A valuable part of a clinician’s training includes the effective identification and careful documentation of all the elements impacting a patient's well-being. Thorough documentation is essential to ensure accurate and timely clinical care. Although electronic health records (EHRs) hold many great opportunities to capture essential details in electronic form, patients could be at risk if all elements of their medical records are not compiled and analyzed. With 990.8 million reported visits to physician offices in 2015 ^[1], odds are that precious information could slip off the radar of even the most dutiful clinical staff. 

The importance of Nature AND Nurture in healthcare

For this reason, providers must adopt a successful population management strategy that considers all elements of a patient’s record, including the estimated 70% of the record that exists as unstructured notes. Structured data is excellent for documenting patient information that ensures a hospital runs effectively but not as efficient for capturing imperative clinical concerns during a patient’s 20-minute encounter with a physician. 

Although the concept of nature vs. nurture has been well-documented for centuries, providers are just now realizing the critical importance of social determinants:

• Does a patient live alone?
• Do they utilize a walking cane?
• Are they on a fixed-income? 

Identifying before protecting: Using I2E to help vulnerable populations

Undoubtedly, EHRs contain a wealth of information to identify patients requiring special attention, such as those with:

Tracking and reporting adverse events

In recent years, regulatory authorities such as the FDA and EMA have placed an increased emphasis on drug safety of marketed products, particularly the tracking and reporting of adverse events. Pharmaceutical companies are expected to regularly screen the worldwide scientific literature for potential adverse drug reactions, at least every two weeks. The use of text mining and other tools to streamline the literature review process for pharmacovigilance is more crucial than ever in order to ensure patient safety, without overloading drug safety teams.

Manual review of adverse events is time-consuming

Eric Lewis (Safety Development Leader at GlaxoSmithKline) talked at the Linguamatics Text Mining Summit about the challenges of reviewing medical literature for safety signals. For example, he looked for literature for a sample of just 20 marketed products across a 300-day period. Eric found that there were on average 60 new references per day (with a total of over 11,000 documents). He found that manual review time was 1.2 to 1.6 minutes per abstract. He extrapolated this to a typical pharma company product portfolio of 200 marketed products, and showed that this volume of literature would take over 2,200 hours to review – hugely time-consuming.