Automated Identification of Patients with Advanced Illness.

Autor:	Brar R; Department of Information Services, Northwell Health, Lake Success, NY., Friedman MI; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.; Department of Clinical Transformation, Northwell Health, New Hyde Park, NY., Dacosta N; Department of Clinical Transformation, Northwell Health, New Hyde Park, NY., Rimar A; Department of Information Services, Northwell Health, Lake Success, NY.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.; Department of Clinical Transformation, Northwell Health, New Hyde Park, NY., Cohen J; Department of Clinical Transformation, Northwell Health, New Hyde Park, NY., Liberman T; Department of Information Services, Northwell Health, Lake Success, NY.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.; Department of Clinical Transformation, Northwell Health, New Hyde Park, NY., Hirsch JS; Department of Information Services, Northwell Health, Lake Success, NY.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY., Bock K; Department of Information Services, Northwell Health, Lake Success, NY.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY., Oppenheim M; Department of Information Services, Northwell Health, Lake Success, NY., Meytlis M; Department of Information Services, Northwell Health, Lake Success, NY.
Jazyk:	angličtina
Zdroj:	AMIA ... Annual Symposium proceedings. AMIA Symposium [AMIA Annu Symp Proc] 2023 Apr 29; Vol. 2022, pp. 269-278. Date of Electronic Publication: 2023 Apr 29 (Print Publication: 2022).
Abstrakt:	Early identification of advanced illness patients within an inpatient population is essential in order to establish the patient's goals of care. Having goals of care conversations enables hospital patients to dictate a plan for care in concordance with their values and wishes. These conversations allow a patient to maintain some control, rather than be subjected to a default care process that may not be desired and may not provide benefit. In this study the performance of two approaches which identify advanced illness patients within an inpatient population were evaluated: LACE (a rule-based approach that uses L - Length of stay, A- Acuity of Admission, C- Co-morbidities, E- Emergency room visits), and a novel approach: Hospital Impairment Score (HIS). The Hospital impairment score is derived by leveraging both rule-based insights and a novel machine learning algorithm. It was identified that HIS significantly outperformed the LACE score, the current model being used in production at Northwell Health. Furthermore, we describe how the HIS model was piloted at a single hospital, was launched into production, and is being successfully used by clinicians at that hospital. (©2022 AMIA - All rights reserved.)
Databáze:	MEDLINE
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