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“PeriGen’s analytic modules take the guesswork out of assessing fetal strips and support informed communication and data sharing among our physicians and nurses. For physicians and nurses especially, it’s helpful to have a second ‘pair of eyes’ to confirm the fetal heart rate patterns that they are viewing onscreen and that their knowledge-based treatment decisions are on the right track.”
“PeriGen’s evidence-based decision support system is like having a maternal fetal expert looking over your shoulder throughout the labor process, offering reassurance and consultation when needed. When we get busy handling multiple deliveries, PeriCALM’s fetal heart monitoring and alert capabilities ensure that we stay on top of all developments. We expect our outstanding quality care for newborns and their mothers to continue and PeriGen helps assure the highest level of safety.”
“PeriGen was great to work with-they get an A+ from the top on down. The company CEO has been involved throughout the process and he, as well as everyone on our team, is quickly accessible. Our PeriGen and Epic teams collaborated closely throughout the planning and installation and ensured that the needs of our Labor and Deliver clinicians and staff were addressed. The roll out was completed on time; the training and education were great; and just two weeks after we deployed PeriGen, everything is running smoothly. Everyone is excited about the data exchange between the two systems and that real-time data can be instantly accessed whenever and where ever it’s needed.”
“PeriGen’s evidence-based fetal surveillance and decision support functionality coupled with its experience interfacing with Epic builds upon our mission to outfit our hospitals with the most sophisticated medical technology. Our goal is to facilitate the very best health outcomes for our patients, including our smallest ones and their moms.”
Video Transcript: Cues-What it does & how it works
Welcome to this webinar on PeriWatch Cues – What It Does & How It Works.
- What is Cues?
- What is its impact?
- How does Cues work?
- When does it work?
- Why is it useful?
First, what is Cues? It is EFM pattern recognition software. As you can see in the panel on the right, it identifies baseline, accelerations marked with green upward pointing triangle, decelerations marked with brown downward-pointing triangles, and contractions. It has been evaluated in terms of its accuracy by a panel of experts with the NICHD. They examined their levels of agreement with Cues using over 100 tracings and reported their agreement results in kappa scores of 0.82 to 1.0. These scores represent very high levels of agreement.
But Cues does much more than simply analyze the tracing. While that is fundamental, it takes that information and presents it in very useful ways to clinicians. Here at the top, you can see 30 minutes of tracings with the Cues’ markings. Below that is a four-hour trend view. There is a slider window which always corresponds to the portion of tracing in the top panel. You can move it to select any 30 minute windows to show in the top panel so that you always can see your current tracing and the context with respect to the surrounding tracing. The bar under the four hour view reflects EFM status. Orange shows where the compressed racing has met or exceeded certain criteria or triggers set by your institution. The calculations under the window summarizes the tracing for that 30 minutes. Finally, you may choose to export these measurements to your EMR and you can edit or select some of the tracings or all of the markings to export.
What Cues does
So now that we have introduced what Cues is, let us examine some we real experience. Here we have a panel with a orange portion in the four hour view. This orange portion reflects the portion of the tracing that has exceeded the HCA oxytocin checklist criteria. The criteria that has been exceeded are contractions. You can see that indicated in bold and caps underneath in the summary of the analysis for that window. Here are the HCA oxytocin checklist criteria, but you may choose any combination of these or any other factor as long as it’s one of the factors that we measure on the tracing. Finally markings that appear while you’re taking care of the patient will not be retained in the tracing.
The Impact Associated with Cues
Now that we have introduced what Cues can do, let us examine a real experience associated with its use. This is a large multi-facility study on mothers at term with a singleton baby. These institutions had a very active and multidisciplinary perinatal safety program. During the decade of this study there were over 78,000 births. You can see rising rates of maternal complexity. BMI greater than 40 in green, hypertension in blue, diabetes and red. All rose during this decade.
The next panel shows some outcomes. The blue columns represent cesarean section rates and you can see that they were rising until PeriGen’s patient safety modules were introduced in 2011. At that time, they stabilized. The rate of babies requiring CPR or ventilation at birth, shown in red, fell steadily over the decade and the rates of babies requiring transfer to the NICU, shown in green rose, between 2006 and 2012 and then reversed directions and fell. In fact, over the course of this study babies requiring CPR, intubation, or ventilation or transferred to the NICU fell over was fifty percent from their highest levels during that study.