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Early warning system at The Hospital of Central Connecticut helps improve patient outcomes

[January 09 2013] - A computerized early warning system being piloted at The Hospital of Central Connecticut automatically alerts caregivers when patients take a turn for the worse, allowing for earlier interventions that can improve patients' outcomes.

The system, currently being piloted on one nursing unit, is expected to go hospital-wide in mid-January, at HOCC's New Britain General campus and Bradley Memorial campus in Southington.

The early warning system works by continuously monitoring patients' electronic health records, looking at data like vital signs, lab test results, key physiological information and diagnoses and problems, said Jeff Finkelstein, M.D., HOCC's chief medical information officer and chief of emergency medicine. He likened the system to Google and other Internet search engines, which constantly crawl the web for information so they can produce search results.

"While care providers are very vigilant to changes in patients' conditions, they can't observe every patient every minute of the day," he said. "This system is checking each patient's electronic record, every minute, 24/7. It can pick up subtle and sudden changes."

The system is programmed to detect certain scenarios - for example, if a patient has a combination of elevated blood sugar, white blood cell count and heart rate - and will automatically send an alert to the primary nurse and a text message to other care providers. The system can detect minor problem scenarios - "the warning before the warning", Finkelstein said -- as well as life-threatening changes.

Recently, the system alerted physicians and nurses to subtle changes in a patient who had just had major, complicated surgery. After reviewing the data and examining the patient, physicians had the patient moved to the critical care unit, where the patient spent a day before being transferred to a regular nursing floor.

"This heightened level of awareness allowed us to intervene much earlier, and avoid deterioration in the patient's condition that could have been life-threatening," said surgeon Rekha Singh, M.D. "There are times when it's not obvious that a patient's condition is worsening. This system helps us identify subtle physiological changes so we can prevent rapid deterioration."

Finkelstein stressed that the early warning system does not replace care providers' critical thinking skills, because once alerted, they must review the data, carefully examine the patient, conduct any needed tests and determine the best course of action.

The early warning system is one of a number of patient safety enhancements resulting from HOCC's conversion of patient written records to electronic records in May.

"This is another example of how we're using the power of electronic medical records to help us save lives," Finkelstein said.