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AI tool reduces risk of unexpected hospital deaths by 26 per cent: Study

CHARTWatch, an artificial intelligence early warning system developed at聽Unity Health Toronto,聽alerts physicians when hospital patients face a high risk of unexpected death or transfer to an ICU
A female doctor checks a computer screen next to a patient in a hospital

(photo by Tempura/Getty Images)

A new study by Toronto researchers evaluates the use of , an artificial intelligence early warning system developed at Unity Health Toronto that monitors hospitalized patients in real-time, identifies those at high risk of unexpected death or transfer to an intensive care unit, and alerts doctors and nurses to intervene early.

The study, , shows a 26 per cent reduction in unanticipated mortality after the tool was implemented in the general internal medicine ward of Unity Health Toronto鈥檚 St. Michael鈥檚 Hospital.

鈥淎s AI tools are increasingly being used in medicine, it is important that they are evaluated carefully to ensure that they are safe and effective,鈥 says lead author Amol Verma, general internist at Unity Health and professor in the department of medicine in the University of Toronto鈥檚 Temerty Faculty of Medicine who led the development and implementation of CHARTWatch.

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Amol Verma (L) and Muhammad Mamdani (supplied images)

鈥淥ur findings suggest that AI-based early warning systems are promising for reducing unexpected deaths in hospitals.鈥

One of the primary sources of unplanned admission to the ICU is the unexpected deterioration of hospitalized patients, which prompted the research team to develop this AI tool and study its effectiveness. 

鈥淭his important study evaluates the outcomes associated with the complex deployment of the entire AI solution, which is critical to understanding the real-world impacts of this promising technology,鈥 says study co-author Muhammad Mamdani, vice president of data science and advanced analytics at Unity Health and director of U of T鈥檚 Temerty Centre for Artificial Intelligence Research and Education in Medicine.

鈥淲e hope other institutions can learn from and improve upon Unity Health Toronto鈥檚 experiences to benefit the patients they serve.鈥 

The study analyzed data from 13,649 patients aged 55 to 80 years old admitted to the general internal medicine unit (9,626 in the pre-intervention period and 4,023 using CHARTWatch) and 8,470 admitted to subspeciality units that did not use CHARTWatch.

Helping to prioritize patient needs

鈥淭he CHARTWatch project started at Unity Health when we asked patients, clinicians, hospital leaders, what would you want to use artificial intelligence for? If you could predict one thing that AI would tell you, what should that be?鈥 says Verma, who is also the Temerty Professor of AI Research and Education in Medicine.

鈥淎nd one of the leading priorities of everyone was to be able to predict in advance which patients might become so sick in hospital that they need ICU or might die.鈥 

During the 19-month-long intervention period, 482 patients in the general internal medicine became high-risk, compared with 1,656 patients who became high risk in the 43-month-long pre-intervention period. There were also fewer non-palliative deaths in the CHARTWatch group than in the pre-intervention group (1.6 per cent versus 2.1 per cent). 

鈥淚f I were a patient, I would be so relieved to know that we have this kind of system,鈥 said co-author Yuna Lee, division head and general internist at St. Michael鈥檚 and professor in the department of medicine at U of T.

鈥淪o, when the patient gets a high-risk alert, they鈥檙e going to be assessed by senior staff right away. Also, they鈥檙e going to have quite close monitoring by nursing staff, so they check on them every one to two hours.鈥

Expanding the impact of CHARTWatch

CHARTWatch inputs more than 100 aspects of a patient鈥檚 medical history and current health status that are routinely stored in the hospital鈥檚 electronic medical record. It analyzes the interactions between these inputs and how they change over time. With that information, it鈥檚 able to categorize each patient by their risk for deterioration and send an alert to prioritize treatment.

The study is one of the first to evaluate how CHARTWatch can benefit hospital patients in Canada and shows the potential real-world impact of AI on the health-care sector. Damian Jankowicz, Unity Health鈥檚 vice-president and chief information and AI officer, says he hopes AI tools such as CHARTWatch will continue to have a profound impact on patients. 

鈥淗opefully with reduced administrative burden on our providers, they will have more time to spend with our patients and really focus on the patient needs,鈥 he says. 

鈥淚 hope that AI will be able to distill the incredible amounts of information that鈥檚 coming at our clinicians into important components and really bring their clinical judgment to the forefront.鈥

This story first was .

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