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Dean NC, Jones BE, Ferraro JP, Vines CG, Haug PJ. Performance and Utilization of an Emergency Department Electronic Screening Tool for Pneumonia. JAMA Intern Med. 2013;173(8):699–701. doi:10.1001/jamainternmed.2013.3299
Author Affiliations: Division of Pulmonary and Critical Care Medicine (Drs Dean and Jones) and Emergency Department (Dr Vines), Intermountain Medical Center, and Department of Internal Medicine, University of Utah (Drs Dean and Jones), Salt Lake City; and Homer Warner Center for Informatics Research, Salt Lake City, Utah (Mr Ferraro and Dr Haug).
Appropriate treatment of pneumonia begins with accurate diagnosis. However, clinicians have difficulty integrating data for clinical decision making.1 Significant variability in pneumonia management exists in the emergency department (ED).2 Decision support might decrease variability and improve care, but physician utilization is historically low.3 An alerting tool is needed for physicians to utilize computer-based pneumonia decision support.
We developed a real-time electronic screening tool that identifies patients with pneumonia by applying Bayesian probabilistic logic to the electronic medical record, and we implemented the tool in 4 EDs. A “P” appears on the ED electronic tracker board when pneumonia likelihood reaches 40%. Clicking on the icon displays pneumonia likelihood and the relevant data (Figure). After confirming the diagnosis, the ED physician proceeds with a linked decision support tool that provides management recommendations.
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