Caroline Vines

Performance and Utilization of an Emergency Department Electronic Screening Tool for Pneumonia

A ppropriate treatment of pneumonia begins with accurate diagnosis. However, clinicians have difficulty integrating data for clinical decision making. Significant variability in pneumonia management exists in the emergency department (ED). Decision support might decrease variability and improve care, but physician utilization is historically low. An alerting tool is needed for physicians to utilize computer-based pneumonia decision support. We developed a real-time electronic screening tool that identifies patients with pneumonia by applying Bayesian probabilistic logic to the electronic medical record, and we implemented the tool in 4 EDs. A “P” appears on the ED electronic tracker board when pneumonia likelihood reaches 40%. Clicking on the icon displays pneumonia likelihood and the relevant data (Figure). After confirming the diagnosis, the ED physician proceeds with a linked decision support tool that provides management recommendations.

Technology implementation impacting the outcomes of patients with CAP.

Community-acquired pneumonia (CAP) combined with influenza is the eighth leading cause of death in the United States. This article examines the literature to understand and describe whether technology implementation has impacted the outcomes of patients with CAP. We conducted an electronic search of PubMed and scanned references of articles meeting inclusion criteria. Twenty-six articles were included in this review. We surveyed this literature for answers to the following questions: Can technology be used to improve quality of care and guideline compliance in CAP? How can we overcome the behavioral bottleneck that prevents adoption of computerized decision support systems? How reliable are our data in the era of electronic medical records? What are the risks associated with technology implementation? No articles demonstrated that technology implementation improves outcomes in the care of patients with CAP.

Community‐acquired pneumonia management and outcomes in the era of health information technology

Pneumonia continues to be a leading cause of hospitalization and mortality. Implementation of health information technology (HIT) can lead to cost savings and improved care. In this review, we examine the literature on the use of HIT in the management of community‐acquired pneumonia. We also discuss barriers to adoption of technology in managing pneumonia, the reliability and quality of electronic health data in pneumonia research, how technology has assisted pneumonia diagnosis and outcomes research. The goal of using HIT is to develop and deploy generalizable, real‐time, computerized clinical decision support integrated into usual pneumonia care. A friendly user interface that does not disrupt efficiency and demonstrates improved clinical outcomes should result in widespread adoption.