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Why Detecting Patient Deterioration is so Challenging

Why Detecting Patient Deterioration Is So Challenging

By David Lamb, PhD, Sr. Director Clinical and Product Management, GE Healthcare, and Connie Rathke, RN, Clinical Insights Manager, GE Healthcare

In 2019, General Electric invested in the development of a new platform to transform how teams of medical professionals deliver patient care. Much of this investment can be credited to the notion that patients don’t suddenly deteriorate - clinicians suddenly notice. While this may be true, detecting that patient deterioration is much more nuanced. One thing is universal: identifying patients at risk of deterioration (prior to requiring heroic efforts to rescue them) is extremely difficult. Why is that? 

In our work, we have seen three fundamental contributors:

  • Caring for patients requires a team effort. As in any high-performing team, communication is critical. This is particularly challenging with the added complexity of patient transfers, staffing changes, and low clinician-to-patient ratios.1 When care teams are ever-evolving with limited resources, it is difficult for all members to be collectively aware of each patient’s status. GE Healthcare has found that there is currently no good solution for this problem, regardless of what technology hospitals use. 
  • The EMR. While the EMR is a great system of record and billing, regardless of which EMR you use, they may pose a challenging system of engagement. Clinicians forage through multiple tabs, windows, and drop downs in search of needed data, while attempting to mentally construct a comprehensive view of the patient. Despite so much valuable data, the complexity of EMRs can make information extremely difficult to find.2 Although paper medical records may have been cumbersome, they did, however, force a single data source to be referenced, enabling face-to-face collaboration in the inpatient department for the patient’s care. Essentially, digitizing the patient record does not equate to easier data accessibility.
  • The progression of patient deterioration itself. The human body is an amazing thing: it can compensate (and mask) the signs of deterioration which would otherwise be obvious. It is rarely a straight-forward picture; other patient disease processes can complicate the evaluation process. Deterioration can be slow and subtle - until it’s not.

The combination of these three sometimes-nuanced factors puts clinicians in a nearly impossible situation. We believe clinicians need technology to help them communicate & collaborate, to intuitively access patient data, and to predict when patients are at risk of deterioration.It’s on this we are laser focused. And, we believe that being empathetic to the clinicians who are in the trenches will help us to develop solutions that truly make a difference. 

Sepsis is one example of patient deterioration where early detection can enable early intervention and better outcomes; it is a powerful example that illustrates our ongoing quest to help “solve” sepsis.

REFERENCES:

  1. Making space for empathy: supporting doctors in the emotional labour of clinical care. BMC Medical Ethics https://www.mdmag.com/medical-news/why-are-emrs-so-terrible Accessed 7/11/2019