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. 2024 Mar;72(3):822-827.
doi: 10.1111/jgs.18673. Epub 2023 Nov 8.

Alerting providers to hospitalized persons with dementia using the electronic health record

Zaldy S Tan  1 , Nabeel Qureshi  1   2 , Pamela Roberts  1   3 , Augustine Guinto  1 , Cameron Escovedo  1 , Phong Chung  1 , Erica Spivack  1 , Mary Nasmyth  1 , Sarah Kremen  1 , Nancy L Sicotte  1
Affiliations

Alerting providers to hospitalized persons with dementia using the electronic health record

Zaldy S Tan et al. J Am Geriatr Soc. 2024 Mar.

Abstract

Background: While patients with dementia entering the hospital have worse outcomes than those without dementia, early detection of dementia in the inpatient setting is less than 50%. We developed and assessed the positive predictive value (PPV) and feasibility of a novel electronic health record (EHR) banner to identify patients with dementia who present to the inpatient setting using data from the medical record.

Methods: We developed and implemented an EHR algorithm to flag hospitalized patients age ≥65 years with potential cognitive impairment in the Epic EHR system using dementia ICD-10 codes, FDA-approved medications, and the use of the term "dementia" in the emergency department physician note. Medical records were reviewed for all patients who were flagged with an EHR banner from October 2022 to May 2023.

Results: A total of 344 individuals were identified who had a banner on their chart of which 280 (81.4%) were either diagnosed with dementia or were on an FDA-approved dementia medication. Forty-three individuals who had confirmed dementia were identified by a medication only (15.4%). Of the patients without confirmed dementia, the majority (N = 33, 9.6%) had a diagnosis of altered mental status, cognitive dysfunction, or mild cognitive impairment. Only 31 individuals (9.0%) had no indication of dementia or cognitive decline in their problem list, past medical history, or medication list.

Conclusions: We found that it was feasible to implement an EHR algorithm for prospective dementia identification with a high PPV. These types of algorithms provide an opportunity to accurately identify hospitalized older individuals for inclusion in quality improvement projects, clinical trials, pay-for-performance programs, and other initiatives.

Keywords: dementia; electronic medical record; patient identification.

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References

REFERENCES

    1. Alzheimer's Association. Alzheimer's Disease Facts and Figures. 2023. https://www.alz.org/media/Documents/alzheimers-facts-and-figures.pdf
    1. Matthews KA, Xu W, Gaglioti AH, et al. Racial and ethnic estimates of Alzheimer's disease and related dementias in the United States (2015-2060) in adults aged ≥65 years. Alzheimers Dement. 2019;15(1):17-24. doi:10.1016/j.jalz.2018.06.3063
    1. Maslow K. How many hospital patients have dementia? In: Silverstein NM, Maslow K, eds. Improving Hospital Care for Persons with Dementia. Springer Publishing Company; 2006.
    1. LaMantia MA, Stump TE, Messina FC, Miller DK, Callahan CM. Emergency department use among older adults with dementia. Alzheimer Dis Assoc Disord. 2016;30(1):35-40. doi:10.1097/WAD.0000000000000118
    1. Shepherd H, Livingston G, Chan J, Sommerlad A. Hospitalisation rates and predictors in people with dementia: a systematic review and meta-analysis. BMC Med. 2019;17:130. doi:10.1186/s12916-019-1369-7

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