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Improving the Care of Premature Infants with JavaScript, Python, and Drools

Jeffrey Miller (Children's Hospital of Philadelphia)
Value-Based Care Salon H-K
Slides:   1-ZIP 

“Modern integrated Electronic Health Records (EHR’s) provide a unique opportunity for employing software algorithms that influence patient and doctor decisions at the point of care. Commercial EHR’s provide a limited amount clinical decision support (CDS) functionality out of the box, however it is often targeted at general populations and is not adequate for supporting complex patient populations. One population underserved by commercial EHR’s are premature infants. The standard of care for these children is highly complex and requires physicians and nurses to track and make decisions based on a number of frequently changing, interdependent variables. In some instances, an incorrect application of the standard can become a life-threatening situation.

This talk will present the Care Assistant, a CDS framework developed by “our group” and being piloted in the care of premature infants at the “Children’s Hospital of Philadelphia”. The Care Assistant uses open source technologies to create unobtrusive, EHR agnostic medical interventions to support complex patients. The discussion will demonstrate how our architecture enables developers to employ familiar technologies such as JavaScript and Python to craft interventions and custom reports that appear native to the EHR. Finally, integration with the JBoss Drools rules engine provides a mechanism to formalize the complex logic needed for supporting medical decision making. Using over 1,000 rules we are able to analyze a premature infant’s latest data in real time and deliver feedback to the clinician immediately. The feedback includes recommendations for feeding, growth rates, blood pressure and RSV immunization all directly in the patient‚Äôs chart. While the current framework executes within the context of CHOP‚Äôs commercial EHR, the talk will discuss the design abstractions that will allow reuse of the code in any browser-based EHR.¬†

Finally, preliminary results of the clinical effectiveness study supporting the proper immunization of premature infants for RSV, a potentially serious respiratory virus, will be discussed."

Photo of Jeffrey Miller

Jeffrey Miller

Children's Hospital of Philadelphia

Jeff Miller is a senior programmer at the Center for Biomedical Informatics (CBMi) at the Children’s Hospital of Philadelphia. He serves in a lead development role for CBMi’s clinical decision support framework.

Jeff’ has previously worked as a software developer for SunGard Availability Services and Siemens Medical Solutions. He has a bachelor’s degree in computer science from The Pennsylvania State University.

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