Stanford Hospital

I worked with the Systems Utilization Research for Stanford Medicine(SURF) Lab on developing an algorithm that could help the Stanford Children’s Hospital with automating the process of implemeting target based care.

The Challenge

Throughout the United States, large hospitals, such as the Stanford Children’s Hospital, are investigating ways to improve the quality of care that they provide to their patients. By combining current evidence and expert consensus, hospitals can develop clinical pathways, which detail the procedures that should be followed for different patient populations. Unfortunately,the process of formulating these pathways is non-standardized. This leads to high variation in clinical practice, which in turn increases the risk of administering inappropriate care and results in higher medical costs.

The Solution

A solution to reducing variations in the standard of care provided by hospitals is to migrate to the system of Target-Based Care. Under Target-Based care, the medical staff extracts the median values for relevant clinical milestones from previous electronic health records(EHR) of patients similar to a recently admitted patient in the hospital. They then share these targets amongst the medical staff and the patient’s family to facilitate a shared understanding on the standard of care that is to be provided to the patient.

At the Stanford Children’s Hospital, the process of generating these targets is done manually and is not scalable. The project’s aim was to develop a partially automated clustering algorithm that would define patient cohorts based on EHR and Registry data. This algorithm would make it possible to scale target-based care across the hospital.

The Impact

By using a simple filtering heurestic, my team was able to closely match the median ICU and median length of stay between the patients in the ventrical septal defect cohort generated manually by the hospital and our cohort generated by the algorithm. For future work, applying this algorithm to other cohorts at the hospital would help in expanding target based care, defining clinical workflows and ultimately improving the standard of patient care.

Project Poster