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June 12, 2014

Birth Data Provides New Tools for Fighting Infection

Increasingly robust data sets collected and maintained by medical researchers over the past decade are helping improve the delivery of health care.

The latest example comes from healthcare giant Kaiser Permanente’s neonatal intensive care units in northern California that are using a new online tool to calculate whether preterm of newborn babies are susceptible to a deadly systemic infection known as sepsis.

The “online sepsis calculator” relies on data sets maintained by Kaiser’s regional research division. Researchers and doctors jointly developed an algorithm for the sepsis calculator based on years of data on the vital signs of mothers and newborns that developed sepsis.

Prior to the calculator, new mothers with fevers of 100.4 degrees or higher went to the neonatal ICU regardless of the baby’s condition. Mother and child were separated and intravenous antibiotics were administered to the newborn.

The sepsis calculator allows physicians to be “smarter on which babies we identify to evaluate and treat for infection,” Dr. Michael Kuzniewicz said in a statement released by Kaiser.

Kaiser stressed that big data initiatives like the sepsis calculator illustrate how clinical data can be used to improve neonatal care while allocating medical resources where they can do the most good.

The healthcare provider’s research arm has been collecting demographic and clinical data over the last decade on every infant born in its northern California coverage region. The dataset includes more than 800,000 birth records. A separate dataset covers more than 50,000 infants admitted to neonatal ICUs in the region.

The key to the effort was that a regional entity like Kaiser was in a position to gather largely unstructured medical data, analyze it and present it to member hospitals in a usable format.

The healthcare provider claims the neonatal data has contributed to a range of system-wide improvements such as a reduction in the number of days infants spend in ICUs along with fewer infections resulting from intravenous antibiotics.

California formed a Perinatal Quality of Care Collaborative a decade ago to collect data, develop benchmarks and monitor the resulting health care. Now, data analytics are available to develop tools like the sepsis calculator.

While the neonatal data has helped improve health care for California’s newborns, the original intent of medical researchers was much less ambitious. Research scientist Gabriel Escobar said the initial purpose of the database was to keep track of infants in neonatal ICUs so they could be invited back for “reunion parties.”

Over the last four years, added regional director of neonatology Dr. Allen Fischer, “we have reached the point where, for example, our hospital-acquired infection rate for the Northern California NICUs together are at the top levels in the entire state, when compared to other groups of hospitals working together.”

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