Automated palliative care consults: is this a good idea?
Ascension and UPenn team up to test the concept
Palliative care programs are sometimes pitched to administrators on the basis of their potential to reduce costs, by shortening length-of-stay or intensity of expensive and unhelpful therapies at the end of life. Observational data suggests palliative care consultation might reduce length of stay and costs, but the question had never been put to a serious randomized trial.
Ascension is a $27 billion, 140-hospital conglomerate operating in 19 states—the third largest system in the U.S by some accounts (after HCA and the VA). At 11 of Ascension’s hospitals in 8 states, where palliative care physicians already worked, University of Pennsylvania researchers and Ascension conducted a stepped-wedge, cluster-randomized trial in which (after at least 4 months of baseline data) each center would randomly go-live with a new process of algorithmically-generated palliative care consults.
The consults occurred as hard-stop EMR pop-ups on chart opening, notifying the attending of a palliative care c…
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