Informatics Infrastructure for Syndrome Surveillance, Decision Support, Reporting, and Modeling of Critical Illness

Herasevich, Vitaly; Pickering, Brian W.; Yue Dong; Peters, Steve G.; Gajic, Ognjen
March 2010
Mayo Clinic Proceedings;Mar2010, Vol. 85 Issue 3, p247
Academic Journal
OBJECTIVE: To develop and validate an informatics infrastructure for syndrome surveillance, decision support, reporting, and modeling of critical illness. METHODS: Using open-schema data feeds Imported from electronic medical records (EMRs), we developed a near-real-time relational database (Multidisciplinary Epidemiology and Translational Research in Intensive Care Data Mart). Imported data domains included physiologic monitoring, medication orders, laboratory and radiologlc investigations, and physician and nursing notes. Open database connectivity supported the use of Boolean combinations of data that allowed authorized users to develop syndrome surveillance, decision support, and reporting (data "sniffers") routines. Random samples of database entries in each category were validated against corresponding Independent manual reviews. RESULTS: The MultIdIsciplinary Epidemiology and Translational Research in Intensive Care Data Mart accommodates, on average, 15,000 admissions to the Intensive care unit (ICU) per year and 200,000 vital records per day. Agreement between database entries and manual EMR audits was high for sex, mortality, and use of mechanical ventilation (κ, 1.0 for all) and for age and laboratory and monitored data (Bland-Altman mean difference ± SD, 1(0) for all). Agreement was lower for interpreted or calculated variables, such as specific syndrome diagnoses (κ, 0.5 for acute lung injury), duration of ICU stay (mean difference ± SD, 0.43±0.2), or duration of mechanical ventilation (mean difference ± SD, 0.2±0.9). CONCLUSION: Extraction of essential ICU data from a hospital EMR into an open, integrative database facilitates process control, reporting, syndrome surveillance, decision support, and outcome research in the ICU.


Related Articles

  • MEWS to e-MEWS: From a Paper-Based to an Electronic Clinical Decision Support System. O'Kane, Tom; O'Donoghue, John; Gallagher, Joe; Aftab, A.; Casey, Aveline; Angove, Philip; Torres, Javier; Courtney, Garry // Proceedings of the European Conference on Information Management;2010, p301 

    It is now well established that many patients already in hospital can suddenly become acutely ill but experience delayed recognition of their physiological deterioration resulting in late referral to critical care or in some cases death. In recent years there has been significant growth in the...

  • Exploiting Temporal Relations in Mining Hepatitis Data. Tu-Bao Ho; Canh-Hao Nguyen; Kawasaki, Saori; Si-Quang Le; Takabayashi, Katsuhiko // New Generation Computing;2007, Vol. 25 Issue 3, p247 

    Various data mining methods have been developed last few years for hepatitis study using a large temporal and relational database given to the research community. In this work we introduce a novel temporal abstraction method to this study by detecting and exploiting temporal patterns and...

  • AMIA Supports Decision Support.  // Health Management Technology;Aug2006, Vol. 27 Issue 8, p38 

    The article focuses on the release of the American Medical Informatics Association of a report entitled, A Roadmap for National Action on Clinical Decision Support, a treatise on how healthcare organizations can optimize the use of, and gains from, clinical decision support programs. Because of...

  • ELECTRONIC MEDICAL RECORDS. Malakar, Rajib // Indian Journal of Dermatology;2006, Vol. 51 Issue 2, p140 

    The article discusses the importance of electronic medical records (EMR). EMR, as described in the 2003 Institute of Medicine patient safety report, is a collection of electronic health information for and about persons electronic access to information by authorized users. It also involves the...

  • Gathering and Managing Diagnostic Tests. Santos, J.; Pedrosa, T.; Ferreira, C.; Costa, C.; Oliveira, J. // CISTI (Iberian Conference on Information Systems & Technologies ;Jun2010, p396 

    Personal health information is constituted in its greatest part by complementary diagnostic tests which are an important medical aid. This information is generated dispersedly because the patient seeks medical care in many different places over his lifetime. Access to a comprehensive set of a...

  • IT in action: AMDIS awards go to three docs, one organization. Conn, Joseph // Modern Healthcare;6/25/2012, Vol. 42 Issue 26, p26 

    The article announces that physicians James Killeen, James Scott and Steve Arendt, and the organization HealtheLink were declared winners of the 2012 awards for outstanding achievement in applied medical informatics from the Association of Medical Directors of Information Systems.

  • Virtua Selects MedCPU's Expert AdvisorTM for OB to Support Its Clinicians in Delivering the Best Patient Care.  // Biomedical Market Newsletter;3/7/2011, p128 

    The article reports that Virtua has selected MedCPU Inc.'s Expert AdvisorTM to support its clinicians in providing the best patient care in obstetrics. As stated, the deployment of MedCPU's Expert AdvisorTM for obstetrics will provide the clinicians an innovative realtime clinical decision...

  • UMass Memorial Health Care Selects MedCPU's Meaningful-Use AdvisorTM for Stage I Meaningful Use Compliance Assurance and Reporting.  // Biomedical Market Newsletter;3/7/2011, p131 

    The article reports that UMass Memorial Health Care in Worcester, Massachusetts has selected MedCPU Inc. to deliver its Meaningful Use AdvisorTM tool to assure compliance of its physicians and hospitals with the Meaningful Use requirements and qualification for the attendant economic incentives....

  • Code status discussions and goals of care among hospitalised adults. Kaldjian, L. C.; Erekson, Z. D.; Haberle, T. H.; Curtis, A. E.; Shinkunas, L. A.; Cannon, K. T.; Forman-Hoffman, V. L. // Journal of Medical Ethics;Jun2009, Vol. 35 Issue 6, p338 

    Background and objective: Code status discussions may fail to address patients treatment-related goals and their knowledge of cardiopulmonary resuscitation (CPA). This study aimed to investigate patients' resuscitation preferences, knowledge of CPA and goals of care. Design, setting, patients...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics