TY - JOUR
T1 - Can a Novel ICU Data Display Positively Affect Patient Outcomes and Save Lives?
AU - Olchanski, Natalia
AU - Dziadzko, Mikhail A.
AU - Tiong, Ing C.
AU - Daniels, Craig E.
AU - Peters, Steve G.
AU - O’Horo, John C.
AU - Gong, Michelle N.
N1 - Funding Information:
Patient Centered Cloud-based Electronic System: Ambient Warning and Response Evaluation (ProCCESs AWARE) is a novel acute care EMR interface, developed at the Mayo Clinic, Rochester, MN, with funding from a CMS Health Care Innovation Award. AWARE contains built-in tools for error prevention, practice surveillance, decision support and reporting, built on an advanced understanding of cognitive and organizational ergonomics. In preliminary studies this system has significantly decreased the cognitive load of bedside clinicians, reduced medical errors [6], and was associated with improved communication, care efficiency, and ease of clinical data management compared to the standard EMR [7].
Funding Information:
ported by Grant Number 1C1CMS330964–01-00 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. The design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication were conducted by the awardee. Findings may or may not be consistent with or confirmed by the findings of the independent evaluation contractor.
Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - The aim of this study was to quantify the impact of ProCCESs AWARE, Ambient Clinical Analytics, Rochester, MN, a novel acute care electronic medical record interface, on a range of care process and patient health outcome metrics in intensive care units (ICUs). ProCCESs AWARE is a novel acute care EMR interface that contains built-in tools for error prevention, practice surveillance, decision support and reporting. We compared outcomes before and after AWARE implementation using a prospective cohort and a historical control. The study population included all critically ill adult patients (over 18 years old) admitted to four ICUs at Mayo Clinic, Rochester, MN, who stayed in hospital at least 24 h. The pre-AWARE cohort included 983 patients from 2010, and the post-AWARE cohort included 856 patients from 2014. We analyzed patient health outcomes, care process quality, and hospital charges. After adjusting for patient acuity and baseline demographics, overall in-hospital and ICU mortality odds ratios associated with AWARE intervention were 0.45 (95% confidence interval 0.30 to 0.70) and 0.38 (0.22, 0.66). ICU length of stay decreased by about 50%, hospital length of stay by 37%, and total charges for hospital stay by 30% in post AWARE cohort (by $43,745 after adjusting for patient acuity and demographics). Better organization of information in the ICU with systems like AWARE has the potential to improve important patient outcomes, such as mortality and length of stay, resulting in reductions in costs of care.
AB - The aim of this study was to quantify the impact of ProCCESs AWARE, Ambient Clinical Analytics, Rochester, MN, a novel acute care electronic medical record interface, on a range of care process and patient health outcome metrics in intensive care units (ICUs). ProCCESs AWARE is a novel acute care EMR interface that contains built-in tools for error prevention, practice surveillance, decision support and reporting. We compared outcomes before and after AWARE implementation using a prospective cohort and a historical control. The study population included all critically ill adult patients (over 18 years old) admitted to four ICUs at Mayo Clinic, Rochester, MN, who stayed in hospital at least 24 h. The pre-AWARE cohort included 983 patients from 2010, and the post-AWARE cohort included 856 patients from 2014. We analyzed patient health outcomes, care process quality, and hospital charges. After adjusting for patient acuity and baseline demographics, overall in-hospital and ICU mortality odds ratios associated with AWARE intervention were 0.45 (95% confidence interval 0.30 to 0.70) and 0.38 (0.22, 0.66). ICU length of stay decreased by about 50%, hospital length of stay by 37%, and total charges for hospital stay by 30% in post AWARE cohort (by $43,745 after adjusting for patient acuity and demographics). Better organization of information in the ICU with systems like AWARE has the potential to improve important patient outcomes, such as mortality and length of stay, resulting in reductions in costs of care.
KW - EMR
KW - ICU
KW - Quality
UR - http://www.scopus.com/inward/record.url?scp=85029635800&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85029635800&partnerID=8YFLogxK
U2 - 10.1007/s10916-017-0810-8
DO - 10.1007/s10916-017-0810-8
M3 - Article
C2 - 28921446
AN - SCOPUS:85029635800
VL - 41
JO - Journal of Medical Systems
JF - Journal of Medical Systems
SN - 0148-5598
IS - 11
M1 - 171
ER -