Tailored Drug Titration through Artificial Intelligence

Optima Integrated Health IncOptimaproposes to demonstrate the clinical efficacy of the decision support technology for medication treatment optimization it validated in a pilot clinical trialoptima BPoptima BP is designed as a physician decision action support aid in timely and safely optimizing medication treatment independent of in office visitsfor patients with uncontrolled hypertensionHTNoptima BP is designed to reduce preventable hospitalizations and the associated incidence of strokeheart failureHFor myocardial infarctionMIevents resulting from high blood pressureBPabove goalUncontrolled HTN affectsmillion AmericansThe cost of HTN associated hospitalizations is $billionorof all hospital costswith rtmillion Emergency DptmEDvisitsoptima BP will improve the quality of life for uncontrolled HTN patientsand reduce this massive burden on the US healthcare systemOur long term objective is to help drive the transformation from the reactive pay for service healthcare paradigm to one that emphasizes preventative care through personalized health surveillanceassessmentand action via timely and safely optimized medication treatmentOur specific aims includeAimdemonstrating the efficacy of optima BP in a randomized clinical trialnpatientsdeployed at UC San Francisco Medical CenterPatients will be randomized to an enhanced careECarm or an optima BP armO BPAll patients will use OmronBP arm cuff to remotely measure their BPFor the patients in the EC armphysicians will be provided with a monthly summary of the OmrondataFor patients in the O BP armaside from the BP monthly summaryphysicians will receiveaa risk stratified patient rosterbnext step actions in medication optimization for each patientandcaccess to optima BP s secure web service medication treatment modeling to investigate how changing current patient data could affect medication choicee gchange in medication choice if BP goal is loweredWe will then examine the BP value reduction between armssuccess rtmmHg decreased systolicrtmmHg decreased diastolic of O BP vsECalong with secondary outcomes between O BP and ECmedication treatment action frequencyED admissions due to HTN related symptoms and associated hospitalizations for strokeHF or MIand overall cost of HTN managementAimoptima BP data processing steps will be optimized to scale up its capability to rtday patient cases processing powerspecific optimization processing tools will be developedOptima ExtractTransformand LoadOETLOptima Survey GeneratorOSGand Optima Message BuilderOMBOETL will provide streamlined scheduling logic to extracting data from EpicEMRelectronic medical recordoptimize data mapping scripts within optima BPand optimize data uploading protocolsOSG will optimize the current generation protocol for patient surveyspatient responseand assignment of patient responses to specific processing modulesOMB will ensure streamlined scheduling of risk stratification updates and scheduled delivery to physician In Basket messaging system within EpicEHR