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The Nature and Variability of Automated Practice Alerts Derived from Electronic Health Records in a U.S. Nationwide Critical Care Research Network

TitleThe Nature and Variability of Automated Practice Alerts Derived from Electronic Health Records in a U.S. Nationwide Critical Care Research Network
Publication TypeWeb Article
Year of Publication2016
AuthorsBenthin C, Pannu S, Khan A, Gong M
Corporate AuthorsNIH/NHLBI PETAL Network
Keywordsalerts, critical care, electronic
Abstract

Abstract
RATIONALE:

The nature, variability and extent of early warning clinical practice alerts derived from automated query of electronic health records (e-alerts) currently employed 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 NIH-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 utilized 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% sites represented in this survey used e-alerts. All but one of these 17 sites used an e-alert for early detection of sepsis-related 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:

A majority 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. Utilization of one common electronic health record vendor at over 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.