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Epic Study Finds Health Data Exchange Lowers Risk of Code Blue

In patients with a higher level of acuity in the ED, the presence of outside health data is linked to a 34 to 63 percent reduced risk of a code blue event, an Epic study found.

Access to outside health data is associated with a reduced risk of code blue events in the emergency department (ED), according to an Epic Research study.

ED clinicians triage patients to determine their acuity level, often using the Emergency Severity Index (ESI). This index helps establish order of care among patients, with level one indicating the most critical cases and level five denoting the least critical.

Research has shown that health information exchange (HIE) through tools like Epic’s Care Everywhere has a significant impact on various ED outcomes, including visit length, imaging, admission rates, and charges.

Care Everywhere documents in a patient’s chart indicate that the patient has a record at another organization that has been sent to the organization where the patient is receiving care.

The researchers sought to understand whether the presence of Care Everywhere documents in patient charts correlates to a lower risk of code blue events in the ED. Code blue events are medical emergencies where a patient requires immediate resuscitation. 

The study analyzed 95 million ED visits between January 1, 2017, and October 1, 2023, with an ESI level of one, two, or three. Of those, 82 million had Care Everywhere documents present. The study excluded patients with an unknown ESI or an ESI level four or five as there are likely more variables for the cause of the code blue.  

The study found that in patients with a higher level of acuity in the ED, the presence of outside health data is correlated with a 34 to 63 percent reduced risk of a code blue event, depending on the patient’s age. 

The risk is lowered more with age for all but the most acute cases, ranging from no reduction in risk for patients under age 17 to a 51 percent reduction for patients over age 65. 

The researchers conducted sensitivity analyses to account for variables such as care received in the prior year and the volume of visits prior to the ED visit and found comparable results. Additionally, the study only included patients with at least five years of data in Cosmos.

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