Using Real World Evidence to Guide Clinical Outcomes and Reduce Costs of Care

How one academic medical center saved $400,000 in one year without the burden of chart review

Clinicians at Stanford Health Care collaborated with Atropos Health to evaluate formulary design and the provisioning of cost-effective care. The real-world evidence provided adjunctive support for formulary decisions and produced significant cost savings for patients and the institution, without impacting clinical outcomes.  

“As a physician with over two decades of experience, I often encounter situations where there are evidence gaps in the clinical literature, or where relevant and high-quality evidence is inaccessible,”  said Dr. Neera Ahuja, the Division Chief of Hospital Medicine and Medical Director of Pharmacy and General Inpatient Medicine at Stanford Health Care. “Now I can access on-demand insights from our EHR data to close those evidence gaps. Here, we demonstrated   a  design for  a safe, effective, and cost-effective formulary and this IHI poster demonstrates how just a few analyses can provide insights for over over $400,000 cost savings. We have also seen how real world evidence from our EHR can be used for other quality clinical operations.”

This study is part of an enduring collaboration between Stanford Health Care and Atropos Health. Over the years, Stanford clinicians have requested  thousands of Prognostograms, reports that provide RWE in less than two days,  to gain insights on clinical questions with local evidence. Together, both institutions are committed to measuring the ROI of putting relevant evidence at clinicians’ fingertips in this way. “We believe personalized evidence will improve clinical outcomes for diverse patient groups, reduce costs of care, and accelerate operational efficiencies in healthcare.” said Valerie Garrett, Medical Director of Client Success at Atropos Health. “We are pleased to partner with Stanford Health Care on pharmacy initiatives and anticipate repeating cycles of insight generation to support evidence-based care at Stanford.” 

Other ongoing projects between Atropos Health and Stanford include:

• Medication Use Evaluations for high cost drugs, non-formulary drugs, and biosimilar adoption

• Formulary Evaluation to provide RWE from other contracted organizations to inform formulary decision-making

• Value Based Care initiatives to demonstrate the impact of pharmacist management on Length of Stay (LoS), readmissions, health equity and population health

• Organization-specific research for care optimization through easily accessible RWE analyses

The poster presented at the IHI Quality Forum highlights:
- Clinicians at Stanford Health Care leveraged Atropos Health to study the difference in outcomes following intervention with a high-cost medication vs. a lower-cost alternative for Stanford Health Care’s patient population using EHR data from 2015-2021. - Findings demonstrated a lack of superior clinical outcomes for the high-cost intervention as compared to the lower cost alternative.

Per study co-author and Administrative Director of Pharmacy at Stanford Health Care, Janjri Desai, PharmD, MBA, “Answering questions about drug efficacy and safety has historically required extensive manual chart review and analyses by pharmacists or residents. It is quite time consuming - making evidence generation a competing priority with other demands on our team. Using this new technology, we get the results via simple Q&A. Then we can leverage the findings for formulary modifications, pharmacy  practice and  publication. We will continue to utilize insights from our clinical data to streamline operations, costs, and enable high-quality patient care. 

This study provided adjunctive evidence for formulary review and augmented clinical decision-making at the point of care. In this way, and via similar examples across departments, Stanford Health Care is at the forefront of an industry-wide shift in adopting novel technologies to facilitate evidence-based practice.

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