Newton Medical Center in New Jersey went live in early August with an “early warning system” that helps clinicians quickly identify patients who may be in decline, as well as patients getting better.
Early results at 148-bed Newton, which is the pilot site for six-hospital Atlantic Health System, are good, says Laura Reilly, manager of nursing practice at the hospital.
The tool is the Rothman Index from software vendor PeraHealth. Rothman captures 26 different types of patient and measuring data from the electronic health record system, runs it through predictive analytics and displays a 0-to-100 score and graphing trends for each patient indicating whether the patient is getting better or declining.
“There’s nothing in the Rothman tool already not in the EHR,” Reilly explains. “With an understandable moment in time, you can look at the graph and see how the patient is doing.”
When considering whether to get the technology, Newton personnel attended a PeraHealth roundtable of clients, and the key takeaway was to not be stingy with monitors that display patient status.
So Newton wasn’t stingy. “We purchased monitors for each unit dedicated to the Rothman Index and put them right where rounds were done and in nursing units. When you walk up on the floor, there is a dedicated unit, and you can’t miss it.”
When looking at the Rothman Index, it isn’t so much looking at a specific number that’s important; it is the trends on graph lines that are most useful, according to Reilly. And sometimes, the trends don’t change much.
“When patients from a nursing home or otherwise chronically ill come into the hospital with a low score and later leave with a low score, that may just be their baseline. We like to see the trend up, but we don’t always see that.”
The Rothman Index also generates certain alerts, such as a 40 percent drop in a patient’s condition in the last 12 hours or a 30 percent drop in the last 24 hours. Overall, the software gets a lot of attention from caregivers, Reilly notes. “We are consistently looking at the Index. Doctors say it helps them decide who to see first.”
Asked how affordable the technology is, Reilly contends it is affordable to hospitals of any size because seeing problems developing sooner translates to lower overall costs of care. While it’s too early to have strong cost findings at Newton, other users of Rothman Index have shared their metrics, showing improved quality of care and lower costs. “We expect to see the same benefits.”
When starting use of the technology, nurses should be on the front lines and the first to use it, Reilly counsels. In the roundtable, other providers told Newton that they initially did not get traction from other clinicians and administrators.
So, Reilly put together a team that included nursing IT, nursing administrators, palliative care, hospitalists, case managers and bed managers. They met weekly to track progress on pushing use of the system and had clinical champions placed in each unit to train colleagues. “I think we’re seeing some benefits early on that we would not have had without the team,” she adds.
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