Decision-support tool reduces deaths from pneumonia in emergency
12 September 2013
A trial of an electronic decision support tool that is linked to
patients' electronic medical records showed it helped to reduce
deaths from pneumonia in emergency departments by up to 25%.
The findings were presented at the European Respiratory Society
(ERS) Annual Congress in Barcelona on 11 September 2013.
Researchers from Intermountain Healthcare and the University of
Utah in the USA tested the effectiveness of the tool on pneumonia
patients in seven emergency departments.
A group of 2,450 patients were assessed when using the electronic
tool and compared to a group of 2,308 patients that were analysed
before the electronic tool was used.
In both groups the researchers looked at hospital admission
rates, length of hospital stay, deaths, secondary hospitalisation
rates and adherence to guidelines.
The results showed a significant reduction in death rates in the
emergency departments where the tool was used. Crude inpatient
mortality rate fell from 5.3% to 3.5% and, after adjusting for
severity, the relative risk of death was reduced by 25%.
The researchers developed an electronic tool because it is often
difficult to fully implement existing guidelines in an emergency
setting. The tool is linked to a patient’s electronic medical
record, so unlike a paper guideline, it automatically extracts data
that predict the severity of pneumonia. The tool then provides
recommendations regarding where the patient should be admitted to,
which diagnostic tests are best to use and which antibiotics are
Dr Barbara Jones, leading author of the study, said: “We are
encouraged by the impact that our tool has had on death rates, and
feel that it is most likely due to more accurate severity assessment
and antibiotic decisions being made in accordance with the
guidelines. While we are encouraged by the results, we plan to
collect more data to explore how the tool is making this impact.”
Dr Nathan Dean, senior author of the study, said: “Although
doctors are free to choose at any time whether to follow the
recommendations, we think that a tool that is individualised and
integrated into the electronic health record is a much more
efficient way of supporting decision-making and making treatment
guidelines quickly accessible during an emergency situation.”