Provider networks in the neonatal intensive care unit associate with length of stay

Cindy Kim, Christoph U. Lehmann, Dupree Hatch, Jonathan S. Schildcrout, Daniel J. France, You Chen

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

We strive to understand care coordination structures of multidisciplinary teams and to evaluate their effect on post-surgical length of stay (PSLOS) in the Neonatal Intensive Care Unit (NICU). Electronic health record (EHR) data were extracted for 18 neonates, who underwent gastrostomy tube placement surgery at the Vanderbilt University Medical Center NICU. Based on providers' interactions with the EHR (e.g. viewing, documenting, ordering), provider-provider relations were learned and used to build patient-specific provider networks representing the care coordination structure. We quantified the networks using standard network analysis metrics (e.g., in-degree, out-degree, betweenness centrality, and closeness centrality). Coordination structure effectiveness was measured as the association between the network metrics and PSLOS, as modeled by a proportional-odds, logistical regression model. The 18 provider networks exhibited various team compositions and various levels of structural complexity. Providers, whose patients had lower PSLOS, tended to disperse patient-related information to more colleagues within their network than those, who treated higher PSLOS patients (P = 0.0294). In the NICU, improved dissemination of information may be linked to reduced PSLOS. EHR data provides an efficient, accessible, and resource-friendly way to study care coordination using network analysis tools. This novel methodology offers an objective way to identify key performance and safety indicators of care coordination and to study dissemination of patient-related information within care provider networks and its effect on care. Findings should guide improvements in the EHR system design to facilitate effective clinical communications among providers.

Original languageEnglish (US)
Title of host publicationProceedings - 2019 IEEE 5th International Conference on Collaboration and Internet Computing, CIC 2019
PublisherInstitute of Electrical and Electronics Engineers Inc.
Pages127-134
Number of pages8
ISBN (Electronic)9781728167398
DOIs
StatePublished - Dec 2019
Event5th IEEE International Conference on Collaboration and Internet Computing, CIC 2019 - Los Angeles, United States
Duration: Dec 12 2019Dec 14 2019

Publication series

NameProceedings - 2019 IEEE 5th International Conference on Collaboration and Internet Computing, CIC 2019

Conference

Conference5th IEEE International Conference on Collaboration and Internet Computing, CIC 2019
CountryUnited States
CityLos Angeles
Period12/12/1912/14/19

Keywords

  • Audit Logs
  • Care Coordination
  • Electronic Health Records (EHR)
  • Neonatal Intensive Care Unit (NICU)
  • Network Analysis
  • Post-Surgical Length of Stay (PSLOS)

ASJC Scopus subject areas

  • Computer Science Applications
  • Management Information Systems
  • Computer Networks and Communications
  • Safety, Risk, Reliability and Quality
  • Information Systems and Management
  • Management Science and Operations Research

Fingerprint Dive into the research topics of 'Provider networks in the neonatal intensive care unit associate with length of stay'. Together they form a unique fingerprint.

  • Cite this

    Kim, C., Lehmann, C. U., Hatch, D., Schildcrout, J. S., France, D. J., & Chen, Y. (2019). Provider networks in the neonatal intensive care unit associate with length of stay. In Proceedings - 2019 IEEE 5th International Conference on Collaboration and Internet Computing, CIC 2019 (pp. 127-134). [8998487] (Proceedings - 2019 IEEE 5th International Conference on Collaboration and Internet Computing, CIC 2019). Institute of Electrical and Electronics Engineers Inc.. https://doi.org/10.1109/CIC48465.2019.00024