How the RI Witness IQ™ solution can help improve standards and clinical outflow across a clinic group

Meaningful analysis of monitored clinical activity from the RI Witness electronic witnessing system is the next step to ensure consistent lab performance across clinics. We spoke with Naval Shah from Indira IVF, a large clinic group of 100-plus locations, where they have implemented the RI Witness upgrade, the RI Witness IQ solution. As a large fertility group with access to data from different clinics, we discuss how the addition of intelligent data collection and analysis into their laboratory management has given them a better overview across their clinic group for enhanced clinic proficiency.

Naval Shah is the Head of Quality Assurance and Training at Indira IVF in India since 2020. He has over 13+ years of experience working within fertility solutions, including consultation, private clinics and embryology services. In 2019, he was chosen as an ESHRE Young Ambassador for India.

Can you tell us about the fertility clinic group – Indira IVF?

When I joined Indira at the beginning of 2020, we had 75 centers. We now have around 107 centers with a clinical team of 200 plus doctors and 140 plus embryologists. We are still growing, making Indira IVF one of the biggest fertility groups in southeast Asia. We use a hub-and-spoke business model which means fifty percent of our centers contain full IVF laboratories, and fifty percent are satellite centers for procedures such as intrauterine insemination (IUI).

Our aim at Indira IVF is to find and integrate the latest innovations into our labs. To be on the lookout for any technical advantages for the betterment of both patients and staff. The introduction of an electronic witnessing system is an example of one such innovation. For our organization, we knew it would help us bring the standardization we wanted across our group of clinics

Can you talk more about your RI Witness™ journey and the addition of the RI Witness IQ solution in your labs?

We introduced RI Witness electronic witnessing into our main centers starting in 2019. In 2022, we have RI Witness in 44 main centers, which is almost 100% across all our labs. Working with CooperSurgical and RI Witness ART management system gave us something we strongly felt our clinic group needed, something more robust with regards to our standard operating procedures (SOPs) and our ways of working as we are a very technology-driven company.

Over the last two years, my colleague, Mr. Vivek, and I worked with the CooperSurgical team on a pilot study to help develop an upgrade to RI Witness, a cloud-based platform called the RI Witness IQ solution. Based on RI Witness data, RI Witness IQ gives clinics greater transparency into their lab performance through access to real-time data insights.

Together with Rob Thompson, Director of Digital Innovation, and Mike Hartland, Software Developer, we worked to create very meticulous timestamps according to our SOPs at Indira IVF because every clinic has its own SOPs. This customization is what makes the RI Witness together with the RI Witness IQ solution so exciting. Throughout this pilot study, as we implemented the IQ solution into our clinics, we were always able to contact the CooperSurgical team whenever we needed support and that was appreciated.

One of the visual data tools developed for the RI Witness IQ solution is a histogram, a graphical display of data that shows the average interval of different procedures performed in IVF lab like pick up, denudation, sperm wash, embryo transfer, etc. For example, initially for ovum pick up, we saw that the average pick up time was around 30 minutes to 45 minutes. When we customized that particular timestamp and provided additional training to the embryologists, we saw a significant time reduction. Today, we have an average of around 20 minutes for ovum pick up which is deemed optimal for our labs and if there is a deviation from this timing, we will investigate immediately.

Can you speak to why timestamps are so pivotal for Indira IVF?

There is a start point and endpoint for every procedure. Timestamps allow us to see how our SOPs work in the real world. RI Witness IQ documents them and helps me review the key performance indicators (KPIs) I want to look at on the RI Witness IQ dashboard. This process drives us closer and closer to standardization across all our labs. That’s how the journey has been for the last two years. As of today, April 2022, we have RI Witness IQ in around 12 centers and once we are satisfied with the standardizations, it will be added to all the 44 centers where RI Witness is already available.

How has RI Witness IQ further improved quality management in the lab?

Since everything is interlinked, the RI Witness IQ solution gives me the real-time data needed for immediate intervention. For example, on the RI Witness IQ dashboard, if I see that one of the clinic’s denudation times went up, I bring up the timestamps captured by RI Witness for analysis. With the RI Witness IQ solution, I can map out the differences in performance between the operators and clinics and review the standardized KPIs for every clinic.

I also want to benchmark the KPIs at the performance level. Everything from the histogram, average times, or operator performance will help me generate a KPI, and then I can standardize SOPs accordingly and indirectly influence our overall success. I’m also excited to implement it further for operations, Quality Assurance (QA) and Quality Control (QC), and research.

Have you utilized the bespoke reports for Indira IVF as a clinic group?

Yes, the RI Witness IQ report helps me keep track of overall metrics across the clinic group for those clinics that have RI Witness installed. It is generated every month and I also subscribe to receive it in my inbox. I can choose the default metrics or, based on previous insights, create tailored metrics for a particular clinic where I can see the average duration for oocyte retrieval, denudation, freezing, thawing, transfer, etc.

Through our timestamps, customized as per our SOPs, we see an increase or decrease in the average timing of different procedures from the monthly reports and share this information during general team meetings with respective centers. This helps us remain vigilant to continually adjust the procedures we have developed to make them even better.

Any new KPIs or other insights you want to review across your clinic group?

That is a work in progress and not yet finalized because it is a pilot study. In the future, I would like to benchmark KPIs for the timestamps for all the procedures and then the time averages from Indira IVF at the individual operator level, clinic level and national level. With these three levels, we can share analytics directly with the embryologist or the operator so they know; that this is the national average, this is the clinic’s average, and this is where they are performing.

Manual errors are an important insight to look at; in terms of the green zone, yellow zone, and red zone, who is performing optimally, passable, or those who need immediate attention. My hope is to generate another level of KPIs from the RI Witness IQ solution to identify these errors more swiftly for fast compliance with our SOPs.

“RI Witness as an electronic witnessing system can help improve laboratory efficiency and combined with RI Witness IQ, vital data insights are now uncovered”

In summary, why should clinics implement the RI Witness IQ solution into their lab?

There are many benefits. We are very happy to have an electronic witnessing system in place and pleased to use the RI Witness IQ solution as a quality assurance tool; to standardize, optimize and customize the needs of our individual clinics and Indira IVF as a clinic group.

RI Witness IQ brings a lot of hope. RI Witness as an electronic witnessing system can help improve laboratory efficiency and combined with RI Witness IQ, vital data insights are now uncovered. The tailored metrics around time performance from RI Witness IQ are already making an impact across our clinics.

We have just started this journey as a pilot study, and we are still learning. We haven’t seen the RI Witness IQ solution utilized at 100% yet. That makes it even more exciting to see how much further we can take it