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New research reveals the importance of integrating patient and nurse verbal communication data into patient risk identification models in home health care settings.
The research results are Journal of the American Medical Informatics Association (JAMIA) It has the potential to revolutionize the way healthcare providers assess and manage high-risk patients.
Home health care is a critical service for more than 6 million patients in the United States, many of whom are over 65 years old and suffer from chronic conditions. Unfortunately, one in three patients treated at home will eventually require an emergency room visit or hospitalization. Existing patient risk identification models rely primarily on electronic medical record data, but have had limited success in detecting these high-risk patients.
The research team led by Dr. Mariam Zolnouri Columbia University School of Nursing, audio-recorded 126 patient-nurse encounters involving 47 patients, 8 of whom subsequently had an ED visit or hospitalization. The team reformulated the risk model to include his three key components: structured data from the Outcomes Assessment Information Set (OASIS), clinical notes, and verbal communication capabilities.
Using advanced natural language processing techniques to analyze patient-nurse interactions and integrating verbal communication data, risk models were improved by 26%. The analysis also revealed that high-risk patients tended to use more risk-related cues, expressed sadness and anxiety, and had longer periods of silence during conversations.
“This development highlights the need for an evolved clinical workflow that routinely records patient and nurse verbal communication in the medical record,” Zolnouri says. “It has the potential to improve patient care, reduce hospitalization rates, and enhance healthcare providers’ ability to quickly identify and address risks during hospitalization and emergency department visits.”
To facilitate this innovative research, the Columbia Nursing Association worked closely with the following institutions: VNS Healthone of the nation’s largest home and community-based healthcare nonprofits, where Zolnouri conducts clinical research.
Other study authors include Dr. Maxime Topaz, associate professor at Columbia College of Nursing; Zoran Kostic, Columbia University School of Electrical Engineering; Kathryn H. Bowles, University of Pennsylvania School of Nursing and VNS Health Home Care Policy Research Center; Margaret V. McDonald, Sridevi Sridharan, Sasha Verges, VNS Health, Center for Home Care Policy and Research. his boyfriend Ali Zolnour from the Faculty of Electrical and Computer Engineering at Tehran University;
