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The Impact of Health Information Technology for Early Detection of Patient Deterioration on Mortality and Length of Stay in the Hospital Acute Care Setting: Systematic Review and Meta-Analysis.
Herasevich, Svetlana; Lipatov, Kirill; Pinevich, Yuliya; Lindroth, Heidi; Tekin, Aysun; Herasevich, Vitaly; Pickering, Brian W; Barwise, Amelia K.
  • Herasevich S; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
  • Lipatov K; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
  • Pinevich Y; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
  • Lindroth H; Department of Nursing, Mayo Clinic, Rochester, MN.
  • Tekin A; Center for Health Innovation and Implementation Science, Center for Aging Research, School of Medicine, Indiana University, Indianapolis, IN.
  • Herasevich V; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
  • Pickering BW; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
  • Barwise AK; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
Crit Care Med ; 50(8): 1198-1209, 2022 08 01.
Article in English | MEDLINE | ID: covidwho-1967913
ABSTRACT

OBJECTIVE:

To evaluate the impact of health information technology (HIT) for early detection of patient deterioration on patient mortality and length of stay (LOS) in acute care hospital settings. DATA SOURCES We searched MEDLINE and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus from 1990 to January 19, 2021. STUDY SELECTION We included studies that enrolled patients hospitalized on the floor, in the ICU, or admitted through the emergency department. Eligible studies compared HIT for early detection of patient deterioration with usual care and reported at least one end point of interest hospital or ICU LOS or mortality at any time point. DATA EXTRACTION Study data were abstracted by two independent reviewers using a standardized data extraction form. DATA

SYNTHESIS:

Random-effects meta-analysis was used to pool data. Among the 30 eligible studies, seven were randomized controlled trials (RCTs) and 23 were pre-post studies. Compared with usual care, HIT for early detection of patient deterioration was not associated with a reduction in hospital mortality or LOS in the meta-analyses of RCTs. In the meta-analyses of pre-post studies, HIT interventions demonstrated a significant association with improved hospital mortality for the entire study cohort (odds ratio, 0.78 [95% CI, 0.70-0.87]) and reduced hospital LOS overall.

CONCLUSIONS:

HIT for early detection of patient deterioration in acute care settings was not significantly associated with improved mortality or LOS in the meta-analyses of RCTs. In the meta-analyses of pre-post studies, HIT was associated with improved hospital mortality and LOS; however, these results should be interpreted with caution. The differences in patient outcomes between the findings of the RCTs and pre-post studies may be secondary to confounding caused by unmeasured improvements in practice and workflow over time.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Medical Informatics / Critical Care Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Crit Care Med Year: 2022 Document Type: Article Affiliation country: CCM.0000000000005554

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Medical Informatics / Critical Care Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Crit Care Med Year: 2022 Document Type: Article Affiliation country: CCM.0000000000005554