Collaborative Efforts of Intermountain, Twine Clinical, and Medical Impact Ventures Honored by the CDC as a Model of VTE Prevention and Care Quality Improvement

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Today, at the 2016 Thrombosis and Hemostasis Summit of North America in Chicago, the U.S. Centers for Disease Control and Prevention recognized Intermountain Healthcare’s collaboration with Twine Clinical Consulting LLC (Twine) and Medical Impact Ventures LLC (MIV) for best-practice protocols & quality improvement efforts to reduce the rate of venous thromboembolism (VTE), or blood clots, among hospital patients.

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Today, at the 2016 Thrombosis and Hemostasis Summit of North America in Chicago, the U.S. Centers for Disease Control and Prevention recognized Intermountain Healthcare’s collaboration with Twine Clinical Consulting LLC (Twine) and Medical Impact Ventures LLC (MIV) for best-practice protocols & quality improvement efforts to reduce the rate of venous thromboembolism (VTE), or blood clots, among hospital patients.

The CDC estimates that, without appropriate prevention, as many as 15% of hospitalized medical patients will develop hospital-acquired blood clots. Often the result of sub-optimal prevention efforts, 900,000 VTE events occur in the U.S. each year, resulting in as many as 100,000 premature deaths and costs as high as $10 billion a year.

National guidelines recommend VTE-risk assessment protocols for hospitalized medical patients, but they aren’t uniformly followed across the nation. Therefore, the CDC began the Healthcare-Associated Venous Thromboembolism Prevention Champion program to recognize health care systems and hospitals that are working to reduce VTE rates and encourage other hospitals to adopt their protocols and best practices.

The collaborative efforts of Intermountain Healthcare, Twine, and MIV, colloquially referred to as the VRI (Venous Thromboembolism Reduction Initiative), harnessed an electronic tool that resides in the electronic patient record. The tool scans the medical record of all hospitalized patients on a daily basis.

“If a patient is found to be at risk for blood clots, and is not receiving an appropriate medicine to prevent clots, the hospitalist caring for them is electronically alerted to the presence of risk and prompted to administer preventative medication or identify the reason why preventative medication might be inappropriate,” said Daniel Wray, MS, MBA, Chief Executive Officer of Twine Clinical Consulting and co-investigator of the project.

As part of the initiative, Intermountain hospitalist physicians are also prompted, on a monthly basis, to visit a physician interface portal with an easily navigable dashboard. There they receive an individualized report of their responses to alerts, their performance, and patient outcomes – all packaged in context with educational opportunities that match their performance profile characteristics. In this way, the hospitalist physicians are provided with educational opportunities tailored to meet their unique educational needs as identified through analysis of their performance and behavior.

These quality improvement efforts were launched at Intermountain Medical Center, Intermountain’s flagship facility, and LDS Hospital, and then implemented at Park City Medical Center, Utah Valley Regional Medical Center, McKay-Dee Hospital, and Riverton Hospital. The initiative is expected to expand across the entire 22-hospital Intermountain Healthcare system.

“The genesis for Twine’s involvement in this initiative was the death of my 92-year-old grandfather,” said Mr. Wray. “He was admitted to the hospital for a respiratory infection and, despite the high risk for VTE associated with his age and presentation, medications to prevent VTE weren’t offered. He suffered a pulmonary embolism a few days later and died. These events focused my attention on the sizeable gap in care quality surrounding VTE prevention. I directed Twine Clinical Consulting to start aggressively raising funds with the hope of exploring new ways to structure care and coordinate VTE prevention efforts within clinical practice. We were able to raise enough funds to engage Medical Impact Ventures and to support Intermountain Healthcare – easily the most quality-conscious healthcare system I’ve come across – in a combined effort to drive substantial improvement in physician behavior and down-stream patient outcomes”.

"The venous thromboembolism reduction initiative (VRI) truly represents the best of collaboration between Intermountain Healthcare, a not-for-profit 22 hospital healthcare system based in Salt Lake City, and a private company, Twine Clinical Consulting LLC,” said Scott Woller, MD, co-Director of Intermountain Medical Center’s Thrombosis Clinic, and principal investigator of the project. “Twine Clinical Consulting’s ability to marshal data management solutions and provide easily interpretable and actionable results highlights the vision and leadership of this company that was clearly founded on principles of improving patient outcomes. The proficiency of Twine Clinical Consulting LLC and Medical Impact Ventures LLC to create a reliable physician interface portal with an easily navigable dashboard was central to the results we observed in the VRI that led to the CDC Healthcare Associated VTE Prevention Challenge Champion award.”

“Healthcare-associated VTE is a serious and growing public health problem,” says Thomas Frieden, MD, MPH, director of the CDC. “These challenge winners saved lives by implementing innovative VTE prevention strategies in their institution. We can all learn from their ideas and work together to protect patients from developing deadly blood clots.”

For more information about the CDC Healthcare-Associated Venous Thromboembolism Prevention Challenge and the specifics of the award winning efforts of Intermountain Healthcare, Twine Clinical Consulting LLC, and Medical Impact Ventures, please visit: and

About Intermountain Healthcare
Intermountain Healthcare is a Utah-based, not-for-profit system of 22 hospitals, 185 clinics, a Medical Group with some 1,400 employed physicians, a health plans division called SelectHealth, and other health services. Helping people to live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and in efficient healthcare delivery.

About Twine Clinical Consulting
The primary focus of Twine Clinical Consulting is to implement healthcare quality improvement initiatives, in collaboration with individual healthcare systems & offices, through comprehensive targeting of therapeutic areas where patient outcomes and cost-efficiencies are sub-standard.

Twine Clinical Consulting combines business, clinical, and process engineering consultation services, along with proven methodologies and technologies, deployed in context with the internal environment and parameters of each individual client healthcare organization, to promote meaningful and durable performance change.
Twine Clinical Consulting acknowledges the generous support for the VRI initiative provided by GlaxoSmithKline, Eli Lilly & Co., Bristol-Myers Squib, Sanofi, and Janssen.

About Medical Impact Ventures
Medical Impact Ventures (MIV) is an innovative health tech company and venture accelerator offering healthcare information technology, medical informatics, and digital health consulting for a wide range of therapeutic areas to make a lasting medical impact.

Medical Impact Ventures owns and develops a range of proprietary technologies, dashboard systems, including medical education and decision support tools for physicians and solutions for enhanced patient engagement and communication.
MIV has been delivering successful initiatives and engagements with clients for nearly a decade that have led to quality and performance improvement, improved patient safety, optimized clinical and administrative pathways, and improved health delivery resulting in significant healthcare cost savings.

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