Electronic Health Reporter

By Tammi Jantzen, co-founder and CFO, Astarte Medical.

The American Hospital Association (AHA) recently determined that 75% of senior hospital executives endorsed the importance of digital innovation. This is incredible progress for the industry, but there are still key areas within hospitals that need to embrace the new technologies available, for both the health of the hospital and its patients.

One of the most underserved departments when it comes to innovation is the Neonatal Intensive Care Unit (NICU). The lack of investment might come from the assumption that it’s too small of a population, but these infants are one of the most expensive patients in a hospital, with some preterm infants staying in the NICU over 100 days.

Nutrition: The Overlooked Piece in Preterm Infant Health

More than 380,000 babies in the United States are born preterm annually, and according to the CDC, in 2018, one in 10 babies was born too early (before 37 weeks of pregnancy). Today, we can survive infants as early as 22 weeks gestational age.

Preterm infants require round-the-clock care in the NICU, including monitoring of their hearts, lungs and temperature. As survival rates for extremely preterm infants improve, attention is now being focused on improving the quality of survival. Optimal nutrition early in life can positively impact not only physical growth, but neurological development, as well.

However, nutrition is rarely taught in medical school and expertise is limited to dietitians, where present, or a clinical researcher who focuses on nutrition. Optimizing feeding and nutrition management in the NICU remains a major challenge for clinicians.

Implementing a standardized feeding strategy has been shown to improve growth outcomes in addition to reducing adverse events, however most NICUs are still using paper-based feeding protocols and require dieticians to make manual calculations using pen, paper and calculator.

This manual process has been the standard practice for decades. Not only does this provide room for error, it creates more work for clinical care teams and is a drain on hospital resources. While technology in support of life saving measures is rampant in the NICU, the utilization of software has been limited to the implementation of electronic medical record systems, such as Epic and Cerner. Investments in technological innovations have not extended to addressing feeding and nutritional support for the tiniest, most vulnerable patients.

It’s 2020: Data Is Everywhere, But Is it Making an Impact?

Recent research, published in the Journal of Perinatology, found that even among hospitals that have adopted clinical decision support (CDS) in NICUs, most do not have an automated system to monitor the quality of nutrition delivered. To overcome the challenges of manual processes, understand protocol adherence or lack thereof, and to gather useful insights from feeding data, clinicians could benefit from a digital tool that allows them to track improvements in feeding milestones over time and observe the correlating patient outcomes.

The issue isn’t lack of available data, but rather capturing and transforming this data into actionable insights for clinicians.

The Future of Care
Forty years ago, nutritional options for preterm infants were extremely limited. If mother’s milk was unavailable, there were only a few options for formula, and determining the proper dosing was a constant struggle.

Currently, there is a wealth of data available on feeding preterm infants, but it has expanded beyond the capacity of any single person or even hospital to manage or understand in real time. In order to truly have an impact on the health of preemies, their families and clinical care staff, we need to focus attention on adapting innovative tools that can harness and transform this data into insights that will improve outcomes for these tiny fighters.