State-of-the-Art Health Information Technology Meets Patient-centered Care

The use of "triggers" to identify ICU patients who may warrant and benefit from palliative care services has been studied and generally predicated on clinical criteria portending an especially poor prognosis (e.g., active stage IV malignancy, terminal dementia, post-cardiac arrest). [...]when these clinical criteria are applied to large populations of ICU patients, the resultant theoretical work load for palliative care services is untenable, given the substantial workforce challenges in the field (8). [...]integrating clinical criteria with patient/family self-reported palliative care needs can theoretically achieve strategic use of palliative care support where it might be most needed, among patients with especially poor prognosis who have self-reported, unmet palliative care needs. Furthermore, the widespread prevalence of alarms and alerts has actually become detrimental to patient safety and health care quality (11). [...]integration of an alert associated with PCplanner should be judiciously applied and carefully vetted to avoid yet another prompt that busy ICU clinicians might simply ignore. In summary, Cox and colleagues developed and piloted a novel information technology tool and related program to evaluate a patient-centered, strategic approach to meeting the palliative care needs of ICU patients and families (1).