Gabriel Escobar, MD
“Real time CDS for predicting inpatient deterioration and rehospitalization: reflections on two Kaiser Permanente pilots”
October 19th, 12:00PM
The Division of Clinical Informatics
1330 Beacon Street, Suite 400
Brookline MA 02446
Beginning in 2013, at two pilot hospitals, Kaiser Permanente Northern California (KPNC) deployed an EWS with 3 components that display in the Epic EMR every 6 hours: an acute physiology score (LAPS2) based on physiologic data in the preceding 72 hours; a longitudinal comorbidity score based on diagnoses incurred over the preceding 12 months; and an Advanced Alert Monitoring (AAM) score. The AAM score is the probability that, within the next 12 hours, a patient will experience cardiac arrest on the ward and/or unplanned transfer to the ICU. As a result of this work, KPNC is deploying this open source system in its remaining 20 hospitals. Using modular components from this early warning system, KPNC has also deployed a rehospitalization prediction system that generates a daily risk estimate at 7 AM; this is in operation at 7 hospitals and preliminary results are encouraging.
In his presentation, Dr. Escobar will focus on three challenges: selection of outcomes to be measured; data management issues that are unique to modern electronic records; and how research scientists interact with operations in the context of a complex organization. Dr. Escobar will keep his presentation short (~30 minutes) to maximize time for discussion with the audience.
Dr. Escobar is a Research Scientist III (equivalent to full professor) at the Kaiser Permanente Division of Research in Oakland, California. He received his MD at Yale University, did a pediatrics residency at the University of California, San Francisco, and then was a Robert Wood Johnson Clinical Scholar at Stanford. He joined The Permanente Medical Group in 1990 and was appointed to the Division of Research in 1991. Between 1991 and 2009, he developed a very successful research program in neonatology, the DOR Perinatal Research Unit, which is now directed by one of his mentees. Beginning in 2001, he developed a research program, known as the Systems Research Initiative, that focuses on adult hospital outcomes, predictive analytics, and informatics. Dr. Escobar has published 151 peer reviewed papers and is also KPNC’s Regional Director for Hospital Operations Research. In this latter capacity, his primary roles are to improve KPNC’s internal measurement capability and to serve as a methodological consultant to KPNC leadership.