Can the Electronic Health Record Identify Vulnerable Older Adults in Need of a Palliative Care Assessment in the Hospital Setting?

Personalized health care that incorporates advance care planning and aligns treatment with patient-centered goals can improve the quality of life of dying individuals and reduce stress, anxiety, and depression in surviving relatives.1, 2 Although several prognostication indices that address all-cause mortality have been developed for use in elderly inpatients, none have been integrated into the electronic health record (EHR) to automatically identify high-risk individuals and used during interdisciplinary team rounds to identify vulnerable hospitalized adults.3 At Aurora Health Care in Milwaukee, Wisconsin, an automated alert for serious medical illnesses has been programmed into the EHR. Built on previous findings,4 the alert is intended to identify a subset of hospitalized individuals with a poor prognosis and to target them for a discussion of their goals of care. This quality improvement report aims to determine whether the automated alert is effective in identifying older inpatients at high risk for mortality.