Developing a COVID-19 WHO Clinical Progression Scale inpatient database from electronic health record data

Priya Ramaswamy; Jen J Gong; Sameh N Saleh; Samuel A McDonald; Seth Blumberg; Richard J Medford; Xinran Liu

doi:10.1093/jamia/ocac041

Developing a COVID-19 WHO Clinical Progression Scale inpatient database from electronic health record data

J Am Med Inform Assoc. 2022 Jun 14;29(7):1279-1285. doi: 10.1093/jamia/ocac041.

Authors

Priya Ramaswamy^{1

2}, Jen J Gong³, Sameh N Saleh^{4

5

6}, Samuel A McDonald^{4

7}, Seth Blumberg^{8

9

10}, Richard J Medford^{4

11}, Xinran Liu¹

Affiliations

¹ Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
² Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California, USA.
³ Center of Clinical Informatics and Improvement Research, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
⁴ Clinical Informatics Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
⁵ Section of Hospital Medicine, Division of General Internal Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
⁶ Department of Biomedical & Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
⁷ Department of Emergency Medicine, University of Texas Southwestern Medical Center, Clinical Informatics Center, Dallas, Texas, USA.
⁸ Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California, USA.
⁹ Centers of Disease Control's Modeling infectious Diseases (MInD) Healthcare Program, USA.
¹⁰ Department of Medicine, University of California San Francisco, San Francisco, California, USA.
¹¹ Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Clinical Informatics Center, Dallas, Texas, USA.

Abstract

Objective: There is a need for a systematic method to implement the World Health Organization's Clinical Progression Scale (WHO-CPS), an ordinal clinical severity score for coronavirus disease 2019 patients, to electronic health record (EHR) data. We discuss our process of developing guiding principles mapping EHR data to WHO-CPS scores across multiple institutions.

Materials and methods: Using WHO-CPS as a guideline, we developed the technical blueprint to map EHR data to ordinal clinical severity scores. We applied our approach to data from 2 medical centers.

Results: Our method was able to classify clinical severity for 100% of patient days for 2756 patient encounters across 2 institutions.

Discussion: Implementing new clinical scales can be challenging; strong understanding of health system data architecture was integral to meet the clinical intentions of the WHO-CPS.

Conclusion: We describe a detailed blueprint for how to apply the WHO-CPS scale to patient data from the EHR.

Keywords: COVID-19; World Health Organization; electronic health records; medical informatics; public health informatics.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

MeSH terms

COVID-19*
Databases, Factual
Electronic Health Records*
Humans
Inpatients
World Health Organization

Abstract

Publication types

MeSH terms

Grants and funding