When Greg Hager thinks about technology and its application in health care, he thinks about a busy emergency room.
Imagine it: physicians and nurses rushing, monitors beeping, alerts sounding, intercoms paging. In one bed, a patient is in cardiac arrest; in another, someone with the flu has a dangerously high fever. Outside, an ambulance pulls up.
For a care provider, at some point, distraction and irrelevant information has to be tuned out in order to focus on the task at hand. It may sound chaotic, but it doesn’t have to be, he says.
Photo by Will Kirk/Johns Hopkins University
Hager, a professor of computer science and director of Johns Hopkins University’s Malone Center for Engineering in Healthcare, says one possible solution to the problem of emergency room crowding is a system that understands the roles of different health care providers in the emergency department and monitors workflow. Such a system could consider how busy the department is overall and prioritize patients accordingly.
“The solution requires an understanding of not only how to go from data to decision, but it also requires an understanding of the impact of that decision,” he says. “A well-engineered solution would help health care providers choose wisely and make decisions that will have the most impact on patient outcomes.”
Today, the Malone Center joins the Armstrong Institute for Patient Safety and Quality in welcoming experts from engineering and the health sciences for a day-long symposium exploring technology’s impact on health care delivery. The Hub caught up with Hager to discuss the current state—and the future—of that intersection.
What is the focus of this year’s symposium?
The theme this year is “Teaming with Technology.” New opportunities in data science and analytics have created the potential for new efficiencies and value, but if you look at the flipside of it, health care is about people taking care of people. So what we want to do is emphasize that it’s not just about creating innovative new technologies—it’s also about understanding how that technology is used by people, and how it affects them.
We want to explore that Human-Technology Frontier and understand how we can make technology innovations more effective. All of us are in this business to have an impact and to change the world for the better. The way we change the world is by understanding each other, understanding our problems and approaches, and driving solutions to be better engineered.
What are some of the projects coming out of the Malone Center that will change the way humans interact with technology in the realm of health care?
Here’s a great example: we have a researcher, Scott Levin, who built an electronic triage system, which would address the issues we just discussed.
Before, there was a standardized approach to triaging patients into five different levels of urgency, and a majority of patients are dropped into the mid-acuity level. Those patients have an uncertain clinical course—and consume a lot of resources—because they’re being examined and undergoing tests before we can decide what should be done to help treat them.
If you can more effectively take that population of patients in the middle and assess the urgency of their care, you can maintain a safer emergency department and save the hospital a lot of time and effort. And you can save the patient potential pain and suffering by making sure they’re in the correct care pathway.
The e-triage system uses basic machine learning methods to look at data on patients coming into the emergency department and helps render a decision about where this patient should go. The neat thing about a system like that is that it not only analyzes the patient, but is adaptive to unique patient populations, departmental objectives, and care systems. It helps physicians prioritize their patients in the larger context and reduces crowding.