In-hospital deterioration prediction

Up to five percent of adult patients on medical-surgical wards deteriorate during their stay, and the standard response, vital signs taken every four to six hours, is both too sparse for the patients at risk and unnecessary for the stable majority. The program builds models that read the data a hospital already collects and turn it into a continuous estimate of risk.

Three strands run in parallel. The Northwell In-hospital Deterioration Model (NIDM) reads the electronic health record and runs in silent mode inside the hospitals' Epic system. A wearable-based model, published in Nature Communications in 2025, predicts clinical deterioration up to 17 hours before onset from nine physiological signals streamed from continuous monitors. An earlier model, published in npj Digital Medicine in 2020, identified patients stable enough to sleep through the night without vital-sign checks.

The work is funded by a $3.19M award from the National Institute of Nursing Research (2023 to 2027) and, from 2026, a National Library of Medicine award to scale wearable foundation models for deterioration detection.