Data-driven approach heads off alarms at Boston Children's

Seeking a way to confront a "quiet cacophony" of beeping, alarming bedside monitors, Boston Children's Hospital has tapped into predictive analytics to forecast changes in patients' conditions before alarms sound.

The Boston Globe reports that the hospital joined forces with a startup to analyze the data monitors put out, like vital signs or respiratory rates, and assess whether the patient's condition is at risk of getting worse.

"There are so many pieces of data coming at the physician. With almost 30 ICU patients, we're just inundated," Joshua Salvin, a pediatric cardiologist at Boston Children's, told the Boston Globe. "If we had something that could tell us where the hot spots are on the floor, we could direct resources to the most sick patients."

The system accumulates a long record of information, and detects changes in relationships between vital signs. It tries to take the guesswork out of data coming out of as many as a dozen machines.

So how does it work? A "Stability Index" pops up on computer screens that hospital physicians monitor at the cardiac ICU. Doctors pick what they want to measure, and then the system renders risk assessment on a scale from 0 to 4. The system is being tested internally, for now.

Nineteen out of 20 hospitals surveyed rank alarm fatigue as a top patient safety concern, according to the results of a national survey presented in January at the annual meeting of the Society for Technology in Anesthesia. Alarm fatigue also is considered the leading health technology hazard, according to the ECRI Institute's most recent list of top health technology hazards.

Hospitals nationwide are turning to informatics to streamline care processes, improving both the efficiency and safety of patient care, as FierceHealthIT reported in 2012. Boston Children's was ahead of the curve then, breaking into patient modeling. According to CIO Dan Nigrin, the hospital saves roughly $1.4 million annually by using informatics in its medication delivery system.

"The pharmacy is made aware of changes much more expeditiously than when we were paper based," Nigrin told FierceHealthIT. "The pharmacy has gotten to essentially be much more of a just-in-time delivery model, where they're continuously delivering medications to the floor, every hour or every two hours, as opposed to every 12. If a medication has changed, the amount of potential waste that occurs because the medication was, for instance, discontinued, has dropped dramatically."

In 2012, Boston Children's also starting working on a platform called Informatics for Integrating Biology and the Bedside (I2B2), which allows end users to look for cohorts of patients that meet a certain criteria.

To learn more:
- read the article in the Boston Globe

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