Hospital slashes false-positive diagnoses with CDS platform

Research points to ways to reduce incorrect assessments of patient conditions
By Bernie Monegain
09:37 AM

Children's Hospital of Pittsburgh of UPMC's electronic surveillance framework for hospitalized kids is poised to significantly reduce false-positive identification of serious health conditions.

This according to new peer-reviewed research published today in the journal Pediatric Critical Care Medicine.

The retrospective study of 16,239 Children's Hospital pediatric admissions between January 2006 and December 2013 compared the use of vital signs, a common indicator of patient condition, to that of PeraHealth's Pediatric Rothman Index, or PRI.

PRI is a patient condition score that uses an algorithm composed of vital signs, lab tests and nurse assessments (skin issues, mental state) to identify patients requiring urgent intervention with pediatric ICU transfer.

The research, conducted by Children's Hospital clinicians, found that use of vital signs alone led to false-positive identification of serious events 46 percent of the time. The PRI had a false-positive rate of just 1 percent.

"Many symptoms of serious pediatric conditions are also found in common conditions that do not require immediate intervention, and vital signs alone cannot discriminate between the two situations," Robert Clark, MD, chief of pediatric critical care medicine at Children's Hospital of Pittsburgh of UPMC, said in a news release announcing the finding. "Our research found the Pediatric Rothman Index to be a favorable electronic trigger for alerting clinicians to the need for rapid response teams, complementing the efforts of our nurses and physicians."

[See also: New research touts EHRs as aid to better diagnosis and Half of medical errors in pediatric cases are preventable.]

Powered by the peer-reviewed Rothman Index, a disease-agnostic universal score for predicting patient readmission and mortality risk, PeraHealth software automatically pulls data from any major electronic health record in real-time. The data is translated into a 0-100 Rothman Index score and presented in color-coded graphs trending patient condition across any care setting. The goal is to promote care team communication across shifts and alert clinicians earlier to unexpected health problems.

The Joint Commission estimates that 85 to 99 percent of alarms in hospitals do not require clinician intervention. This can lead to alarm fatigue and other alarm hazards, which the ECRI Institute found to be the number one patient safety concern for 2015.

"False-positive alarms cause anxiety for care teams, patients and families, and can lead to clinicians becoming desensitized to true patient emergencies while placing pressure on already constrained hospital resources," said PeraHealth co-founder and chief science officer Michael J. Rothman, in a statement. "Having a surveillance system that reliably alerts care teams to the need for emergency intervention is essential to helping clinicians provide the right care to the right patients at the right time."

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