New Constellations 2019 | Page 38

NEPHROLOGY • CONTINUED FROM PREVIOUS PAGE “For physician researchers, that would take all of our lives,” says Dr. Faubel. “For them it’s just more code.” Soon, that code will pull de-identified EMR data from Children’s Colorado, University of Colorado systems and public health records to flow everything from patient history to electrolyte levels to CRRT effluent into a convenient dashboard for M-TRAC researchers. Led by Dr. Soranno, it’s been the largest-scale project in Health Data Compass’s five-year history. “We gave them a huge document of variables and variables and variables,” says Dr. Soranno. “The database searches diagnostic codes, so we had to come up with literally hundreds of definitions. It really was tedious. But that was where the collaboration really paid off. Everyone got a chance to include what they wanted. We came up with 300 variables altogether.” “A lot of it is flow sheet data,” says Davis. “So, for example, you could enter heart rate into the flow sheet every ten minutes and have minute-by-minute tracking of all these outcomes. It’s a great way to capture complex data elements over time. But the scope was definitely challenging.” “It’s our hope and expectation that this will be the biggest critical care and nephrology research database in the world,” says Dr. Soranno. The background work complete, it’s still a few months from coming online. The next stage is to assess the database’s accuracy by manually pulling records and comparing them against its returns. It’s a huge data set, and Davis expects bugs. Fine-tuning the algorithms is just part of the process. M-TRAC researchers are already analyzing the kind of systemic information the database will pull. And they’re already finding connections. For example, patients with AKI and elevated chloride levels have nine times the risk of mortality — a life-threatening problem potentially solved by a simple change of fluids. The database will accelerate the pace of those kinds of findings immeasurably. For patients with chronic, systemic conditions like HLHS — and for almost every patient, child or adult, in every ICU — those findings will save lives. That’s exciting. For Dr. Soranno, the most exciting part is what stands to be revealed. “We don’t know what we don’t know,” she says. “Yet.” ● 36 NEPHROLOGY 100% 1-year patient and graft survival ~50% Of transplants in 2018 came from living donors TOP 5 Nationwide for nephrology programs in volume of total and living donor kidney transplants 36 Specialists provide support to those close to home and traveling out of state NO BRAKES Lucy Washburn was a fussy baby. For new parents Cynthia and Brad Washburn, that didn’t seem unusual. That’s just what kind of baby Lucy was. But when Cynthia noticed at 3 months what looked like a hernia around Lucy’s groin, she decided to take her to the pediatrician near their home in Winter Park, Colorado, nestled into the mountains west of Denver at about 9,500 feet. “They drew blood,” says Brad, “and it all just exploded from there.” continued on the following page LEADERSHIP: Jens Goebel, MD Chief, Pediatric Nephrology For nephrology healthcare professional resources, visit childrenscolorado.org/ NephrologyHCP. NEW CONSTELLATIONS 37