title: Integrating Real Time Data to Improve Outcomes in Acute Kidney Injury.
abstract: Critically ill patients with acute kidney injury requiring renal replacement therapy have a poor prognosis. Despite well-known factors, which contribute to outcomes, including dose delivery, patients frequently miss the target dose and volume removal. One major barrier to effective care of these patients is the traditional dissociation of dialysis device data from other clinical information systems, notably the electronic health record (EHR). This lack of integration and the resulting manual documentation leads to errors and biases in documentation and missed opportunities to intervene in a timely fashion. This review summarizes the technological advancements facilitating direct connection of dialysis devices to EHRs. This connection facilitates automated data capture of many variables - including delivered dose, ultrafiltration rate and pressure measurements - which in turn can be leveraged for data mining, quality improvement and real-time targeted therapy adjustments. These interventions hold the promise to significantly improve outcomes for this patient population.
authors.affiliation: Division of Nephrology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, USA.
authors.forename: Jamie S
authors.initials: JS
authors.lastname: Hirsch
authors.forename: Sumit
authors.initials: S
authors.lastname: Mohan
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D057225:Data Mining; D057286:Electronic Health Records; D006801:Humans; D058996:Quality Improvement; D006435:Renal Dialysis; D016896:Treatment Outcome