INTEGRATING DATA SCIENCE INTO CLINICAL PRACTICE: A CASE ... · INTEGRATING DATA SCIENCE INTO...
13
INTEGRATING DATA SCIENCE INTO CLINICAL PRACTICE: A CASE STUDY IN SEPSIS Dr Jonathan Perlin Dr Edmund Jackson
Transcript of INTEGRATING DATA SCIENCE INTO CLINICAL PRACTICE: A CASE ... · INTEGRATING DATA SCIENCE INTO...
1 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
INTEGRATING DATA SCIENCE INTO CLINICAL PRACTICE: A CASE STUDY IN SEPSIS
Dr Jonathan Perlin
Dr Edmund Jackson
2 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
HCA HEALTHCARE
HCA hospitals care for 28M+ encounters annually
• Admissions – 1,800,000 • Deliveries – 230,000 • ER visits – 8,600,000 • Physician Clinic Visits –
9,500,000 • Surgeries – 1,400,000
233,000 employees • 79,000 nurses • 47,000 allied health
professionals • 37,000 affiliated physicians • 3,100 employed physicians
& 1,000 practitioners
176 Hospitals in the U.S. and 6 in the U.K.
114 Ambulatory Surgery Centers
51 Freestanding Ers 1,400 Sites of care
3 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
NEXT GENERATION PERFORMANCE: SEPSIS IMPROVEMENT
Sepsis Mortality: #11 in U. S. #9 in Hospitals #3 in ICU #1 in non-cardiac ICU
Sep
sis
surv
ival
Time
Detecting & Predicting Sepsis Early [____]
Descriptive Predictive What is Happening? What is going to happen
Model Performance AUC 0.86 Sens 0.85 Spec 0.85
4 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
Imagine: the ideal clinician…
5 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
Imagine: the ideal clinician…
Current: Screens performed at shift change
Screens by Hour of Day 666 Positive
Screens 20,419 Screens
Performed
= 3.3% Hit Rate
Single Hospital January Sepsis Volume (Positive Sepsis Screen)
= 666 Patients
6 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
Imagine: the ideal clinician… Single Hospital January Sepsis Volume (Positive Sepsis Screen)
= 666 Patients
SPOT Enabled: Screens performed when SPOT detects
SPOT Detections by Hour of Day 666 Positive
Screens 722 SPOT Detections
= 92.2% Hit
Rate
Current: Screens performed at shift change
Screens by Hour of Day 666 Positive
Screens 20,419 Screens
Performed
= 3.3% Hit Rate
7 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
SPOTLIGHTS
8 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
Bedside RN Performs Screen
In meditech (< 60 minutes)
SPOT receives Screen result
CNO/CMO Performance
Oversight
SPOT Signal
Monitor Tech Signal Relay (< 5 minutes)
Sepsis Coordinator Management
4 3
1 2
Workflow
Mobile
9 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
SPOT INTERFACE ELEMENTS
10 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
VALUE AND RELIABILITY
11 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
Concordance with Sepsis Screens
580 patients did not receive a sepsis screen, of which 71 had sepsis detected by the model.
No Sepsis Screen SIRS Sepsis Severe Sepsis 601 patients screened had a maximum sepsis screen level of SIRS positive, of which 261 had sepsis detected by the model.
88 patients had a maximum sepsis screen level of sepsis, all of which had sepsis detected by the model.
45 patients had a maximum sepsis screen level of severe sepsis, 44 of which had sepsis detected by the model.
Positive model reaction
Negative model detection
Legend
• Machine detects 132 of 133
patients with at least Tier 2
(Sepsis).
• Misses 1 Tier 3 (Severe
Sepsis) patient
• Machine detects 464 patients vs
734 total patients with at least
SIRS screen.
12 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
INTEGRATION LAYERS
Network
Data
Algorithm
Presentation
Workflow
Management
13 | CSG – Data Science CONFIDENTIAL – Contains proprietary information. Not intended for external distribution.
MEASUREMENT 2.0: PREDICTIVE & PRESCRIPTIVE
Digital Dividend: The Ultimate Value – Lives Saved
