A high number of senior living and care residents have dementia on admission, or develop it during their stay, despite never receiving a formal diagnosis.
When these “secret” dementia patients, however, have an emergency – say, a fall – and are hospitalized, they can catch the new care team unaware and struggling to make appropriate clinical decisions.
To avoid this pitfall, new research is looking at electronic health records to flag individuals who might have dementia, possibly undiagnosed, so that when they arrive at a hospital, the care team is ready.
The study authors used the example of a person who has had a fall and being unable to accurately describe his condition and medical history, or to communicate his own sound judgments about future care to a hospital team.
Up to 40% of older adults with mild or early-onset dementia do not have dementia diagnoses, one study shows. The new research, led by a team from Cedars–Sinai Medical Center in Los Angeles, noted that “early detection of dementia in the inpatient setting” is less than 50%.
The research found similar numbers when using AI to analyze EHR records of study participants: Of the 64 patient records reviewed that had no dementia diagnosis, the AI found 33 shown signs of altered mental status or cognitive dysfunction. Overall, that involved approximately 10% of the EHR records reviewed, which included both people with confirmed dementia and those who showed no record of cognitive decline.
“These types of algorithms provide an opportunity to accurately identify hospitalized older individuals for inclusion in quality improvement projects, clinical trials, pay-for-performance programs and other initiatives,” the study authors concluded.
To make sure clinicians are able to take advantage of the new information the AI can give them about patients, Cedars-Sinai also instituted a training program to make sure all care staff knew how to respond to possible dementia.
Data sharing between points of care and different EHR systems is becoming increasingly important for healthcare providers, as health records are constantly updated from new data collection tools.
Although the dementia research foretells a positive outcome for both patients and their caregivers, the flip side of that is the unintentionally morbid study on EHR discrepancies — also from California — that showed that care teams were filling medications and appointments for patients who already had died, the McKnight’s Tech Daily recently reported.
