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The hTEE Approach: Making the Right Decision

The Problem

Hemodynamically Unstable Patient

Patient Management

Current cardiac monitoring tools lead to improper management of hemodynamically unstable patients.

This results in poor utilization of resources and exploding budgets. Insertion of hTEE into the managementprocess leads to improved outcomes and reduced costs.

Indirect Data Cannot identify the cause of

instability Presents risk associated with

invasive devices

Prolonged instability Organ dysfunction Shock

Increased length of stay Unnecessary operations Increased life support Unnecessary use of vasopressors

Decisions based on assumption Sends the patient in the wrong

direction

Incorrect Therapy

Reduced Outcomes

Increased CostImprove Outcomes and

Decrease Costs

AdjustTherapy

Assess Cardiac

Performance byDirect Visualization

AdjustTherapy

Re-Assess

hTEEApproach

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ImaCor Inc. 839 Stewart Avenue Suite #3 Garden City, NY 11530 P: 877.244.0657 F: 516.393.0969 info@imacorinc.com ImaCorInc.com

The hTEE Approach: Making the Right Decision

The effectiveness of hTEE is best illustrated when its insertion into the patient careprocess results in a management change: fluid direction, pressor reduction or weaning,

or prevention of a re-operation/return to cath lab.

Ochsner HospitalNew Orleans, LA

The below table is a cost analysis of 10 patients.Eight had their management changed dueto hTEE. Of these eight, hTEE data prevented

two from making a return trip to the OR. Theother six had their fluid management changedwith four of those having pressors weaned orreduced. Extrapolating the below results for 100patients illustrate a high probability cost savingsin the range of $250 to $550K.

Vanderbilt UniversityMedical Center

Cost analysis based on Retrospective review of1st 17 CT surgery patients with ImaCor probeby Chad Wagner M.D. of Vanderbilt University

Medical Center. This data was generated fromthe first 17 patients using hTEE technology atVanderbilts CTICU. When extrapolated over 100patients, high probability cost saving is in therange of $268 to $488K.

Thomas Jefferson UniversityHospital SCCU

Peer reviewed publication 21 patientssequentially selected post cardiac surgery(Mechanical Circulatory Support and Heart

Transplant) for hTEE monitoring. Of 21patients, 19 patients had intervention guidedby hTEE. This includes 10 where ventriculardysfunction was detected. For 21 patients,high probability cost saving is in the range of$15.75K to $147K.

Nicholas Cavarocchi, MD et al

10 Patients Tested

Better Fluid Mgmt 6 patients

Reduced Pressors 4 patients

Avoided Re-Op 1 patient

Confirmatory 2 patients

Mean Cost of 1 ICU Day $2,500

Mean Cost of Re-Op $25,000

LOS Cost Reduction $20,000

Cost Reduction Re-Op 1 patient x $25,000 =$25,000

Vanderbilt University Medical Center, Nashville, TN.

17 Patients Tested

Changed Fluid Mgmt 8 patients

Avoided Re-Op 2 patients

Mean Cost of 1 ICU day $2,500Mean Cost of Re-Op $25,000

Cost Reduction Re-op 2 patients = $50,000

LOS Cost Reduction

1 Day x 10 Patients $25,000

Savings $75K - $17K (probes) =$58K or $3.4K perpatient

Thomas Jefferson University Hospital, Philadelphia, PA.

21 Patients Tested

Changed Fluid Mgmt 6 patients

Bi-V Failure Detected 10 patients

Tamponade Diagnosis 3 patientsObservation 2 patients

LVAD, Cannula Position,Thrombus 6 patients

Mean Cost of 1 ICU Day $3,500

Length of Stay CostReduction, Assume1 day for 21 Patients $73,500

Savings $73.5K - $21K (probes) =$52.5K or $2.5K perpatient