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 linicians
in the Children’s Emergency Department (ED) who helped develop
a software program to track signs of bioterrorism have found that
it also provides valuable information for predicting day-to-day
emergencies.
Known as EDScope,
the project started over the summer as part of the hospital’s
continuing efforts at “syndromic surveillance,” or surveying
hospitals and clinics for clusters of particular diseases that may
signal a bioterrorist attack.
“The challenge has always been that people come into the ED
individually, not all at once,” says Michael
Shannon, MD, interim chief of Emergency Medicine. “So
it was hard to determine if there was a change in the pattern of
a given set of symptoms. EDScope lets us see those patterns and
identify potential problems before they get out of hand.”
The software was developed by the Informatics Program, implemented
by the Information Services Department, and gives ED staff a real-time
look at the types of problems treated on a given day. The symptoms
of each patient admitted to the ED are entered into the computer
in 14 basic categories (such as rash or meningitis). Physicians,
nurses and other staff can then consult a computerized readout—which
is updated about every 15 minutes—that shows all the activity
in the ED that day and for the previous week.
Here comes the amazing part: Ben
Reis, PhD, from Informatics, and Miliken Tyler from ISD
designed EDScope to compare the data for a given day with information
from the more than 500,000 Children’s ED visits in the last
11 years. If the computer analysis finds, for example, that more
people have been admitted for respiratory symptoms than is normal
for that time of the year and day of the week, a red flag alerts
staff that a pattern may be developing.
Since the system went into use, Shannon and his ED colleagues have
also found they can use the information to predict more common emergency
room activities with high accuracy. “We’ve always known
that we got more trauma patients in the summer and patients with
the flu in the winter,” says Shannon. “But with EDScope,
we can predict what specific types of patients we’re likely
to get on any given day next month or even next April.”
Ken
Mandl, MD, who is faculty in both the Informatics program
and the Division of Emergency Medicine, bridged the gap between
the two very different disciplines, and recognizes the potential
in this type of collaboration. “This is the first Informatics
program that has been transferred with a clinical application,”
he says. “We see it as a great model for how to take cutting
edge research and development and implement it through ISD.”
“EDScope serves as a mutual learning exercise for both groups,”
says Daniel
Nigrin, MD, MS, chief information office. “ISD gains
knowledge about new research and development, and Informatics learns
what goes into the development and maintenance of a production-ready
hospital application.”
For his part, Shannon would like to explore the use of the software
at other hospitals in the area so the data is that much more useful.
“Right now there’s no place else in the country that can
do this, but our goal is to share information with other hospitals
and create a network for identifying disease patterns.” —MC
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