Intermountain Health medical informaticists developed a clinical decision support platform that uses evidence-based medicine and artificial intelligence to accelerate patient treatment and integrate with electronic health records in real time.

WHY IT MATTERS
Every Intermountain Health hospital or urgent care in seven states will eventually be able to access the new platform, an ePneumonia app and future apps, according to Craig Richardville, the nonprofit health system's chief digital and information officer.

Emergency room physicians at Intermountain Medical Center in Murray, Utah, have been using the tools to improve the speed of diagnosis and accelerate pneumonia treatment.

"Patient care is often complex and very personal," Richardville said in Friday's statement.

The new platform helps providers "give patients the best, individualized care possible and helps ensure the right decision is being made at the right time."

Dr. Kathryn Kuttler, advanced decision support director at Intermountain, explained that the platform is a standards-based workflow engine that integrates a variety of services.

Operating outside of the EHR, and using the Fast Healthcare Interoperability Resources common standard healthcare language, the platform allows clinicians to read from and write to the patient health records in real time.

It also continuously updates the workflows as new test results are added to the patient’s medical record, and uses AI and a deep neural network to interpret chest images.

"Diagnostic services are executed by an AI, Bayesian network," Kuttler said.

Clinicians use the data from the ePneumonia app – along with the information and nuances they’ve gathered during their visit with the patient – to help them determine the best course of treatment, Intermountain says.

The app has broad applications, because published pneumonia care guidelines have been historically difficult to follow at the bedside, and they have a complex workflow, said Dr. Nathan Dean, section chief of pulmonary and critical care medicine at Intermountain Medical Center and principal investigator of the studies.

"In the studies, we demonstrated a 36% relative decrease in 30-day mortality for pneumonia patients, which is more than 100 lives saved annually. We observed 17% increase in outpatient disposition from the emergency department and increased the use of antibiotic best practices."

Dean also noted that the ePneumonia app is also "one of the most complicated apps to build, as there are more than 50 data elements that go into diagnosis, assessment of illness severity and decision-making for patients with pneumonia."

THE LARGER TREND
Combining machine learning with evidence-based decision support to reduce diagnostic errors has been a key focus of digital transformation innovations for care delivery.

"Incorporating newly developed algorithms that take advantage of machine learning, neural networks and a variety of other types of artificial intelligence can help address many of the shortcomings of human intelligence," Dr. John Halamka, president of Mayo Clinic Platform, previously told Healthcare IT News.

More recently, David Lareau, CEO of Medicomp Systems, said the broad acceptance of FHIR is going to usher in a flood of data that can support access to clinically relevant data and could even reduce post-chart and post-encounter reviews for risk-based contracts.

"The documentation needs to reflect a complete profile of what you did to manage that condition for that patient," he said during a January HIMSS TV Digital Checkup about diagnostically connected data.

He said that, particularly with value-based care, provider organizations need to be able "to get a quick view of all the data" and be sure they are meeting requirements.

"We need a new set of tools to be able to let physicians, nurses, everybody else see the information they need, when they need it, and it needs to be diagnostically-focused."

ON THE RECORD
"The platform has the capability to effectively perform and represent complex clinical processes and enables more rapid development of both clinical and business workflows," Kuttler said in the statement.

Also, "this will help create a more seamless experience for patients."

Dr. Diego Ize-Ludlow, Intermountain's chief health information officer, added:

"This novel platform and the ePneumonia app are both tools that really align with what we’re doing generally in value-based care: to diagnose people earlier, improve patient safety and quality of care, with the simultaneous goal to reduce healthcare costs."

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.