Brigham and Women’s Hospital in Boston applied an AI algorithm to facilitate timely transitions to hospice for patients presenting in the emergency department.

After this effort was initiated in 2021, about 54% of eligible patients elected the hospice benefit, compared to 22% in years prior, a new study in JAMA Network Open indicated. For most of these patients, hospice care began within one to two days of prognosis.

“When patients come to an emergency room near the end of life, the default is typically to admit them to the hospital, engage them in conversations about goals and end-of-life care and potentially move them into hospice care,” said study author and Brigham and Women’s emergency physician Dr. Christopher Baugh, in a press release. “However, this lengthy progress can take longer than the patient has left to live.”

For the study, researchers used an AI algorithm that analyzes patients’ electronic health data and flags potential hospice candidates. These patients were placed on observation status rather than being admitted.

Hospital staff then had goals-of-care discussions with patients and families to facilitate health care decisions. These conversations included emergency department care facilitators in consultation with the hospital’s palliative care team and relevant specialists, such as oncologists or neurologists, depending on the patient’s condition. The study population included 270 patients.

Implementation of the program also involved biannual virtual training for staff on the benefits of the program and the need for timely hospice transitions.

“Identifying hospice candidates quickly after ED arrival mostly falls on the shoulders of ED clinicians, so our goal with the program is to make this process as simple and efficient as possible,” Baugh said. “With our approach, we’re able to mobilize the hospice transition within one to two days most times, which is much faster than would be possible if the patient was admitted directly into inpatient care.”