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The COVID-19 pandemic has infected millions of people around the world, spreading rapidly and causing a flood of patients that risk overwhelming clinical facilities. Whether in urban or rural areas, hospitals have limited resources and personnel to treat critical infections in intensive care units, which must be allocated effectively. To assist clinical staff in deciding which patients are in the greatest need of critical care, we develop a predictive model based on a publicly-available data set that is rich in clinical markers. We perform statistical analysis to determine which clinical markers strongly correlate with hospital admission, semi-intensive care, and intensive care for COVID-19 patients. We create a predictive model that will assist clinical personnel in determining COVID-19 patient prognosis. Additionally, we take a step towards a global framework for COVID-19 prognosis prediction by incorporating statistical data for geographically and ethnically diverse COVID--19 patient sets into our own model. To the best of our knowledge, this is the first model which does not exclusively utilize local data.
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A User Interface Informing Medical Staff on Continuous Indoor Environmental Quality to Support Patient Care and Airborne Disease Mitigation
This project seeks to investigate the under addressed issue of indoor environmental quality (IEQ) and the impacts these factors can have on human health. The recent COVID-19 pandemic has once again brought to the forefront the importance of maintaining a healthy indoor environment. Specifically, the improvement of indoor air flow has shown to reduce the risk of airborne virus exposure. This is extremely important in the context of hospitals, which contain high concentrations of atrisk individuals. Thus, the need to create a healthy indoor space is critical to improve public health and COVID-19 mitigation efforts. To create knowledge and provide insight on environmental qualities in the hospital setting, the authors have designed and built an interface to deploy in the University of Virginia Hospital Emergency Department (ED). The interface will display room-specific light, noise, temperature, CO 2 , humidity, VOC, and PM 2.5 levels measured by the low-cost Awair Omni sensor. These insights will assist ED clinicians in mitigating disease-spread and improving patient health and satisfaction while reducing caregiver burden. The team addressed the problem through agile development involving localized sensor deployment and analysis, discovery interviews with hospital clinicians and data scientists throughout, and the implementation of a human-design centered Django interface application. Furthermore, a literature survey was conducted to ascertain appropriate thresholds for the different environmental factors. Together, this work demonstrates opportunities to assist and improve patient care with environmental data.
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- Award ID(s):
- 1823325
- PAR ID:
- 10293434
- Date Published:
- Journal Name:
- 2021 Systems and Information Engineering Design Symposium (SIEDS)
- Page Range / eLocation ID:
- 1 to 6
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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The COVID-19 pandemic has changed the lives of many people around the world. Based on the available data and published reports, most people diagnosed with COVID-19 exhibit no or mild symptoms and could be discharged home for self-isolation. Considering that a substantial portion of them will progress to a severe disease requiring hospitalization and medical management, including respiratory and circulatory support in the form of supplemental oxygen therapy, mechanical ventilation, vasopressors, etc. The continuous monitoring of patient conditions at home for patients with COVID-19 will allow early determination of disease severity and medical intervention to reduce morbidity and mortality. In addition, this will allow early and safe hospital discharge and free hospital beds for patients who are in need of admission. In this review, we focus on the recent developments in next-generation wearable sensors capable of continuous monitoring of disease symptoms, particularly those associated with COVID-19. These include wearable non/minimally invasive biophysical (temperature, respiratory rate, oxygen saturation, heart rate, and heart rate variability) and biochemical (cytokines, cortisol, and electrolytes) sensors, sensor data analytics, and machine learning-enabled early detection and medical intervention techniques. Together, we aim to inspire the future development of wearable sensors integrated with data analytics, which serve as a foundation for disease diagnostics, health monitoring and predictions, and medical interventions.more » « less
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The COVID-19 pandemic accelerated the adoption of remote patient monitoring technology, which offers exciting opportunities for expanded connected care at a distance. However, while the mode of clinicians’ interactions with patients and their health data has transformed, the larger framework of how we deliver care is still driven by a model of episodic care that does not facilitate this new frontier. Fully realizing a transformation to a system of continuous connected care augmented by remote monitoring technology will require a shift in clinicians’ and health systems’ approach to care delivery technology and its associated data volume and complexity. In this article, we present a solution that organizes and optimizes the interaction of automated technologies with human oversight, allowing for the maximal use of data-rich tools while preserving the pieces of medical care considered uniquely human. We review implications of this “augmented continuous connected care” model of remote patient monitoring for clinical practice and offer human-centered design-informed next steps to encourage innovation around these important issues.more » « less
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Abstract Background We previously developed and validated a predictive model to help clinicians identify hospitalized adults with coronavirus disease 2019 (COVID-19) who may be ready for discharge given their low risk of adverse events. Whether this algorithm can prompt more timely discharge for stable patients in practice is unknown. Objectives The aim of the study is to estimate the effect of displaying risk scores on length of stay (LOS). Methods We integrated model output into the electronic health record (EHR) at four hospitals in one health system by displaying a green/orange/red score indicating low/moderate/high-risk in a patient list column and a larger COVID-19 summary report visible for each patient. Display of the score was pseudo-randomized 1:1 into intervention and control arms using a patient identifier passed to the model execution code. Intervention effect was assessed by comparing LOS between intervention and control groups. Adverse safety outcomes of death, hospice, and re-presentation were tested separately and as a composite indicator. We tracked adoption and sustained use through daily counts of score displays. Results Enrolling 1,010 patients from May 15, 2020 to December 7, 2020, the trial found no detectable difference in LOS. The intervention had no impact on safety indicators of death, hospice or re-presentation after discharge. The scores were displayed consistently throughout the study period but the study lacks a causally linked process measure of provider actions based on the score. Secondary analysis revealed complex dynamics in LOS temporally, by primary symptom, and hospital location. Conclusion An AI-based COVID-19 risk score displayed passively to clinicians during routine care of hospitalized adults with COVID-19 was safe but had no detectable impact on LOS. Health technology challenges such as insufficient adoption, nonuniform use, and provider trust compounded with temporal factors of the COVID-19 pandemic may have contributed to the null result. Trial registration ClinicalTrials.gov identifier: NCT04570488.more » « less
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Abstract Objective: The aim of this study was to investigate the performance of key hospital units associated with emergency care of both routine emergency and pandemic (COVID-19) patients under capacity enhancing strategies. Methods: This investigation was conducted using whole-hospital, resource-constrained, patient-based, stochastic, discrete-event, simulation models of a generic 200-bed urban U.S. tertiary hospital serving routine emergency and COVID-19 patients. Systematically designed numerical experiments were conducted to provide generalizable insights into how hospital functionality may be affected by the care of COVID-19 pandemic patients along specially designated care paths, under changing pandemic situations, from getting ready to turning all of its resources to pandemic care. Results: Several insights are presented. For example, each day of reduction in average ICU length of stay increases intensive care unit patient throughput by up to 24% for high COVID-19 daily patient arrival levels. The potential of 5 specific interventions and 2 critical shifts in care strategies to significantly increase hospital capacity is also described. Conclusions: These estimates enable hospitals to repurpose space, modify operations, implement crisis standards of care, collaborate with other health care facilities, or request external support, thereby increasing the likelihood that arriving patients will find an open staffed bed when 1 is needed.more » « less
- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Conference Paper:
- https://doi.org/10.1109/SIEDS52267.2021.9483774
