AirStrip OB Return On Investment (ROI) Analysis

Labor and delivery is among the most litigious areas of U.S. hospitals. The average indemnity cost for cases in which birth results in a negative, actionable outcome is $2.5 million. Sixty percent of these cases result from communication errors between the physician and nurse. AirStrip OB closes this communication gap by delivering virtual real-time fetal and maternal waveforms to mobile devices, laptops and desktops.

To better understand how AirStrip OB can mitigate risk, take the ROI Challenge. Discover how an investment in AirStrip OB can contribute to positive outcomes for patients, doctors and hospitals.

Average
Frequency

Estimated
Cost
  Calculate ROI
Total number of births by your physicians or at your facility, annually: Please enter a positive, whole number. 
Total number of users at your facitlity that will be licenced to use AirStrip OB: Please enter a positive, whole number. 
1 Adverse outcome rate per 1,000 births:  
2 Total number of problematic cases you can anticipate annually: 0.00  
3 Percent of cases that will incur expenses
(defense costs, medical expert reviews, etc.): 		% $90,000
4 Percent of cases that will incur indemnity costs
(awards, settlements, arbitration, etc.): 		% $2,500,000
Total perinatal claims estimated annually and their associated costs: 0 $0

AirStrip OB specifically targets 64% of the
top risks in labor and delivery

    
5 Delay in diagnosis and treatment of fetal distress: 0 $0
6 Misinterpretation of fetal heart monitoring data: 0 $0
7 Communication breakdowns among clinicians: 0 $0
Total perinatal claims targeted by the AirStrip OB product: 0 $0

8 With AirStrip OB, you can reasonably expect
a 10% loss prevention impact

    
9 Reasonable estimate of lives at-risk and the dollars that could
be saved by implementing the AirStrip OB program: 		0 $0
  1. National average is 6.34 per 1,000. The range is from 3.3 per 1,000 (IHI target) to 7.358 per 1,000 (AHRQ estimate). 1 per 1,000 has been reported (a), (b), (c), (d)
  2. Total number of problematic cases annually
  3. Nearly all perinatal cases with adverse outcomes will have to be defended to some extent. In terms of cost, the national average is $90,000; the best reported is $70,000 and defense costs exceeding $500K are not uncommon. (c), (e), (f), (g), (h), (i)
  4. National average is 60%. Best reported is 44% with a high of 75% noted. Average award is $2.5 M. Range varies based on multiple factors, but has been reported from $1.2 M to $25 M (e), (f), (g), (h), (i), (j), (k), (l)
  5. Factor in 24-31% of meritorious cases. Includes clinical judgment failures involving selection and management of therapy in labor and delivery, and failure to note and act upon relevant findings. (d), (i), (j), (k), (l), (m)
  6. Factor in 20% of meritorious cases. Includes clinical judgment failures involving lack of or inadequate assessment and patient monitoring (d), (i), (k), (l), (m), (n), (o), (p)
  7. Factor in 20% of meritorious cases. Teamwork is cited as an issue in 76% of meritorious claims; 43% may be preventable. Issues include failure/delays interpreting, reporting and receiving findings and failed communication among providers regarding patient condition (d), (i), (k), (l), (m), (n), (o), (p)
  8. Reasonable impact range: 10-30% change in factors, behaviors that contribute to loss. A 40% reduction was reported by one organization. (m), (n), (o), (p), (q), (r ), (s), (t)
  9. Rate of impact (ie: 10%) times the total number of targeted cases and the relevant at-risk dollars
  1. Cherouny PH, Federico FA, Haraden C, Leavitt Gullo S, Resar R. Idealized Design of Perinatal Care. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2005.
  2. AHRQ Patient Safety Indicator for birth trauma. National Healthcare Quality Report 2004. AHRQ Publication No. 05-0013.
  3. Landon, L. Wall Street Journal. New Practices Reduce Childbirth Risks Amid Soaring Liability Costs, Hospitals Curb Use of Drugs And Other Procedures to Speed Labor. WSJ. July 12, 2006; Page D1.
  4. Groff, H. Understanding CRICO's Perinatal Claims. FORUM. March 2001. Volume 21. No. 1. Pp. 1-3.
  5. PIAA Claim Trend Analysis. 2004. Physician Insurers Association of America.
  6. Chandra, A. Nundy, S., Seabury, S. The Growth Of Physician Medical Malpractice Payments: Evidence From The National Practitioner Data Bank Health Affairs Web Exclusive, May 31, 2005.
  7. American College of Obstetricians and Gynecologists. Preserving patient access to women's health care: the facts and figures behind the liability crisis. 2004.
  8. National Practitioner Data Bank 2005 Annual Report. U.S. Department of Health and Human Services Health Resources and Services Administration. Bureau of Health Professions Practitioner Data Banks Branch
  9. Medical Malpractice: Verdicts, Settlements and Statistical Analysis Updated Edition. Horsham, PA: Jury Verdict Research; 2005:12. The median malpractice award for a childbirth-related claim involving obstetricians and hospitals was $2.5 million
  10. Gardner, R. Obstetrics-related Claims. FORUM. February 2006. Volume 24. No. 1. Pp. 10-11; 18.
  11. Lavalley, D., Hoffman, J. Obstetrics-related Claims 1997-2007. FORUM. September 2007. Volume 25. No. 3. Pp. 2-5.
  12. White AA, Pichert JW, Bledsoe SH, Irwin C, Entman SS. Cause and effect analysis of closed claims in obstetrics and gynecology. Obstet Gynecol. 2005;105(5 Pt 1):1031-1038. More than one-third of OB adverse events were associated with communication problems
  13. Simpson KR, Knox GE. Common areas of litigation related to care during labor and birth: Recommendations to promote patient safety and decrease risk exposure. J Perinat Neonat Nurs. 2003;17:110-125.
  14. JCAHO. Preventing infant death and injury during delivery. Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Sentinel Event Alert, Issue 30, July 21, 2004.
  15. United States DOD. Effects of a team intervention i? labor and delivery. LD Study Summary 24 Nov 2004
  16. Guyatt G, Rennie D, Hayward R. Users' guides to the medical literature: essentials of evidence-based clinical practice. Chicago: AMA Press; 2002. Results updated by Michael Leonard et al in 2004.
  17. Staff education and a culture of safety initiative at Women and Children's Hospital of Buffalo WCHOB) equated to a greater than 36 percent relative reduction in risk to patients.
  18. M.M. Mello, D.M. Studdert, and T.A. Brennan, "The New Medical Malpractice Crisis," New England Journal of Medicine 348, no. 23 (2003): 2281-2284.
  19. Agency for Healthcare Research and Quality. (2004). AHRQ's Patient Safety Initiative: Building Foundations, Reducing Risk An Interim Report to the United States Committee on Appropriations (No. 4-RG005).
  20. Thorpe, K.E. "The Medical Malpractice 'Crisis': Recent Trends and the Impact of State Tort Reforms," Health Affairs 23 (2004): w26-w27 states that cap awards are 17.1 percent lower than in states that don't
  21. Lawrence J. McQuillan and Hovannes Abramyan, U.S. Tort Liability Index: 2006 Report (San Francisco: Pacific Research Institute, 2006).