Cedars-Sinai Pilots EHR Algorithm to Better Spot Dementia in Older Adults 

Cedars-Sinai has developed a new method for analyzing electronic health records to determine if an older adult has dementia. The findings could help clinicians provide better care earlier.

The nonprofit hospital and medical research center based in Los Angeles recently published its findings in the Journal of the American Geriatrics Society. Those findings essentially indicated it is viable to use an EHR algorithm like the one that the hospital developed for dementia identification.

“The objective is to ensure that patients who are potential patients with dementia or age related cognitive decline get referred to the subspecialty care and other care resources that they need,” Cameron Escovedo, physician leader of Enterprise Information Services at Cedars-Sinai, told Senior Housing News.

The algorithm, which is currently in use on two floors of the hospital, searches through a patient’s record and alerts medical staff if the patient meets certain criteria, including a diagnosis of cognitive decline or a medication related to treating cognitive decline. The algorithm analyzes multiple points during a residents’ stay in a hospital or community, from admission to discharge. 

The notes generated by the algorithm can then be seen by primary care providers following a person’s hospital stay.

“There might be bread crumbs along the way, that might clue you in. This physician may have identified cognitive decline, but did not rise to the level of it’s so obvious that they consulted psychiatry,” Escovedo said. “So we had to build rules that would identify all of those little bread crumbs.”

For the pilot, Cedars-Sinai selected patients living with chronic conditions that would be further exacerbated by cognitive decline. Escovedo said there is likely still underreporting among Cedars-Sinai, but the algorithm is helping to catch more cases that otherwise could have gone unnoticed for now.

Cedars-Sinai also built a training program to help workers better care for older adults with dementia. The organization published its results of that training program in the journal Geriatric Nursing in late 2023.

Cedar-Sinai is now expanding use of the algorithm to other units and patients 65 or over living with conditions potentially contributing to cognitive decline. The organization is also planning a second phase of the algorithm meant to connect older adults living with cognitive decline with the primary care services they need. 

“We think it’s going to take the form of some kind of alert to the primary care provider that says, ‘Hey, your patient, flagged as having potential age related cognitive decline on their most recent hospital visit, take a look at this documentation from the hospital based care team to see what they recommend, and then sign these orders for referrals to subspecialty care and supportive care, based on the assessment that they did in the hospital,’” Escovedo said.

The goal will be to condense the information and make it easily accessible for primary care providers in one “seamless workflow,” Escovedo added.