The UNIVANTS of Healthcare Excellence award program recognizes 12 new teams for transformational care

The UNIVANTS of Healthcare Excellence program is proud to announce 12 new integrated clinical care teams that are recognized for achieving measurably better health outcomes by “UNIFYING” across disciplines to enable the development and implementation of “AVANT-GARDE” processes. Among many applications from across the globe, the final outcomes for the 2024 UNIVANTS of Healthcare Excellence awards revealed three top global winners, three teams of distinction, and six teams of achievement.

The 2024 top global winners of this prestigious healthcare excellence award include British Columbia Centre for Disease Control, Premier Integrated Labs Sdn. Bhd., and Kaiser Permanente Southern California.

GetCheckedOnline: Better access to testing for sexually-transmitted and blood-borne infections

An integrated clinical care team from the British Columbia Centre for Disease Control in Vancouver, Canada, recognized that screening for sexually transmitted and blood-born infections (STBBI) is not only a crucial step in enabling treatment and mitigating transmissions, but that accessing regular screening can be difficult. Compounding the challenge of access, is the stigma often associated with STBBI testing. With this in mind, GetCheckedOnline (GCO) was created in partnership with the BC Public Health Laboratory, Provincial Laboratory Medicine Services, LifeLabs, and participating regional health authorities. GCO is an anonymous, internet-based testing service offering a range of STBBI tests. Patients create anonymous test requisitions on the GCO website; receive free-of-charge testing at participating collection sites; and depending on the results, findings are either given online or by a specialized STBBI nurse.¹

Thanks to the GCO program, patients are more engaged in their STBBI care. 87% of people testing through GCO report that they test earlier and more often than they would if they were testing through a regular clinic or healthcare provider. This is particularly true for equity-seeking populations. Further, by streamlining STBBI testing, ten-fold more patients can be managed through GCO compared to equivalent nursing time in the Provincial STI Clinic at the BC CDC. This enables enhanced resource utilization and reduced costs to the overall healthcare system.

Early detection of metabolic-dysfunction associated steatotic liver disease using FIB-4

Metabolic-dysfunction associated steatotic liver disease (MASLD, formerly NAFLD) is a leading cause of liver disease worldwide, with the global prevalence increasing, likely due in part to the obesity epidemic.² The phenomenon is especially true in Malaysia where rates of obesity, diabetes, and prediabetes are high.³ Consequently, screening for MASLD is important for mitigating long-term adverse outcomes, however, this can be difficult due to the often-asymptotic nature of MASLD, with symptoms typically manifesting only once the disease has progressed. While the gold standard for diagnosing liver disease is a liver biopsy, screening requires less invasive and more accessible options. Non-invasive screening options exist, including FibroScan and liver function tests (LFTs), however, both are not without significant limitations including access to Fibroscan and/or the difficulties often reported in primary care associated with interpreting and/or following up on LFTs. Thus, the need for a clinical care pathway that can easily enable screening, diagnosis, and treatment for MASLD in primary care is of the upmost importance. 

In response to this need, Premier Integrated Labs Sdn. Bhd. in Kula Lupar, Malaysia implemented the Fibrosis-4 (FIB-4) scoring system for early MASLD screening in high-risk patients. This screening enables early intervention, when needed, and improved outcomes. One of the keys to success is that FIB-4 utilizes easily accessible and affordable clinical and laboratory parameters: age, ALT, AST and platelet count. Since implementation in July 2022, more than 39,000 patients have been screened, of which 5,662 patients were newly identified with ‘moderate- or high-risk’ of MASLD, enabling early referral and appropriate intervention. For those at ‘low-risk’ no further referral is required, saving time and resources. Utilizing FIB-4 to guide care has not only improved resource utilization, but has improved wellness and enhanced clinical decision-making. 

Improved management of patients with high LDL-C through electronic health record-directed algorithms for guideline-concordant high-intensity statin prescribing

Cardiovascular diseases (CVDs) are the leading cause of death globally, thus, risk minimization efforts are of high importance.⁴ One such risk factor is dyslipidaemia, which is characterized by elevated low-density lipoprotein cholesterol (LDL-C). Statin initiation for those patients is known to not only reduce LDL-C but help mitigate future CVD risk. Unfortunately, high-intensity statins are underutilized among adults with LDL-C ≥190 mg/dL.⁵ Understanding this care gap, an integrated clinical care team at Kaiser Permanente Southern California implemented the High LDL-C Statin Start program, under the SureNet umbrella.

This program uses algorithms to scan electronic health records to identify adults with a recent LDL-C result ≥190 mg/dL and no evidence of any statin fill within the prior 2–6 months. Subsequently, high-intensity statin orders, along with follow-up lipid panel orders are automatically generated for primary care provider approval. Primary care providers are alerted of pending statin and lab orders by care managers, and once approved, letters are sent to each patient with reminders to retrieve their statin medication and to complete a follow-up lab test. This cross-functional and collaborative effort has improved the likelihood patients will fill their prescription by 32% (relative increase), patients are now 41% more likely to complete follow-up testing, and most importantly, 21% more likely to lower their LDL-C. An important success factor for this initiative is that clinicians did not find that it substantially increased their workload, even suggesting more education to enable awareness. 

These impressive and diverse care initiatives involve impactful and meaningful outcomes enabling recognition with the 2024 UNIVANTS of Healthcare Excellence awards. Congratulations to all teams who received recognition in 2024!

For more information on UNIVANTS, the 2024 winners, and/or to apply starting Aug 1st, please visit www.UnivantsHCE.com.

References

1. Gilbert M, Salway T, Haag D, et al. Use of GetCheckedOnline, a Comprehensive Web-based Testing Service for Sexually Transmitted and Blood-Borne Infections. J Med Internet Res. 2017;20;19(3):e81. doi:10.2196/jmir.7097.

2. Teng ML, Ng CH, Huang DQ, et al. Global incidence and prevalence of nonalcoholic fatty liver disease. Clin Mol Hepatol. 2023;29(Suppl):S32-S42. doi:10.3350/cmh.2022.0365.

3. Chan WK, Chuah KH, Rajaram RB, et al. Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A State-of-the-Art Review. J Obes Metab Syndr. 2023;30;32(3):197-213. doi:10.7570/jomes23052.

4. Cardiovascular diseases. Who.int. Accessed June 28, 2024. https://www.who.int/health-topics/cardiovascular-diseases.

5. Mefford MT, Zhou M, Zhou H, et al. Safety Net Program to Improve Statin Initiation Among Adults With High Low-Density Lipoprotein Cholesterol. Am J Prev Med. 2023;65(4):687-695. doi:10.1016/j.amepre.2023.04.009.