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Electronic tool reduces community-acquired pneumonia mortality
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A novel electronic tool designed to aid pneumonia diagnosis and treatment may reduce mortality resulting from community-acquired cases of the disease, according to recent data.
“Because of the complexity of pneumonia, physicians can’t easily make consistent decisions that follow current treatment recommendations,” Nathan C. Dean, MD, chief of critical care medicine at Intermountain Medical Center in Salt Lake City, said in a press release. “The result is, doctors have to rely on their unaided judgment on how to best treat pneumonia patients.”
Dean and colleagues developed a computer program able to monitor clinical data collected through the electronic medical records of ED patients. Combining previous testing results, chest X-ray imagery and an estimated risk for drug-resistant bacteria, the program alerts physicians that a patient may have the disease. If pneumonia is confirmed, the program then will recommend optimal treatment options tailored to each patient’s record.
“This tool doesn’t take over for doctors, but it does assemble the needed information, calculates the patients’ severity of illness and likelihood of infection with resistant bacteria, and presents recommendations to help doctors make better decisions,” Dean said. “It’s all about giving local doctors tools to be more consistent, objective and focused on best practices.”
To measure the program’s effectiveness, researchers examined 30-day, all-cause mortality rates among pneumonia patients following deployment at four intervention EDs from December 2011 to November 2012. Results were compared with previous pneumonia mortality rates (December 2009 to November 2010) in the same departments, as well as mortality rates during the intervention period in three EDs without the tool.
The study population comprised 4,758 ED pneumonia patients (median age, 58 years; 53% women). Fifty-nine percent of patients were admitted into a hospital, and 62.6% were evaluated with the tool.
Severity-adjusted mortality was reduced among patients with community-acquired pneumonia treated in intervention EDs (OR = 0.53; 95% CI, 0.28-0.99), but no difference was seen among health care-associated pneumonia mortality (OR = 1.12; 95% CI, 0.45-2.8). In addition, there was no difference in overall mortality between EDs that did or did not use the tool (OR = 0.69; 95% CI, 0.41-1.16).
“This study demonstrates the feasibility and potential benefit of real-time electronic clinical decision support for ED pneumonia patients,” the researchers wrote.
Dean and colleagues are developing an improved version of the tool, according to the press release, and plan to increase deployment when it is available.
Disclosure: The researchers report no relevant financial disclosures.
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