Capturing Concerns about Patient Deterioration in Narrative Documentation in Home Healthcare.


Journal

AMIA ... Annual Symposium proceedings. AMIA Symposium
ISSN: 1942-597X
Titre abrégé: AMIA Annu Symp Proc
Pays: United States
ID NLM: 101209213

Informations de publication

Date de publication:
2022
Historique:
medline: 3 5 2023
pubmed: 2 5 2023
entrez: 2 5 2023
Statut: epublish

Résumé

Home healthcare (HHC) agencies provide care to more than 3.4 million adults per year. There is value in studying HHC narrative notes to identify patients at risk for deterioration. This study aimed to build machine learning algorithms to identify "concerning" narrative notes of HHC patients and identify emerging themes. Six algorithms were applied to narrative notes (n = 4,000) from a HHC agency to classify notes as either "concerning" or "not concerning." Topic modeling using Latent Dirichlet Allocation bag of words was conducted to identify emerging themes from the concerning notes. Gradient Boosted Trees demonstrated the best performance with a F-score = 0.74 and AUC = 0.96. Emerging themes were related to patient-clinician communication, HHC services provided, gait challenges, mobility concerns, wounds, and caregivers. Most themes have been cited by previous literature as increasing risk for adverse events. In the future, such algorithms can support early identification of patients at risk for deterioration.

Identifiants

pubmed: 37128448
pii: 686
pmc: PMC10148365

Types de publication

Journal Article Research Support, U.S. Gov't, P.H.S. Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

552-559

Subventions

Organisme : AHRQ HHS
ID : R01 HS027742
Pays : United States
Organisme : NINR NIH HHS
ID : T32 NR007969
Pays : United States
Organisme : NINR NIH HHS
ID : F31 NR019919
Pays : United States

Informations de copyright

©2022 AMIA - All rights reserved.

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Auteurs

Mollie Hobensack (M)

Columbia University School of Nursing, New York, NY, USA.

Jiyoun Song (J)

Columbia University School of Nursing, New York, NY, USA.

Sena Chae (S)

University of Iowa College of Nursing, Iowa City, IA, USA.

Erin Kennedy (E)

University of Pennsylvania School of Nursing, Philadelphia, PA, USA.

Maryam Zolnoori (M)

Columbia University School of Nursing, New York, NY, USA.

Kathryn H Bowles (KH)

Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA.
University of Pennsylvania School of Nursing, Philadelphia, PA, USA.

Margaret V McDonald (MV)

Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA.

Lauren Evans (L)

Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA.

Maxim Topaz (M)

Columbia University School of Nursing, New York, NY, USA.
Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, NY, USA.

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