Exciting research
By definition, the research on display at the RIV is the best of the best. “It’s difficult to get your work accepted at a national meeting, and it’s a high honor to be selected as a finalist. The poster abstracts or oral presentations that win are always remarkable pieces of work,” Dr. Cumbler said.
Some of this year’s most exciting projects examine prediction models and scoring systems for patients with infections such as sepsis or influenza, he said. “One of the most fascinating abstracts looked at deep learning, or machine learning, to create algorithms to predict sepsis and decompensation in ways that simplistic models might not. Many of our current prediction rules are designed around simple acronyms, because they’re easy to remember: the ABCD score, the CURB-65 score. But if you looked at the source code of the Google search algorithm – not that they’d let you – you’d discover that it doesn’t translate to a simple four-variable prediction model. It’s incredibly complex; it looks at interactions between variables.”
This research attempts to move medical prediction models in that direction, Dr. Cumbler said. “Examining deep learning models, or neural networks, to help clinicians make more accurate predictions and take better care of patients – we are getting a taste of the future of clinical medicine at HM18.”
Several research projects highlighted at RIV this year examine ways to make better use of the data in the electronic health record.
“One of the pieces of research I’m particularly excited to hear more about looks at how the vast data that exists within electronic health records is actually used,” Dr. Cumbler said. “With electronic health records, we have all of the information in a patient’s record at our fingertips, yet this creates incredible new challenges for the hospitalist needing to make decisions in real time, with the limitations of our organic neural networks.” Dr. Cumbler revealed that one of the research teams sharing their work at HM18 explored how hospitalists interact with the volume of information that exists within the health record at the time of admission. “The results are pretty amazing,” he said.
Another project Dr. Cumbler found fascinating examines the impact of delivery of real-time performance data to hospitalists on their phones, and how it affected practice across a number of different performance metrics.
“We will see a project using game theory to teach quality improvement and another sharing important quality improvement work occurring at the intersection of evidence-based medicine and patient experience – like looking at how to keep patients NPO for less unnecessary time,” he said. “It makes perfect sense that we don’t want to keep people hungry in the hospital longer than we need to. It’s really interesting seeing how one team worked to make that happen and what they found.”
The importance of the RIV
The influence of the RIV program extends far beyond the conference itself; there are implications for the field of hospital medicine today and into the future.
“The RIV competition allows the field in hospital medicine to mature and evolve, so we remain cutting edge,” Dr. Mathews said. “That’s the beauty of the innovation field: Research is built off of it.”
Dr. Cumbler said that the growth and evolution of the RIV is reflective of the maturation of hospital medicine as a specialty. “It’s transitioning from a different way to organize patient care to learning more, in a scientific way, about how care can and should be delivered.”
At its heart, the RIV is really about community, he added. “The community of hospitalists is sharing knowledge, graciously and unselfishly, so that we can all improve the quality of care that we’re providing and give patients safer care, a better experience, and improved outcomes.”
Finally, RIV offers a way for hospitalists to be engaged in lifelong learning. “The presenters are teaching from their experience, and the hospitalists who come to the RIV get to leave better clinicians, researchers, and leaders as a result,” Dr. Cumbler said. “These things, to me, are about our evolution as a profession.”
© Frontline Medical Communications 2018-2021. Reprinted with permission, all rights reserved.