Using Big Data to Prevent Cardiac Arrhythmias

As many as two-thirds of elderly patients admitted to acute-care settings are exposed to multiple medications  known to interfere with the ability of the heart to “recharge” between beats, which could lead to a life-threatening form of cardiac arrhythmia.

Although  a rare health occurrence, more than 150 common medications – including azithromycin and ondansetron – can contribute to prolonged heart-recharging intervals, which may lead to serious complications and/or longer hospital stays.

To address this problem, University of Arizona researchers will implement alerts embedded in patients’ electronic health records to estimate risk and to assist health-care providers in mitigating sudden cardiac death. Funded by a two-year, $766,000 grant from the Agency for Healthcare Research and Quality, the project uses health information technology to support maximum safety and effectiveness of medicines for patients who are more likely to be affected. The team will work within 28 Banner Health facilities throughout Arizona, California, Colorado, Nebraska, Nevada and Wyoming.

“Real-time precision-guided prescribing will save lives and prevent drug-induced arrhythmias for patients in all of the University’s clinical partners, including Banner Health,” said C. William Heise, MD, assistant professor, Division of Clinical Data Analytics and Decision Support at the UA College of Medicine – Phoenix.

The project will use electronic health records and prescribing systems to identify patients at high risk of harm from medications and immediately send electronic messages to advise doctors of the risk and how to prevent the development of potentially life-threatening heart rhythm disorders and sudden death.

The grant also will fund educational programs to inform health-care providers how to best utilize and respond to the computer-generated advisories.

“We are excited to have this opportunity to work closely with Banner Health data scientists and to evaluate a medication safety program within the entire health-care system,” said Daniel Malone, RPh, PhD, FAMCP, scientific leader for the grant, who is professor at the UA College of Pharmacy with a joint appointment in the UA Mel and Enid Zuckerman College of Public Health.

The project builds on data that already is captured in patents’ electronic medical records, including data that is imported automatically from the hospital’s electrocardiogram equipment.

“In addition to making this alert as specific and precise as possible, we will conduct usability testing to ensure it works in the provider’s workflow,” said Corneliu Antonescu, MD, MBI, FAAP, clinical assistant professor, Department of Biomedical Informatics, at the UA College of Medicine – Phoenix and a physician informatist with Banner Health.

The research team also includes other UA faculty members, including Raymond Woosley, MD, PhD, co-director of the Division of Clinical Data Analytics and Decision Support at the UA College of Medicine – Phoenix; Tyler Gallo, PharmD, assistant professor, pharmacy practice and science, from the UA College of Pharmacy and UA College of Medicine – Phoenix; and Sheila Gephart, PhD, RN, associate professor with the UA College of Nursing. Assisting in the project is Jim Tisdale, PharmD, professor of pharmacy practice with Purdue University College of Pharmacy.

This project is supported by grant No. R18HS026662 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.

About the University of Arizona College of Pharmacy

The University of Arizona College of Pharmacy is the premier pharmacy college in the Southwest, and one of the top in the nation focused on drug discovery, toxicology, pharmaceutics, outcomes sciences, pharmaceutical education and research through interprofessional training and collaborative public/private partnerships. Preparing pharmacists and pharmaceutical scientists in undergraduate, professional, graduate and post-doctoral programs, the college embraces an entrepreneurial spirit, providing tailored educational opportunities to broaden students' experiences. As the first health sciences college at the UA, the college has a long history of improving science and health both in Arizona and around the world. For more information, please visit pharmacy.arizona.edu

About the University of Arizona Health Sciences

The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. The UA Health Sciences includes the UA Colleges of Medicine (Phoenix and Tucson), Nursing, Pharmacy and Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the growing Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, the UA Health Sciences reaches across the state of Arizona and the greater Southwest to provide cutting-edge health education, research, patient care and community outreach services. A major economic engine, the UA Health Sciences employs approximately 4,000 people, has approximately 800 faculty members and garners more than $140 million in research grants and contracts annually. For more information: uahs.arizona.edu (Follow us: Facebook | Twitter | YouTube | LinkedIn | Instagram)

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Originally Posted: 
Monday, May 13, 2019 - 1:22am