Bringing Data to Life with Simulation
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This document presents a study comparing the efficiency of cryoballoon ablation and radiofrequency ablation procedures, showing that cryoballoon procedures were statistically faster across multiple metrics, including lab occupancy, procedure time, and fluoroscopy time. A retrospective analysis of 348 patient charts indicated significant time savings with the cryoballoon approach. The findings suggest potential economic advantages for electrophysiology lab managers by reducing inefficiencies and overtime related to these procedures.
Bringing Data to Life with Simulation
- 1. Bringing Data to Life with Simulation Modeling the Economic Value of Procedure Efficiency Reece Holbrook, Technical Fellow CRHF Economics, Reimbursement and Evidence May 11th, 2017
- 2. Modeling the Economic Value of Procedure Efficiency Background – Radiofrequency (RF) vs Cryoballoon 2 RF Ablation Catheter (point by point approach) Cryoballoon Ablation Catheter (anatomical approach)
- 3. • Retrospective chart collection study • 348 patient charts were examined (220 cryoballoon and 128 RF procedures) • Hospital resource utilization compared in several categories. Cryoballoon mean +/- SEM (N) Irrigated RF mean +/- SEM (N) Average Time Savings with Cryoballoon procedure % reduction by Cryoballoon procedure P-Value EP Lab Occupancy Time (minutes) “patient-in to patient- out” 246.8 ± 3.1 (N=213) 283.1 ± 4.7 (N=125) 36.3 minutes 13% <.001 Procedure Time (minutes) “skin to skin” 173.5 ± 3.1 (N=214) 199.8 ± 4.3 (N = 127) 26.3 minutes 13 % <.001 LA Dwell Time (minutes) “transeptal to last catheter out” 147.9 ± 3.2 (N=143) 166.7 ± 4.4 (N=101) 18.8 minutes 11% <.001 Fluoroscopy Time (minutes) 33.3 ± 1.0 (N=210) 42.4 ± 1.8 (N=118) 9.1 minutes 21% <.001 Length of hospital stay (hours) 26.6 ± 0.6 (206) 27.6 ± 1.4 (116) NS NS >.05 (NS) In this study Cryoballoon ablation procedures were found to be statistically faster on average than point-by-point RF ablation in four categories: Lab occupancy, procedure time, LA dwell time, and fluoro time. DeVille JB, Comparison of Resource Utilization of Pulmonary Vein Isolation: Cryoablation versus RF ablation with Three- Dimensional Mapping in the Value PVI Study. JIC. June 2014 Modeling the Economic Value of Procedure Efficiency Cryoballoon vs. RF Catheter Ablation Procedure Efficiency Comparison
- 4. Modeling the Economic Value of Procedure Efficiency Background – Why Should an EP Lab Manager Care? More Effective • Overtime Avoidance, Time for Additional Cases • “Lab Occupancy Time” • Detailed Distribution • Accounting for Real World Complexity Somewhat Effective • Cost per Minute • “Procedure Time” • Average Only • Assuming Only This Data Point Matters 4
- 5. Modeling the Economic Value of Procedure Efficiency Methods 5 Detailed Lab Occupancy from VALUE PVI Real World Complexity from Administrators EP Late Block Schedule Lab Results Delayed Room Turnover No Nurse to Move Patient
- 6. 7 Modeling the Economic Value of Procedure Efficiency Sample Model Run
- 7. Modeling the Economic Value of Procedure Efficiency Model Validation
- 8. Modeling the Economic Value of Procedure Efficiency Results 9 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0% Days of Overtime Days with Incremental Procedure RF Cryo
- 9. Modeling the Economic Value of Procedure Efficiency Publication 1010