Researchers at Penn Medicine, a component of the University of Pennsylvania, have developed a predictive analytics system that increased the organization’s number of palliative care consultations by 74%.
The system, called Palliative Connect, extracts clinical data from an organization’s electronic medical records and uses machine learning to analyze 30 factors of a patient’s likely prognosis during a six month period, which is the time frame physicians use to determine whether a patient is ready for a palliative care consultation. Based on these data, the system assigns the patient a score that indicates their suitability for palliative care, according to a recent study in the Journal of General Internal Medicine.
“There’s widespread recognition of the need to improve the quality of palliative care for seriously ill patients, and palliative care consultation has been associated with improved outcomes for these patients,” Katherine Courtright, MD, an assistant professor of Pulmonary, Allergy and Critical Care, and Hospice and Palliative Medicine and co-author of the study.
A team of researchers assessed the performance of Palliative Connect for eight weeks between December 2017 and February 2018. During that study period, researchers applied Palliative Care connect to a cohort of 134 inpatients at a Philadelphia hospital and compared results to a similar population of 138 patients selected from a time before the system was introduced.
In the group to which Palliative Connect was applied, palliative care consultations rose from 22 to 85. Palliative care practitioners also engaged with those patients on average a day and a half earlier in the course of their hospital stay.
Researchers indicated that this was the first scalable data-driven prediction system to undergo testing in a clinical setting. Other systems have been tested, according to the study, but few that have been tested as rigorously.
One factor to consider is that physicians had the ability to decline to offer a palliative consultation for patients who were identified by the system, and the study indicated that 43% declined consultations for some patients, indicated that the felt the patient’s current care was meeting their needs.
None of the patients who were offered a consultation refused it, the study showed.
“This approach helps us get a foot in the door and really explain what palliative care is to patients and their families,” Courtright explained. “Sometimes, there is this sense from primary teams that patients or families are hesitant or don’t want to talk about palliative care, but, when a palliative care clinician walks into the room and explains what they do, often people really are glad to see us there.”
