Electronic Medical Record Automated Alerts Notify Physicians When Patients at Risk of Death

Validated system for monitoring electronic health records in real time predicts patients at a higher risk for mortality, according to new report published in The American Journal of Medicine

Philadelphia, PA, May 17, 2016

Hospitalized patients can deteriorate quickly, requiring prompt identification and treatment, especially since each hour of treatment delay can increase the risk of mortality. In a new study published in The American Journal of Medicine, researchers have implemented an automated process that continuously samples electronic medical record (EMR) data in real time and triggers an alert to the physician at the patient’s bedside to warn of potential clinical decline.

Using a sophisticated algorithm that looks for at least two of the four systemic inflammatory response syndrome (SIRS) criteria plus at least one of 14 acute organ dysfunction (OD) parameters, the alert was implemented in a real-world setting across 24 Banner Health hospitals, which include small critical access facilities to medium sized community hospitals as well as academic teaching centers. These predictive analytics were able to clearly identify a majority of the high-risk patients within 48 hours of admission and enabled early and targeted medical intervention.

“This study highlights our experience at Banner Health in using EMR to successfully identify patients with potential for clinical deterioration. This has also helped in the early identification and appropriate treatment of life-threatening conditions like sepsis,” commented lead author Hargobind Khurana, MD, of the Banner Health System. “We believe this approach applied consistently across our hospitals is one of the reasons why our sepsis mortality rate at Banner is much better than what is expected nationally.”

The study shows the experience of implementing an automated SIRS/OD alert system in a large health care system over a span of 1.5 years, and involving more than 300,000 hospitalized patients. The results revealed that this alert identified, early during hospital stay, a small group of patients (1 in 5 hospitalized patients) that were responsible for the majority of hospital deaths (about 90% of all cause hospital mortality). Patients who triggered the alert had a significantly higher chance of dying (hazards ratio of 4) in that hospital stay when compared to patients who did not trigger the alert.

“Clearly there are many impressive benefits that an EMR can bring to a health system that has significantly invested in this technology,” emphasized Dr. Khurana. “EMR-based alerts bring these benefits directly to a patient’s bedside where they are needed the most. Predictive analytics used in a systematic manner, are no longer just inert computerized algorithms, but are invaluable tools in the hands of an organized health care system that has learned how to apply them consistently. This is technology in action, helping improve patient outcomes, and it only promises to become more precise in the very near future.”


Notes for editors
“Real-Time Automated Sampling of Electronic Medical Records Predicts Hospital Mortality,” by Hargobind S. Khurana, MD; Robert H. Groves, Jr., MD; Michael P. Simons, MD; Mary Martin, PharmD; Brenda Stoffer, RN; Sherri Kou, MS; Richard Gerkin, MD; Eric Reiman, MD; and Sairam Parthasarathy, MD (doi: 10.1016/j.amjmed.2016.02.037). This article appears online in advance of The American Journal of Medicine, Volume 129, Issue 10 (October 2016),published by Elsevier.

Full text of this article is available to credentialed journalists upon request. Contact Jane Grochowski at +1 215 239 3712 or ajmmedia@elsevier.com to obtain copies. Journalists who would like to interview the authors should contact Bill Byron, Vice President, Public Relations, Banner Health, at +1 602 747 4702 (office), +1 602 541 1205 (mobile), or Bill.Byron@bannerhealth.com.

About The American Journal of Medicine
The American Journal of Medicine, known as the “Green Journal,” is one of the oldest and most prestigious general internal medicine journals published in the United States. It has an Impact Factor of 5.003 and is ranked #8 out of 153 General and Internal Medicine titles based on number of total citations, according to the 2014 Journal Citation Reports® published by Thomson Reuters.

AJM, the official journal of The Association of Professors of Medicine, a group comprised of chairs of departments of internal medicine at 125-plus US medical schools, publishes peer-reviewed, original scientific studies that have direct clinical significance. The information contained in this article in The American Journal of Medicine is not a substitute for medical advice or treatment, and the Journal recommends consultation with your physician or healthcare professional. AJM is published by Elsevier.

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