January 14, 2022

Behind-the-scenes alert system ‘another set of eyes’

Our Advance Alert Monitor program uses predictive analytics to address serious complications before they happen. It earned an award for quality and patient safety.

Erin Fowler-Jones, shown with her husband and 3 adult children, received the medical attention she needed thanks to the Advance Alert Monitor program.

As a neonatal intensive care nurse for 39 years, Erin Fowler-Jones knows what exceptional care looks like. When she arrived at a Kaiser Permanente emergency department in Northern California because of a worsening foot infection, she was impressed by the attention and care she received.

“From the first night I was admitted through the next day,” she recalled, “I had staff constantly coming by, monitoring my condition, and making sure that I was OK.”

What Fowler-Jones didn’t know was that in addition to her care team frequently visiting her, our award-winning Advance Alert Monitor program was also hard at work ensuring her health and safety.

An early warning system

Advance Alert Monitor is an advanced program that helps prevent emergencies in the hospital before they happen. Every hour, the program automatically analyzes hospital patients’ electronic health data. If it identifies a patient at risk of serious decline, it sends an alert to a specialized virtual quality nursing team which then reanalyzes the data to determine what level of on-site intervention is needed.

To predict which patients are likely to decline — meaning they might soon need emergency resuscitation or need to be transferred to the intensive care unit — the program uses a powerful analytical engine that takes into account many patient factors. These factors include laboratory test results and vital signs, such as heart rate, blood pressure, and body temperature.

“It takes a team approach to ensure the patients are well cared for by intervening early and providing the appropriate medical treatment,” said Vanessa Martinez, DNP, RN, director of Virtual Nursing Care at Kaiser Permanente in Northern California.

Gabriel Escobar, MD, a research scientist at Kaiser Permanente and lead author of a New England Journal of Medicine study on the Advance Alert Monitor, recognizes that alert systems are nothing new to hospitals but says this program is different.

“What is unique about AAM is that it is not just a sophisticated statistical model,” Dr. Escobar said. “Rather, it is an integrated system that links accurate and timely risk estimates with a health care team that includes physicians and nurses who combine the predictions with carefully defined workflows.”

The program uses that data along with learnings from the more than 1.5 million patient records in our electronic health record system to assign each patient a score. When a patient’s score rises above a certain level, an alert is sent.

“Kaiser Permanente is able to power Advance Alert Monitor due to our vast electronic health record system,” Dr. Escobar said. “With all that data, the program can produce very accurate patient risk scores.”

Saving lives behind the scenes

Fowler-Jones had no idea her condition had triggered an alert, or that a behind-the-scenes team was carefully monitoring her condition. But she’s thankful for it — Advance Alert Monitor may have saved her life.

“I just knew that my doctor’s focus was on my health and that I was carefully being watched,” she said. “It was an overwhelming relief to me.”

Advance Alert Monitor has been providing peace of mind to Kaiser Permanente patients and families since it first started rolling out in Northern California hospitals in 2015. It’s now used at all 21 of our hospitals in Northern California.

The recent Advance Alert Monitor study published in the New England of Journal Medicine found that the system was responsible for preventing 520 deaths per year over a 3-and-a-half-year study period. It also showed a lower incidence of ICU admissions and shorter hospital stays.

Recognition for improving quality and patient safety

Advance Alert Monitor recently earned the Austco Excellence Award for Quality and Patient Safety at the 2021 International Hospital Federation Awards.

“Advance Alert Monitor reflects our commitment to providing the safest care possible by leveraging advances in data and science technology,” said Andy Bindman, MD, executive vice president and chief medical officer at Kaiser Permanente. “Because of this program, we are identifying patients who need immediate attention, intervening early, and providing the high-quality, exceptional care that our patients and families deserve.”

Because Fowler-Jones’ care teams responded quickly to her condition, she was treated appropriately and within a few days was well enough to return home.

“Advance Alert Monitor is an amazing idea,” she said. “It’s like another guardian, and sometimes all you need is another set of eyes watching over you.”