Emergency Medicine
Rapid Decision-Making

Enhancing Rapid Decision-Making & Patient Safety in the ED With Realize-365

How Realize-365 speeds up chart review, surfaces sepsis-consistent findings early, and helps clinicians cross-check medication histories in high-volume emergency settings.

70-80% Faster

Reduction in chart-review time

Earlier Visibility

Sepsis-consistent findings surfaced 1-3 hrs earlier

Discharge Safety

Prevents QT-prolongation risks

Clinical Background

Patient: Marcus Rivera, 44y (Presentation: Acute chest pain, dizziness, shortness of breath)

Setting: Busy urban ED, high patient volume. PMH: Hypertension, obesity (BMI 34), mild intermittent asthma. Reason for ED Visit: Sudden onset chest tightness and near-syncope.

1

Rapid Chest Pain Record Review for ACS Work-Up

Clinical Problem

The ED team needs to classify Mr. Rivera’s chest pain severity and determine immediate vs urgent vs routine evaluation. However, the relevant information is scattered across triage notes, prior labs, vitals, and old EKGs, slowing urgent decision-making.

Realize-365 Action

Query: "Compile prior EKGs, last lipid panel, risk factors, and current triage vitals relevant to ACS work-up."

Triage Pain Score: 7/10, substernalConcerning
Current EKG: New borderline ST depressions V4–V5High-risk feature
Triage Vitals: BP 162/94, HR 104Hemodynamically borderline

Insight: Surfaced findings — borderline ST depressions, elevated triage pain score, borderline vitals — are documented high-risk features for ACS, for clinician review.

Impact

  • Reduces chart-review time by 70–80%.
  • Supports rapid safe decision-making in < 1 minute.
2

Sepsis Screening for Undifferentiated Fever

Clinical Problem

Mr. Rivera develops a fever (101.9°F) and tachycardia 2 hours into ED observation. Nursing notes mention "possible confusion," but the ED physician has not yet reviewed all vitals, labs, and nursing comments. Subtle sepsis indicators may be missed without automated consolidation.

Realize-365 Action

Query: "Analyze vitals, lactate, WBC, and nursing documentation from the last 2 hours. Determine if sepsis criteria are met."

ParameterExtracted ValueCriteria Match
Temp & HR101.9°F / 112 bpm✔ Meets criteria
Lactate2.3 mmol/L✔ Elevated
Mental StatusMild confusion✔ Organ dysfunction

Insight: Documented vitals, lactate, and mental status changes meet the charted criteria for severe sepsis (SIRS + suspected infection + elevated lactate), flagged for clinician review against the sepsis bundle protocol.

Impact

  • Surfaces sepsis-consistent findings 1–3 hours earlier than manual review.
  • Reduces time-to-antibiotics, improving outcomes.
3

Medication Cross-Check Before ED Discharge

Clinical Problem

After stabilization, Mr. Rivera is ready for discharge with prescriptions for azithromycin (suspected atypical pneumonia), prednisone (short burst), and albuterol inhaler. However, he recently received QT-prolonging medications (Ondansetron) at an urgent care center, and the ED team is unsure if azithromycin is safe. Searching multiple medication histories is slow and error prone.

Realize-365 Action

Query: "Review all active medications, urgent care prescriptions from the last 30 days, and identify any QT-prolonging interactions with azithromycin."

AzithromycinModerate QT Risk - Requires check
Ondansetron (recent UC visit)High QT Risk - Additive interaction
Prednisone & AlbuterolLow Risk - Safe

Insight: Concurrent azithromycin + ondansetron is flagged in the record as a known QT-prolongation interaction, for clinician review before discharge.

Impact

  • Prevents QT-related arrhythmia risk during ED discharge.
  • Saves 5–7 minutes of manual medication cross-checking.

Why this case matters

Speed & Accuracy

In the ED, minutes matter. Realize-365 consolidates scattered data in seconds, allowing clinicians to make faster, better-informed decisions.

Sepsis Detection

By correlating nursing notes (confusion) with vitals and labs, Realize-365 surfaces sepsis-consistent findings early, supporting bundle compliance.

Medication Safety

Checking for interactions like QT prolongation before discharge prevents bounce-backs and adverse events.