Preventing post-operative delirium (POD) and improving outcomes with computable guidelines

Recorded October 24, 2024 at SNOMED CT Expo 2024 in Seoul, Korea.

202467 Preventing post-operative delirium (POD) and improving outcomes with computable guidelines – the Digi-POD project - Sophie Klopfenstein (DE)

Postoperative delirium (POD) is a complication that can occur in patients with risk factors after a surgical intervention because of external triggers, such as surgery type, drugs or electrolyte imbalance. It is characterized by an acute and fluctuating beginning, disturbance of vigilance and consciousness, and cognitive dysfunction, that cannot be explained by chronic neurologic or psychiatric conditions. POD is particularly common in older patients and associated with poor clinical outcomes and increased healthcare costs, but its incidence can be reduced by applying a combination of patient-tailored pre-, intra- and post-operative measures. To that end, the European Society of Anesthesiology and Intensive Care Medicine (ESAIC) has recently updated its evidence-based clinical practice guideline on the prevention of POD in adults. However, these guideline recommendations are not always fully implemented in clinical practice due to various reasons, including unawareness of guideline applicability in certain clinical contexts. Therefore, in Digi-POD, a multicenter project funded by the German Federal Joint Committee, we convert the narrative ESAIC guideline into a computable format that we integrate into a clinical decision support system. This system is then applied in a clinical study to investigate if the guideline adherence can be increased using a computable guideline, and POD ultimately be prevented. Our system requires guidelines represented as Fast Healthcare Interoperability Resources (FHIR) artefacts and clinical data stored in the Observational Medical Outcomes Partnership (OMOP) common data model (CDM). This presentation focuses on the activities required to translate and process the ESAIC POD guidelines into computable knowledge.