Fong Allan, Harriott Nicole, Walters Donna M, Foley Hanan, Morrissey Richard, Ratwani Raj R
National Center for Human Factors in Healthcare, MedStar Health, 3007 Tilden St. NW, Suite 7M, Washington, D.C. 20008, USA.
Georgetown University Medical Center, 3800 Reservoir Rd NW, Washington, D.C. 20007, USA.
Int J Med Inform. 2017 Aug;104:120-125. doi: 10.1016/j.ijmedinf.2017.05.005. Epub 2017 May 11.
Many healthcare providers have implemented patient safety event reporting systems to better understand and improve patient safety. Reviewing and analyzing these reports is often time consuming and resource intensive because of both the quantity of reports and length of free-text descriptions in the reports.
Natural language processing (NLP) experts collaborated with clinical experts on a patient safety committee to assist in the identification and analysis of medication related patient safety events. Different NLP algorithmic approaches were developed to identify four types of medication related patient safety events and the models were compared.
Well performing NLP models were generated to categorize medication related events into pharmacy delivery delays, dispensing errors, Pyxis discrepancies, and prescriber errors with receiver operating characteristic areas under the curve of 0.96, 0.87, 0.96, and 0.81 respectively. We also found that modeling the brief without the resolution text generally improved model performance. These models were integrated into a dashboard visualization to support the patient safety committee review process.
We demonstrate the capabilities of various NLP models and the use of two text inclusion strategies at categorizing medication related patient safety events. The NLP models and visualization could be used to improve the efficiency of patient safety event data review and analysis.
许多医疗服务提供者已实施患者安全事件报告系统,以更好地了解和改善患者安全。由于报告数量众多以及报告中自由文本描述的长度,审查和分析这些报告通常既耗时又耗费资源。
自然语言处理(NLP)专家与患者安全委员会的临床专家合作,协助识别和分析与用药相关的患者安全事件。开发了不同的NLP算法方法来识别四种与用药相关的患者安全事件,并对模型进行了比较。
生成了表现良好的NLP模型,将与用药相关的事件分类为药房配送延迟、配药错误、Pyxis差异和开处方错误,曲线下面积的受试者工作特征分别为0.96、0.87、0.96和0.81。我们还发现,在不使用解决文本的情况下对摘要进行建模通常会提高模型性能。这些模型被集成到仪表板可视化中,以支持患者安全委员会的审查过程。
我们展示了各种NLP模型在对与用药相关的患者安全事件进行分类时的能力以及两种文本包含策略的使用。NLP模型和可视化可用于提高患者安全事件数据审查和分析的效率。