Pilot Deployment of ePNa Into Epic EHR

NCT06008314 | Not Yet Recruiting

• 1 other identifier: 1052404
• Study Type: interventional
• Target: 6,917
• Locations: 0 countries
• Sites: N/A

Brief Summary

Intermountain Health has developed a electronic decision support tool to help doctors provide the best care for pneumonia. The purpose of this study is to enhance the existing tool (called ePneumonia (electronic Pneumonia) or ePNa) so that it can be used at other institutions, and to test deployment of the tool at another institution's hospitals.

Conditions

Pneumonia

Keywords

Decision Support

Outcome Measures

Primary Outcomes (1)

• 14-day hospital-free days

  14-day hospital-free days (a metric which captures outpatient disposition from the emergency department, secondary hospital admission, and length of stay)

  14 days after initial presentation to the emergency department

Secondary Outcomes (5)

• 30-day all-cause mortality

  At 30 days after initial ED presentation

• ED length of stay (hours)

  At ED discharge

• ICU length of stay (days)

  At ICU discharge

• Number of patients admitted to floor who are subsequently transferred to ICU within 72 hours

  At 72 hours after inpatient admission

• Time from ED presentation to first antibiotic dose (minutes)

  At time of first antibiotic dose

Study Arms (1)

Implementation at Vanderbilt University Medical Center (VUMC) & Vanderbilt Wilson County Hospital

EXPERIMENTAL

ePNa (the decision support tool) will be implemented at 2 EDs that are part of the Vanderbilt Health system.

Other: ePNa

Interventions

ePNa OTHER

Real-time, automated clinical decision support tool for pneumonia (called "ePNa")

Implementation at Vanderbilt University Medical Center (VUMC) & Vanderbilt Wilson County Hospital

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• For the baseline database and assessment of clinical outcomes, all data will be pulled from the Epic Clarity data warehouse.
• patients that presented to the Vanderbilt and Wilson county EDs who are \>= 18 years old will be identified by ICD-10 codes for pneumonia or acute respiratory failure or sepsis with secondary pneumonia codes for the baseline database.
• An additional 2500 patients that presented to the Vanderbilt and Wilson county EDs who are \>= 18 years old will be identified by having had conventional PA (posteroanterior) and lateral or portable CXRs (chest X-rays), independent of ICD-10 codes.
• During the one year pilot trial, patients seen in the 2 EDs, who are \>= 18 years old will be identified by ICD(International Classification of Diseases)-10 codes for pneumonia or acute respiratory failure or sepsis with secondary pneumonia codes (estimated to comprise 1800 patients).

You may not qualify if:

• For all above patients:
• Patients seen with a history of recent trauma.
• Subsequent episodes of pneumonia from the same patient within the study period.
• Patients directly admitted to hospice/comfort care.
• Patients admitted to a non-study hospital for further care.
• Patients transferred from outside hospitals.
• Patients without radiographic evidence of pneumonia or with clear radiographic evidence for an alternative diagnosis.

Sponsors & Collaborators

• Nathan Dean: lead
• Agency for Healthcare Research and Quality (AHRQ): collaborator
• Vanderbilt University: collaborator
• Stanford University: collaborator

MeSH Terms

Conditions

Pneumonia

Condition Hierarchy (Ancestors)

Respiratory Tract Infections; Infections; Lung Diseases; Respiratory Tract Diseases

Study Officials

• Nathan Dean, MD

  Intermountain Health

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Valerie Aston, MBA

CONTACT

801-507-4606; Valerie.Aston@imail.org

David Tomer, MS

CONTACT

801-507-4694; David.Tomer@imail.org

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Professor, Pulmonary and Critical Care Medicine

Study Record Dates

• First Submitted: August 4, 2023
• First Posted: August 23, 2023
• Study Start: February 1, 2025
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: September 28, 2023

Record last verified: 2023-09

Data Sharing

• IPD Sharing: Will not share