The nature and variability of automated practice alerts derived from electronic health records in a U.S. nationwide critical care research network

Cody Benthin, Sonal Pannu, Akram Khan, Michelle Gong

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Rationale: The nature, variability, and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently used in acute care settings for clinical care or research is unknown. Objectives: To describe e-alerts in current use in acute care settings at medical centers participating in a nationwide critical care research network. Methods: We surveyed investigators at 38 institutions involved in the National Institutes of Health-funded Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL) for quantitative and qualitative analysis. Measurements and Main Results: Thirty sites completed the survey (79% response rate). All sites used electronic health record systems. Epic Systems was used at 56% of sites; the others used alternate commercially available vendors or homegrown systems. Respondents at 57% of sites represented in this survey used e-alerts. All but 1 of these 17 sites used an e-alert for early detection of sepsisrelated syndromes, and 35% used an e-alert for pneumonia. E-alerts were triggered by abnormal laboratory values (37%), vital signs (37%), or radiology reports (15%) and were used about equally for clinical decision support and research. Only 59% of sites with e-alerts have evaluated them either for accuracy or for validity. Conclusions:Amajority of the research network sites participating in this survey use e-alerts for early notification of potential threats to hospitalized patients; however, there was significant variability in the nature of e-alerts between institutions. Use of onecommon electronic health record vendor at more than half of the participating sites suggests that it may be possible to standardize e-alerts across multiple sites in research networks, particularly among sites using the same medical record platform.

Original languageEnglish (US)
Pages (from-to)1784-1788
Number of pages5
JournalAnnals of the American Thoracic Society
Volume13
Issue number10
DOIs
StatePublished - Oct 1 2016

Fingerprint

Electronic Health Records
Critical Care
Research
Clinical Decision Support Systems
Vital Signs
Acute Lung Injury
National Institutes of Health (U.S.)
Radiology
Medical Records
Pneumonia
Research Personnel
Clinical Trials
Surveys and Questionnaires

Keywords

  • Acute respiratory distress syndrome
  • Electronic health record alerts
  • Sepsis
  • Survey

ASJC Scopus subject areas

  • Medicine(all)
  • Pulmonary and Respiratory Medicine

Cite this

The nature and variability of automated practice alerts derived from electronic health records in a U.S. nationwide critical care research network. / Benthin, Cody; Pannu, Sonal; Khan, Akram; Gong, Michelle.

In: Annals of the American Thoracic Society, Vol. 13, No. 10, 01.10.2016, p. 1784-1788.

Research output: Contribution to journalArticle

@article{f1438efc242d425c9c4963616e975f94,
title = "The nature and variability of automated practice alerts derived from electronic health records in a U.S. nationwide critical care research network",
abstract = "Rationale: The nature, variability, and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently used in acute care settings for clinical care or research is unknown. Objectives: To describe e-alerts in current use in acute care settings at medical centers participating in a nationwide critical care research network. Methods: We surveyed investigators at 38 institutions involved in the National Institutes of Health-funded Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL) for quantitative and qualitative analysis. Measurements and Main Results: Thirty sites completed the survey (79{\%} response rate). All sites used electronic health record systems. Epic Systems was used at 56{\%} of sites; the others used alternate commercially available vendors or homegrown systems. Respondents at 57{\%} of sites represented in this survey used e-alerts. All but 1 of these 17 sites used an e-alert for early detection of sepsisrelated syndromes, and 35{\%} used an e-alert for pneumonia. E-alerts were triggered by abnormal laboratory values (37{\%}), vital signs (37{\%}), or radiology reports (15{\%}) and were used about equally for clinical decision support and research. Only 59{\%} of sites with e-alerts have evaluated them either for accuracy or for validity. Conclusions:Amajority of the research network sites participating in this survey use e-alerts for early notification of potential threats to hospitalized patients; however, there was significant variability in the nature of e-alerts between institutions. Use of onecommon electronic health record vendor at more than half of the participating sites suggests that it may be possible to standardize e-alerts across multiple sites in research networks, particularly among sites using the same medical record platform.",
keywords = "Acute respiratory distress syndrome, Electronic health record alerts, Sepsis, Survey",
author = "Cody Benthin and Sonal Pannu and Akram Khan and Michelle Gong",
year = "2016",
month = "10",
day = "1",
doi = "10.1513/AnnalsATS.201603-172BC",
language = "English (US)",
volume = "13",
pages = "1784--1788",
journal = "Annals of the American Thoracic Society",
issn = "2325-6621",
publisher = "American Thoracic Society",
number = "10",

}

TY - JOUR

T1 - The nature and variability of automated practice alerts derived from electronic health records in a U.S. nationwide critical care research network

AU - Benthin, Cody

AU - Pannu, Sonal

AU - Khan, Akram

AU - Gong, Michelle

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Rationale: The nature, variability, and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently used in acute care settings for clinical care or research is unknown. Objectives: To describe e-alerts in current use in acute care settings at medical centers participating in a nationwide critical care research network. Methods: We surveyed investigators at 38 institutions involved in the National Institutes of Health-funded Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL) for quantitative and qualitative analysis. Measurements and Main Results: Thirty sites completed the survey (79% response rate). All sites used electronic health record systems. Epic Systems was used at 56% of sites; the others used alternate commercially available vendors or homegrown systems. Respondents at 57% of sites represented in this survey used e-alerts. All but 1 of these 17 sites used an e-alert for early detection of sepsisrelated syndromes, and 35% used an e-alert for pneumonia. E-alerts were triggered by abnormal laboratory values (37%), vital signs (37%), or radiology reports (15%) and were used about equally for clinical decision support and research. Only 59% of sites with e-alerts have evaluated them either for accuracy or for validity. Conclusions:Amajority of the research network sites participating in this survey use e-alerts for early notification of potential threats to hospitalized patients; however, there was significant variability in the nature of e-alerts between institutions. Use of onecommon electronic health record vendor at more than half of the participating sites suggests that it may be possible to standardize e-alerts across multiple sites in research networks, particularly among sites using the same medical record platform.

AB - Rationale: The nature, variability, and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently used in acute care settings for clinical care or research is unknown. Objectives: To describe e-alerts in current use in acute care settings at medical centers participating in a nationwide critical care research network. Methods: We surveyed investigators at 38 institutions involved in the National Institutes of Health-funded Clinical Trials Network for the Prevention and Early Treatment of Acute Lung Injury (PETAL) for quantitative and qualitative analysis. Measurements and Main Results: Thirty sites completed the survey (79% response rate). All sites used electronic health record systems. Epic Systems was used at 56% of sites; the others used alternate commercially available vendors or homegrown systems. Respondents at 57% of sites represented in this survey used e-alerts. All but 1 of these 17 sites used an e-alert for early detection of sepsisrelated syndromes, and 35% used an e-alert for pneumonia. E-alerts were triggered by abnormal laboratory values (37%), vital signs (37%), or radiology reports (15%) and were used about equally for clinical decision support and research. Only 59% of sites with e-alerts have evaluated them either for accuracy or for validity. Conclusions:Amajority of the research network sites participating in this survey use e-alerts for early notification of potential threats to hospitalized patients; however, there was significant variability in the nature of e-alerts between institutions. Use of onecommon electronic health record vendor at more than half of the participating sites suggests that it may be possible to standardize e-alerts across multiple sites in research networks, particularly among sites using the same medical record platform.

KW - Acute respiratory distress syndrome

KW - Electronic health record alerts

KW - Sepsis

KW - Survey

UR - http://www.scopus.com/inward/record.url?scp=84992579911&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84992579911&partnerID=8YFLogxK

U2 - 10.1513/AnnalsATS.201603-172BC

DO - 10.1513/AnnalsATS.201603-172BC

M3 - Article

VL - 13

SP - 1784

EP - 1788

JO - Annals of the American Thoracic Society

JF - Annals of the American Thoracic Society

SN - 2325-6621

IS - 10

ER -