MDClone’s ADAMS platform closes the loop from analysis to impact

Hospitals have no shortage of data, but in most cases, “very little of it is built around the idea of using it for research, analytics, insights and clinical understanding,” asserts Dr. Aaron Galaznik, chief medical officer of MDClone.

That’s certainly not the case at the McGill University Health Centre (MUHC), in Montreal, and a growing number of healthcare organizations around the world that have adopted MDClone’s ADAMS platform to drive quality improvement initiatives.

MDClone describes the ADAMS platform – an acronym for Ask-Discover-Act-Measure-Share – as a “powerful, self-service healthcare data exploration platform enabling collaboration, research and innovation.”

It’s billed as a self-service data exploration tool because it isn’t necessary to be trained as a data analyst to use it. Equally important, it makes use of synthetic data to safeguard individual patient information.

Encompassing Montreal General Hospital, the Montreal Children’s Hospital, the Montreal Neurological Institute, and several other specialized services, MUHC is one of Quebec’s leading healthcare organizations.

It acquired the ADAMS platform in June 2024, and it’s now used by as many as 300 of the organization’s clinicians and researchers.

Beyond MUHC, MDClone is represented in eight countries, with hundreds of customer use cases and over 160 peer-reviewed publications documenting outcomes across health systems worldwide.

When launching the ADAMS platform last summer, MUHC announced a ‘Solve the Stay’ campaign to address the hospital’s patient length of stay problem impacting access to care and emergency department overcrowding, said Dr. Alan Forster, MUHC’s vice president of quality, innovation, and performance.

The campaign focused on using the ADAMS platform to identify strategies and initiatives for reducing patient length of stay.

There was an education program for anybody who wanted to participate. Help was also offered to translate any ideas into action and then track them to measure the results.

The campaign’s first round resulted in the identification of 19 improvement ideas, 11 or 12 of which are now moving forward. Ideas were graded in accordance with the number of hospital days that could be saved and MUHC staff responsible for them were celebrated at town halls.

One thing the data confirmed was that many patients admitted to hospital are at the end of their lives and that for some of these patients the care may not be creating benefits on quality of life. For example, certain patients were passing away in hospital after prolonged critical care that continued long beyond when there was any chance of survival, said Dr. Forster.

The clinicians weren’t systematically identifying patients who had a high risk of dying, nor were staff having conversations with them about their end of life wishes, including care in a more appropriate setting either at home, in a hospice or a long-term care facility.

Some seriously ill patients were receiving unnecessary life-extending therapies that detracted from a meaningful quality of life, and resulted in discomfort, loss of dignity and accompanying pain. “So, we are now working with our palliative care team, our oncologists and critical care physicians to roll out a serious illness conversation-guide and training,” said Dr. Forster.

The conversation guide and training are used to engage with patients and families in a delicate discussion about alternatives early enough in a patient’s hospital stay to allow them to participate in decision-making.

Also contributing to excessive hospital length of stay, according to the data unearthed by the ADAMS platform, are patients waiting for access to the OR.

“They come in through the emergency department needing an urgent surgery and they’re spending too many days in hospital waiting for the operation to occur,” said Dr. Forster. “That’s mostly due to OR availability, not patient condition.”

More important than the impact on hospital beds is the impact on care.

For the patients waiting for surgery, there is a negative impact on their overall condition due to immobility, the effect of the untreated surgical condition, and the effects of medications to treat pain. There is also an impact on other patients because of congestion in the emergency department and blocking opportunities for elective surgical admissions.

As a result of this, there’s a big push right now to do an OR redesign to address these problems.

Another issue revealed in the data was that patient discharge is often delayed pending special investigations, such as imaging, which haven’t occurred.

This, in turn, is often related to the day of the week a patient is admitted. “If a patient is admitted on a Thursday or Friday, they’ll wait longer than if they were admitted on a Monday or Tuesday,” said Dr. Forster. “That’s because we cut back on our procedures and staffing over the weekend. We do that for financial reasons, but we don’t necessarily see the negative impact that has on hospital flow issues. Furthermore, the cost of the extra patient days exceeds the cost of the radiology technical staff.”

One obvious solution is to increase staffing over the weekend for imaging technologists. “The trick for management is to get the balance correct – and we can only do that with the data demonstrating the trade-offs,” said Dr. Forster.

In June, MUHC also launched what it calls an IMPACT Centre (https://muhc.ca/IMPACT) to foster collaboration necessary to develop and scale new technologies.

“A common problem is that industry is left on its own to develop their solutions outside of a healthcare setting, so we created the IMPACT Centre … because one of the things companies need is access to the data,” said Dr. Forster. This is where the synthetic data capabilities of the ADAMS platform shine because industry is allowed to access data without compromising patient privacy.

The availability of synthetic data is also important for MUHC’s collaborative research with other ADAMS platform users around the world, including the University of Chicago Medicine and Salt Lake City-based Intermountain Health.

The synthetic data behaves like the original data and the statistical relations of properties are preserved. However, any information that can be used to identify the patient associated with the data is stripped out, explained Dr. Galaznik.

In addition to its use by technology companies and external healthcare organizations, synthetic data is also used internally by healthcare organization staff who don’t have the required permissions for data access.

The self-service capability of the ADAMS platform empowers many more people at MUHC to participate in research and quality improvement initiatives. “We have 15,000 people who could participate in quality improvement activity,” said Dr. Forster. “That’s how big our institution is. We have clinicians, students and residents from all over the world who come here to learn and contribute. They’re highly motivated and very accomplished people.”

Telling them to wait in line for an analyst to access the hospital’s data slows the process, but that’s the predominant model because of privacy laws and the complexity of hospital information systems, he noted.

If MUHC had to use the conventional model of funneling an increased volume of research through the data shop, said Dr. Forster, it wouldn’t be able to hire enough data analysts to get the job done.

According to Dr. Forster, the ADAMS platform is very easy to use, “but some of the underlying concepts are a little more complicated and take time for people to learn if they haven’t been exposed to them in the past.”

Still, anyone with basic statistical training picks it up overnight while those who have never worked with data and have never done any statistical analysis have a bit more of a learning curve.

A technology solution like MDClone’s ADAMS platform that offers access to a healthcare organization’s data isn’t sufficient to foster a quality improvement culture. Also essential is a strong leadership commitment to quality and a workforce that’s motivated, feels safe to try new things and identify when things aren’t working, claims Dr. Forster.

MDClone supports research sharing through an extensive catalog of use cases and case studies on its website because healthcare organizations often have the same problems, observed Galaznik.

They all want to improve the quality of care, identify patients in need of urgent outreach or manage their pharmacy and lab spend, “so the purpose of our global catalog is to provide our users with a repository of different success stories at different organizations.”

Its website features use cases on operational efficiency and specific diseases, including chronic kidney disease, heart failure, pulmonary embolism, diabetes and hyperlipidemia, as well as case studies and white papers by ADAMS platform users around the world.

“We make a point of sharing all of this to inspire people to take advantage of the data they have and make it actionable,” said Dr. Galaznik. “Health systems have invested heavily in electronic health record systems, data warehouses and analytics tools, so the challenge isn’t a lack of data. It’s not having access to a technology solution like the ADAMS platform and its ability to turn data into measurable action.”