Harnessing the Power of Electronic Health Records to Improve Palliative Care Service Delivery for Patients with Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition and the third-leading cause of death in the U.S. Despite experiencing similar symptom burdens and reductions in quality of life to patients with cancer, hospitalized patients with COPD receive palliative care services far less commonly. Efforts to improve palliative care for patients with COPD are hindered, in part, by the significant variability in disease trajectory and experience among this highly heterogeneous population. Current approaches that identify patients in need of specialty palliative care often rely on nonspecific diagnostic or inaccurate prognostic criteria leading to potentially inefficient use of these already strained services.
Natural language processing tools and machine learning methods offer a novel approach to improve the value of specialty palliative care services. This project seeks to use a data-driven approach to “unlock” the rich clinical narrative embedded within the electronic health record to identify different phenotypes of hospitalized patients with COPD experiencing palliative care needs. By relying on existing data within the electronic health record and using qualitative interviews with patients and their surrogates to refine the identified phenotypes, this approach is both scalable and patient-centered. This work will provide the essential foundation for future studies aimed at developing electronic predictive models to identify patients in real-time at risk of having palliative care needs and testing the effectiveness of targeted interventions among different risk strata. This work is supported by a collaboration with the Parkland Center for Clinical Innovation.
Katherine Courtright earned an MD from Temple University School of Medicine, and completed a residency and chief residency in Internal Medicine and a fellowship in Pulmonary and Critical Care Medicine at the University of Pennsylvania. She completed a clinical research fellowship and earned an MS (Health Policy) from the University of Pennsylvania. In 2016,she joined the faculty of the Division of Pulmonary, Allergy, and Critical Care at the University of Pennsylvania and undertook additional clinical training in Palliative and Hospice Medicine. Dr. Courtright’s research interests include developing novel computational methods to harness the vast information embedded within the electronic health record to improve the value of specialty palliative care services for seriously ill hospitalized patients by directing such resources to those most likely to benefit from them.