MAPPP vs avoMD

Despite the considerable efficacy of antithrombotics and the increased number of oral anticoagulants now available, preventable bleeding and thrombotic events are still unacceptably common. While recently marketed agents require less laboratory monitoring, problems with the clinical management of anticoagulated patients persist, particularly in the peri-procedural period. Surgery and invasive medical interventions increase the risk of bleeding, while withholding anticoagulants increases the risk of thrombosis due to the underlying condition(s) for which anticoagulation was originally prescribed. The clinical team must therefore balance these competing risks and make educated decisions regarding the decision to interrupt oral anticoagulation for a medical procedure and, if interrupted, whether to "bridge" anticoagulation with injectable anticoagulants, such as low molecular weight heparin (LMWH) in warfarin treated patients. This guide is intended to: -Assist clinicians in the simultaneous evaluation of procedure-related bleeding risk and underlying risk of thrombosis -Guide decisions regarding the interruption of anticoagulation and the use of anticoagulant "bridging" -Provide detailed guidance for drug dosing and laboratory monitoring in the peri-procedural period -Encourage clear communication between clinicians involved in prescribing anticoagulants and performing invasive procedures This material was created by the multidisciplinary members of the Peri-Procedural Task Force of the New York State Anticoagulation Coalition and IPRO, the Medicare Quality Improvement Organization for New York State, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy. 10SOW-NY-AIM-7.3-14-01

avoMD: Preoperative Eval provides quick, interactive, and educational guidance to help clinicians evaluate and prepare adult patients for noncardiac surgery. The app is based primarily on the 2014 ACC/AHA Perioperative Guidelines but also includes additional comments from reviews of the literature up to September 2020. It was developed in conjunction with Dr. Steven Cohn, a leading expert in Perioperative Medicine. The app incorporates co-morbidities, patient medications, interactive medical calculators (like RCRI, MICA, ACS-SRC, DASI), and other information and tools to help clinicians assess the risk of surgery. avoMD provides links to the evidence-based references and best practices, as well as more detailed explanations on the recommendations, so that clinicians can enhance their learning experience. Dr. Steven Cohn is currently Professor Emeritus at the University of Miami Miller School of Medicine, having served as the Medical Director of the UHealth Preoperative Assessment Center (UPAC) and the Medical Consultation Services at the University of Miami Hospital and Jackson Memorial Hospital. He was the former Chief of the Division of General Internal Medicine at SUNY Downstate and the Director of the Preoperative Medical Consultation Clinic and Medical Consultation Service at Kings County Hospital Center. avoMD transforms clinical guidelines and content into interactive, next-gen apps. The team is led by physicians and informaticians from Columbia, Yale, and Harvard, while current partners include leading academic medical centers, urgent care providers and a growing number of residency programs and medical schools across the US. The company won the 2020 pitch competitions at Columbia Engineering and Penn Medicine and recently joined StartUp Health and 500 Startups. Interested in customizing avoMD for your department/institution? Contact info@avomd.io for more information.