Vasc-Alert, a pioneer in vascular access surveillance, has announced the publication of a study in the Journal of Vascular Access (JVA) validating its Vasc-Alert surveillance technology for dialysis patients.
The study shows that the technology reliably predicts which patients may suffer from stenosis, or blockage, in their access—and may even be better than clinical monitoring alone. “We knew the Vasc-Alert technology was effective, but these results showed that it performs even better than we anticipated,” said study co-author Robert Provenzano (Ascension St John Hospital, Detroit, USA).
Not only does the study confirm the benefits of the surveillance technology to both patients and medical providers, added Vasc-Alert’s president John Kennedy, it’s also part of a new wave of analytic methods “that can reduce medical costs by avoiding high-cost vascular access complications.”
The study, at Henry Ford Hospital in Detroit, examined 38 patients who were receiving dialysis through an arteriovenous (AV) access. Researchers performed a physical and ultrasound exam on all these patients, comparing the results to the access risk score produced by Vasc-Alert’s proprietary algorithm that predicts how likely the patients were to suffer from access complications.
The technology works by using data that is already collected by the dialysis machines, such as arterial and venous pressures, to derive the pressures in the vascular access. These results are then reduced to a simple one to 10 access risk score. The higher the score, the more likely it is that patients will experience stenosis and require an intervention to prevent complications.
In the study, half of the patients had scores of one, two, or three (meaning low risk) and half had scores of eight, nine, or 10 (high risk). The researchers evaluated both groups of patients for access stenosis by both physical and ultrasound examinations, or what is called clinical monitoring.
The results were clear and striking. Patients identified with high risk scores were seven times more likely to experience stenosis than patients with low risk scores.
Lalathaksha Kumbar (Henry Ford Hospital, Detroit, USA), who was the lead author of the study, estimates that the technology can decrease the incidence of thrombosis by “at least 30–40%,” he said. Since problems related to vascular access, including failure due to stenosis, cause about 20% of the hospitalisations and many deaths among the more than half a million Americans on dialysis, and also result in an estimated US$2.8 billion in healthcare costs, the use of Vasc-Alert can bring substantial benefits to the entire healthcare system, Kumbar said. “Because of what it can do, it should get into the clinical practice yesterday.”
Moreover, because the Vasc-Alert technology uses data collected automatically during dialysis, it requires no additional staff effort or time to test the access, reducing the burden on overworked dialysis personnel.
“The technology really is good,” said Terry Litchfield, a nationally recognised kidney patient advocate. She compares the risk score to a warning light in a car—when the light flashes an alert, it shows that there is a potential problem that needs checking out.
Vasc-Alert’s technology also fits into a larger trend in healthcare—the use of analytics to provide new value by improving care and reducing overall costs. A recent McKinsey report predicts the emergence of a US$1 trillion “value-based care market” in which providers are willing to pay for data-driven preventive care and analysis in order to keep their patients healthy and out of the hospital. Payers and providers are eager to adopt predictive analytic solutions that address major areas of costs in new data-driven value-based care world.
Healthcare providers can begin using Vasc-Alert’s surveillance technology simply by subscribing to the service at a nominal cost-per-patient. “Compared to the total costs associated with access complications such as loss of the AV access, the cost of Vasc-Alert is a rounding error,” said Kennedy. Given the technology’s potential to save thousands of dollars in access replacements, “I think more and more providers are going to see that as having a value to them rather than being a cost,” said Provenzano.