5/07
   • Expected Date: 5/07
   • Status: Pending

• Project Plan
  • Project plan presentation
  • Project plan proposal
  • Requirement and use cases
• Project Background Reading
  • See Bibliography below for links.
• Project Checkpoint
  • Project checkpoint presentation
• Paper Seminar Presentations
  • Stephen's paper seminar presentation
  • Vamsi's paper seminar presentation
• Project Final Presentation
  • PDF of Poster
• Project Final Report
  • Final Report

• Lau BD, Haider AH, Streiff MB, et al. Eliminating Health Care Disparities With Mandatory Clinical Decision Support: The Venous Thromboembolism (VTE) Example. Med Care. 2015;53(1):18-24.
• Streiff MB, Carolan HT, Hobson DB, et al. Lessons from the Johns Hopkins Multi-Disciplinary Venous Thromboembolism (VTE) Prevention Collaborative. BMJ. 2012;344:e3935.
• Office of the Surgeon General (US); National Heart, Lung, and Blood Institute (US). The Surgeon General's Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism. Rockville (MD): Office of the Surgeon General (US); 2008. Available from: http://www.ncbi.nlm.nih.gov/books/NBK44178/

https://integration.johnshopkins.edu/stash/projects/VTEP/repos/vte/browse (Note that access is restricted due to patient identified information)

https://github.com/schen1092/VTE-Webtool (public git with patient sensitive information removed).