Creating a Clinical Systems Integration Strategy to Drive Improvement

Utilizing big data from electronic health records in pediatric clinical care

“…In the world of informatics, data systems increase in sophistication from simple data gathering and reporting, (such as from an EHR report on a patient's labs at the bedside), to aggregating and analyzing data in populations or themes ("data analytics"), to predicting patients at risk for a disease or worsening conditions ("predictive analytics"), or linking health observations with health knowledge to influence clinical decisions ("prescriptive analytics" or "clinical decision support") 4,5 Clinical decision support (CDS)…”

“…It is a means to improve outcomes by improving workflows through ease of documentation, provision of alert information at the point of care, and improvement in the cognitive understanding of the clinician An institution or practice's hardware and software, and data management processes are critical to its capability to use CDS and often utilize electronic health records (EHRs) as the vehicle to deliver that support. 4,5 CDS in electronic health systems can be broadly categorized into two types based on the underlying approach to decision making:…”

“…It is a means to improve outcomes by improving workflows through ease of documentation, provision of alert information at the point of care, and improvement in the cognitive understanding of the clinician An institution or practice’s hardware and software, and data management processes are critical to its capability to use CDS and often utilize electronic health records (EHRs) as the vehicle to deliver that support. 4 , 5 CDS in electronic health systems can be broadly categorized into two types based on the underlying approach to decision making: (1) knowledge-based (or rule-based) that relies on rules and associations of compiled information obtained from domain experts; (2) non-knowledge based (or data-driven) systems that employ statistical and artificial intelligence (with or without machine learning techniques) to identify and learn from patterns in data 57 , 58

Fig. 1 Healthcare organizational maturity in analytics over time using sepsis as a case study.

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“…An institution or practice’s hardware and software, and data management processes are critical to its capability to use CDS and often utilize electronic health records (EHRs) as the vehicle to deliver that support. 4 , 5 CDS in electronic health systems can be broadly categorized into two types based on the underlying approach to decision making:…”

“…1). 4,5 USING ANALYTICS FOR QI IN PEDIATRIC SEPSIS In order to illustrate the use of big data for QI (either in a local clinical care improvement project or in the use of collated big data that can drive change collectively), we illustrate a case example of pediatric sepsis. Sepsis is a potentially life-threatening complication of an infection in the blood and occurs when the body's efforts at fighting infection trigger an inflammatory response throughout the body.…”