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About 450,000 patients who are hospitalized each year in the U.S. wind up with a potentially preventable venous thromboembolism (VTE), or blood clot. It could result from time spent lying in a bed, surgery, or injury to a vein caused by a broken bone or muscle damage. Left untreated, clots can prevent normal blood flow to various parts of the body, or they can break off, travel to the lungs and cause issues such as shortness of breath or sudden death.
To prevent blood clots, doctors admitting patients to the hospital evaluate them for their risk of developing one. They consider numerous risk factors such as patient weight, age and current medications, and — if it’s determined the person is at risk — prescribe anti-clotting medications and devices such as mechanical wraps that squeeze the legs to keep blood flowing.
However, evaluating patients during admission “can be challenging, because a lot of things are happening while clinical teams are working to admit a patient,” says Richard Day, director of The Armstrong Institute Precision Medicine Center of Excellence for Patient Safety and Quality. “Our goal is to use information technology to make the process as efficient and accurate as possible.”
Precision Medicine at Work
Enter the Johns Hopkins’ Precision Medicine Analytics Platform (PMAP), a data analytics tool that enables more advanced data science applications than the electronic health record alone. For this purpose, PMAP allows experts to analyze all care provided to prevent VTE at The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center. If a clot does occur, the system can help clinicians understand how care might be improved.
“One of our big breakthroughs was to be able to provide feedback to each individual physician, most of whom are residents doing the admitting process,” Day says. “We can now give them very specific, case-by-case, patient-by-patient feedback that shows what risk factors were identified, what specific medication and dosage should have been ordered, and whether they met guidelines established by our physician experts or did something different. It’s a great learning tool for the provider and helps refine the guidelines and improve the system.”
Day’s group has been sharing the information with clinical groups on a monthly basis for medicine and surgery patients at The Johns Hopkins Hospital. They plan to further tailor the tool for specialties such as Gyn/Ob, neurosurgery and orthopaedics, as well as scale the tool to support Johns Hopkins Medicine’s community hospitals. Additionally, they’re working toward a function within the electronic health record to automatically pull known information essential to complete the VTE risk assessment and then help guide clinicians on appropriate anti-clotting prescriptions in real time as they’re admitting patients.
More information about venous thromboembolism.
