Methods

We developed a programme that uses Epic Electronic Health Record (EHR) to automatically extract relevant data from patients' electronic health records, including their history, clincal findings, and blood results to generate a National Emergency Laparotomy Audit (NELA) Parsimonious score. To validate the accuracy of the Generated NELA score, we compared our results with those obtained using the NELA score calculator with both normal and extreme values.

Results

The study found that our automated NELA scoring system produced highly accurate results, generating the same estimated morbidity and mortality values as the NELA Calculator regardless of input (Figure 1). Additionally, the automated system was considerably faster than manual scoring methods, markedly reducing the time required to generate a score. The data is displayed to the end-user to help ensure contemporaneous clinical decision making and correct supervision levels as dictated by the NELA recommendations. A tracker is also included to display missing parameters if the score cannot be calculated.

Discussion

The development of an automated NELA scoring system using Epic EHR allows for faster identification of higher-risk patients, especially in an urgent/emergent setting. By accurately and quickly identifying patients at risk for complications, more targeted perioperative interventions can be implemented. Our study demonstrates the feasibility and effectiveness of using the customisable features available on the Epic’s EHR to extract relevant data and generate NELA scores.

Acknowledgements

The authors would like to acknowledge Epic For their support in developing the scoring system, as well as the creators of the NELA risk prediction tool.