University College London Great Ormond Street Institute of Child Health, London, UK
Data Research Innovation and Virtual Environment (DRIVE), Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
BMJ Health Care Inform. 2024 Oct 10;31(1):e101072. doi: 10.1136/bmjhci-2024-101072.
Interactions between patients and healthcare professionals (HCP) during hospital admissions are complex and difficult to interrogate using traditional analysis of electronic patient record (EPR) data. The objective of this study was to determine the feasibility of applying temporal network analytics to EPR data, focusing on HCP-patient interactions over time.
Network (graph) analysis was applied to routinely collected structured data from an EPR for HCP interactions with individual patients during admissions for patients undergoing renal transplantation between May 2019 and June 2023. Networks were constructed per day of admission within a session, defined by whether the patient was in the intensive care unit (ICU) or standard hospital ward. Connections between HCP were defined using a 60 min period. Reports were generated visualising daily interaction network structures, across individual admissions.
2300 individual networks were constructed from 127 hospital admissions for renal transplantation. The number of nodes or HCP per network varied from 2 to 45, and network metrics provided detail regarding variation in the density and transitivity, changes in structure with different diameters and radii, and variations in centralisation. Each network analysis metric has a contribution to play in describing the dynamics of a daily HCP network and the composite findings provide insights that cannot be determined with standard approaches.
Network analysis provides a novel approach to investigate and visualise patterns of HCP-patient interactions which allow for a deeper understanding of the complex nature of hospital patient care and could have numerous practical operational applications.
患者与医疗保健专业人员(HCP)在住院期间的互动是复杂的,使用传统的电子病历(EPR)数据分析方法难以探究。本研究的目的是确定将时间网络分析应用于 EPR 数据的可行性,重点关注 HCP 与患者随时间的互动。
对 2019 年 5 月至 2023 年 6 月期间接受肾移植的患者在住院期间与每位患者的 HCP 交互的常规 EPR 中收集的结构化数据应用网络(图)分析。在每个会话内按入院天数构建网络,定义依据为患者是否在重症监护病房(ICU)或标准医院病房。使用 60 分钟时间段定义 HCP 之间的连接。生成报告,以可视化每个住院的日常交互网络结构。
从 127 例肾移植住院患者中构建了 2300 个个体网络。每个网络的节点或 HCP 数量从 2 到 45 不等,网络指标详细说明了密度和传递性的变化、不同直径和半径的结构变化以及集中化的变化。每个网络分析指标在描述每日 HCP 网络的动态方面都有一定的作用,综合发现提供了无法通过标准方法确定的见解。
网络分析提供了一种新的方法来研究和可视化 HCP-患者互动的模式,这有助于更深入地了解医院患者护理的复杂性质,并可能具有许多实际的操作应用。