Clinical Evidence

How Corewell Health Reduced LOS for DKA Patients, Slashing Costs by Almost $1M

Objective

To evaluate the impact of EndoTool IV insulin dosing software on mortality, length of stay, readmission rates, and cost of care for patients treated for Diabetic Ketoacidosis (DKA) at Corewell Health West.

Method

This retrospective study examined patient outcomes for those treated for DKA at Corewell Health West between January 1, 2023, and June 30, 2024. The analysis focused on patients managed using the EndoTool IV (ETIV) computerized insulin dosing software, which tailors insulin dosing based on real-time patient data. Outcomes measured included length of stay (LOS), in-hospital mortality, readmission rates, and direct cost of care. These were compared to expected outcomes using risk-adjusted data from the Vizient Clinical Data Base, which aggregates data from 115 academic medical centers nationwide.

Key Evaluation Areas

Total Patients Treated for DKA: 7,378
Patients Managed with EndoTool IV: 100%
Key Outcomes Measured:
- Length of Stay (LOS)
- Mortality
- Readmission Rates
- Direct Cost of Care

Results

Outcome	Corewell (Actual)	Expected	Index / Impact
Length of Stay	5.15 days	5.82 days	514 days saved
Mortality	2.3%	3.2%	6 fewer deaths
Direct Cost	$8,125	$9,329	$912,298 saved
Severe Hypoglycemia	0.006%	Not measured	Extremely low risk
ICU Utilization	85%	49%	Higher acuity, better outcomes
Readmission Rate	14.43%	15.04%	On par with national average

Conclusion

The use of EndoTool IV insulin dosing software at Corewell Health West has led to reduced length of stay, improved mortality outcomes, and substantial cost savings, while maintaining high safety standards with extremely low hypoglycemia rates. The software demonstrated its effectiveness even in a setting with higher ICU utilization, proving its robustness in critical care scenarios.