Performance and Utilization of an Emergency Department Electronic Screening Tool for Pneumonia

A ppropriate treatment of pneumonia begins with accurate diagnosis. However, clinicians have difficulty integrating data for clinical decision making. Significant variability in pneumonia management exists in the emergency department (ED). Decision support might decrease variability and improve care, but physician utilization is historically low. An alerting tool is needed for physicians to utilize computer-based pneumonia decision support. We developed a real-time electronic screening tool that identifies patients with pneumonia by applying Bayesian probabilistic logic to the electronic medical record, and we implemented the tool in 4 EDs. A “P” appears on the ED electronic tracker board when pneumonia likelihood reaches 40%. Clicking on the icon displays pneumonia likelihood and the relevant data (Figure). After confirming the diagnosis, the ED physician proceeds with a linked decision support tool that provides management recommendations.