Svetlana Herasevich, MD,
Research Fellow
Mayo Clinic
Rochester, Minnesota
Disclosure information not submitted.
Kirill Lipatov, MD
Clinical Fellow
Mayo Clinic College of Medicine
Rochester, Minnesota, United States
Disclosure information not submitted.
Yuliya Pinevich, MD
Research Fellow
Mayo Clinic
Rochester, Minnesota, United States
Disclosure information not submitted.
Heidi Lindroth, PhD,RN
Nurse Scientist
Mayo Clinic Rochester
Rochester, Minnesota, United States
Disclosure information not submitted.
Vitaly Herasevich, MD, PhD, FCCM
Professor of Anesthesiology and Medicine
Mayo Foundation
Rochester, Minnesota
Disclosure information not submitted.
Brian Pickering, MD, MB, BCh, BAO
Professor
Mayo Clinic - College of Medicine, United States
Disclosure information not submitted.
.jpg "Amelia Barwise, MB, PhD, BCh, BAO photo")
Amelia Barwise, MB, PhD, BCh, BAO
Research Associate
Mayo Clinic
Rochester, United States
Disclosure information not submitted.
Title: Health Information Technology for Detection of Patient Deterioration:Systematic Review/Meta-Analysis
Introduction: To evaluate the impact of health information technology (HIT) for early detection of patient deterioration on mortality and length of stay in acute care hospital settings.
Methods: We searched Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus from 1990 through January 19, 2021. We included studies that enrolled patients who were hospitalized, in intensive care unit (ICU), or admitted through the emergency department, compared HIT for early detection of patient deterioration with usual care, and reported at least one endpoint of interest - hospital or ICU length of stay (LOS), or mortality at any time point. Study data was abstracted by two independent reviewers using a standardized data extraction form. Random-effects meta-analysis was used for quantitative synthesis of data.
Results: A total of 31 studies were included. Of these, 9 were randomized controlled trials and 22 were pre-post studies. Compared to usual care, HIT for early detection of patient deterioration was associated with a reduction in hospital mortality for the entire study cohort (OR 0.83 [95% CI 0.75, 0.91]) as well as for those study patients who met the criteria for deterioration (OR 0.76 [95% CI 0.62, 0.93]). Hospital length of stay was reduced in those patients who met the criteria for deterioration (mean difference -0.420 [95% CI -0.746, -0.094]). ICU LOS did not change significantly.
Conclusions: HIT for early detection of deterioration was associated with lower odds of hospital mortality. In the subgroup of patients meeting deterioration criteria, HIT was also associated with a reduction in hospital LOS. The evaluation of other practice changes that may also have influenced outcome improvements could not be assessed in this study.