PS 4-60 POINT OF CARE DATA COLLECTION AND ANALYTICS IN TRAUMA SURGERY

Wednesday, October 26, 2016
Bayshore Ballroom ABC, Lobby Level (Westin Bayshore Vancouver)
Poster Board # PS 4-60

S. Morad Hameed, MD MPH1, Larissa Roux, MD MPH PhD2, Alan Hubbard, PhD3, Rachel Callcut, MD, MSPH4, Maureen Brennan, CHIM, CAISS, PMP5, Hubert Bandurski1, Igor Muravyov1, Lew Cohen1 and Mitchell Jay Cohen, MD, FACS6, (1)T6 Health Systems, Chestnut Hill, MA, (2)T6 Health Systems, Vancouver, BC, Canada, (3)University of California at Berkeley, Berkeley, CA, (4)UCSF, San Francisco, CA, (5)Vancouver, BC, Canada, (6)University of Colorado Department of Surgery, Denver, CO

Purpose: The care of severely injured patients requires high stakes decision-making and action under conditions of great uncertainty. In an overwhelming sea of data, these decisions are often informed by 1 or 2 pieces of data and clinical experience or subjective feeling, The recent development of powerful, mobile electronic data collection devices and the widespread availability of wireless communication networks, have the potential to capture, analyze and communicate data in rapidly evolving clinical crises to support clinical best practices and to optimize team dynamics. This study describes the design and testing of a mobile, electronic clinical user interface and a background metadata engine that harnesses all data sources to inform trauma team decision-making and performance improvement in real time.

Methods: A streamlined, iPad-based user interface, designed to closely mirror clinical processes in trauma care, was built on a comprehensive foundation of trauma resuscitation data. The interface enables trauma teams to collect data in real time during the process of trauma care, and to wirelessly relay it to a spectrum of data visualization and analytics applications to promote patient-specific best practices and optimization of trauma team dynamics. The user interface and data flow were tested in a series of high fidelity simulations

Results:  The iPad based user interface was successful in mirroring clinical care and clinical data collection, including in the real-time world of acute trauma resuscitation. Trauma teams found that an electronic platform designed to cross-populate multiple mobile devices and with overhead displays, increased the organization, structure and transparency of acute care in the trauma resuscitation bays, and promoted the creation of shared mental models and common priorities. Patient-specific decision support tools triggered by accruing clinical data were found to be useful in the validation of decisions and in point of care education of the team.

Conclusions: It is feasible for trauma teams to collect real time clinical data at the point of trauma resuscitation, and to stream it to instantaneous data visualization and analytics applications (Figure), to inform and optimize decision making and team communication.