Demonstration Projects

The UH ADVANCE Center is comprised of three initial demonstration projects, addressing common health care issues that are associated with high rates of diagnostic error, and include a range of healthcare settings and age groups. The goal of these projects is to examine current diagnostic practice or response to diagnostic interventions, using a consensus-based and data-driven approach to develop improved diagnostic standards.

Demonstration Project #1: Unintentional Weight Loss (UWL) in Adults

Goal: Determine best practice for identifying and evaluating unintentional weight loss in adults, through detailed analysis of electronic health records.

Project Aims:

1. Identify and characterize UWL applying four commonly used definitions,
2. Identify patterns of care and outcomes for patients with UWL, and
3. Create and improve diagnostic algorithms for UWL with recommendations presented to our Diagnosticians’ Panel for review, with final approval from our Board of Advisors.

Principal Investigators: Kelsey Ufholz, PhD, and Goutham Rao, MD

Demonstration Project #2: Home Blood Pressure Monitoring in African American Adolescents

Goal: Assess the diagnostic accuracy of home-based screening for pediatric hypertension in a higher risk population (African American adolescents) using ambulatory blood pressure monitoring (ABPM) as the gold standard.

Project Aims:

1. Among African American adolescents age 13 – 17 years, determine the accuracy of a 3-day home blood pressure monitoring (HBPM) screening protocol for hypertension,
2. Determine the convenience, acceptability, and level of engagement of families with HBPM and ABPM, and
3. Put forth recommendations for HBPM for diagnosis of hypertension in adolescents in general, in collaboration with our Diagnosticians’ Panel and Board of Advisors.

Principal Investigators:  Goutham Rao, MD, and Sarah Ronis, MD, PhD

Demonstration Project #3: Sepsis in Adults and Children

Goal: Improve early diagnosis of sepsis in two specific populations: (1) children admitted to community hospital emergency departments; and (2) adults admitted to community emergency departments, and adult inpatients across our health system.

Project Aims:

1. Implement a region wide pediatric sepsis trigger tool across 18 community emergency departments and monitor its impact,
2. Refine the pediatric sepsis trigger tool based on patterns of care and outcomes,
3. In adult patients, implement an Epic sepsis tool across all community adult EDs and inpatient wards in our system and monitor its impact, and
4. Pair the sepsis tool with a multidisciplinary inpatient sepsis huddle and response team to initiate appropriate treatment and reduce morbidity and mortality.

Principal Investigators:  Jessica Goldstein, MD and Charles Macias, MD, MPH