Clinical tool enhances patient care and ensures physicians can adapt quickly
When Hurricane Helene struck North Carolina in late September, four UNC Health hospitals and more than 100 clinics in Western NC lost power and connectivity – an unprecedented situation for the healthcare system. The storm also damaged one of the country’s largest IV fluid manufacturing facilities, causing a nationwide shortage of this essential clinical supply. This shortage escalated to a national crisis, requiring swift and innovative responses from healthcare systems across the United States.
Within a matter of hours, UNC Health used AgileMD clinical pathways to address the shortage while ensuring high-quality care, guiding clinical teams to make the best possible use of their limited supply and maximize alternative approaches. These pathways are presented to the clinicians as part of their normal workflow in patients’ electronic medical records, making it easy to adopt the new guidelines that allow UNC Health providers to conserve IV fluids without compromising care. Core to the pathway response was a focus on oral rehydration — like drinking water or Pedialyte — which can be a safe alternative to IV fluids in patients who can tolerate them. When front line staff follow pathway guidance on ways to address nausea first, for example, they can ensure that more patients are able to comfortably use this method, reserving IV fluids for the most critical cases, such as patients who are unconscious.
UNC Health was only nine months into deploying their AgileMD pathways program when Helene hit, but the oversight team was ready to act fast when tasked with responding to the fluid shortage.
“When hospital leadership said ‘go,’ we developed an adult inpatient oral rehydration pathway and had it live in the electronic health record in just six and a half hours,” explained Cheri Warren, RN, UNC Health’s HCS Director – Clinical Applications. A version for the Emergency Department came the same day, followed by a separate pediatric pathway, with weight-based adjustments.
“The key to AgileMD’s speed is pathway development by clinical authors, easy order integration within the pathway, and rapid dissemination,” said Vineeta Khemani, UNC Health’s Executive Director for Clinical Applications & Enterprise Architecture. “This can obviate the need for cumbersome IT changes to the EHR, which cannot be deployed as quickly or at scale.”
In a coordinated effort between marketing, information systems, and clinical leadership, the new guidelines were communicated anywhere clinicians might see them, such as in patient safety huddles, on a dedicated SharePoint site, screensavers and in flyers in break rooms.
UNC Health currently has AgileMD pathways deployed to promote adoption of evidence-based clinical practices and improved patient outcomes across all UNC Health hospitals and clinics, many of which are in rural counties. Over 1,500 clinicians have leveraged the tool for more than 3,000 patients since the February 2024 go-live, with the newest oral rehydration pathways among the fastest adopted and used nearly 500 times in just the first week. UNC Health actively engages with other health systems using AgileMD’s clinical pathways and is sharing their content on the AgileMD library so that other health systems can quickly adapt best practices to their local needs.
“We are often dealing with the very same care challenges as our peer organizations and we shouldn’t all have to reinvent the wheel,” said Cyndi Hall, UNC Health System Executive Director for Care Redesign. “We have benefited greatly from pathways designed by other health systems and are happy to pay it forward on this one. We can compete on a lot of different things but doing the right thing for patients is not one of them.”
AgileMD’s co-founder and CEO, Borna Safabakhsh, agrees. “Unforeseen emergencies, like supply shortages and emerging disease threats, are not uncommon in healthcare where the stakes could not be higher and resources are already constrained,” he noted. “UNC Health’s use of AgileMD pathways to address the IV fluid shortage and then share that with the community at large is a perfect example of what these tools can do.”
About UNC Health
UNC Health is a state entity and an affiliated enterprise of the University of North Carolina system, comprised of nearly 20 hospitals and more than 900 clinics along with the clinical patient care programs of the UNC School of Medicine (SOM). It exists to improve the health and well-being of North Carolinians and others we serve and to further the teaching mission of the University of North Carolina SOM. UNC Health provided more than $800 million in Uncompensated Charity Care during the past five years. Our hospitals have received numerous awards and recognition for quality care, patient safety, and the overall patient experience.
About AgileMD
AgileMD is a clinical decision support software company, driven to improve patient outcomes by making evidence-based care universally accessible. Since its founding at the University of Chicago, their work has been evaluated in 80 peer-reviewed publications and the company has received nearly $3 million in federal funding from the U.S. Department Health & Human Services (HHS). AgileMD’s clinical pathways and FDA-cleared early warning device, eCART, have been used by over 135,000 providers in more than 250 U.S. hospitals in the care of over 4 million patient encounters, including at some of the nation’s leading community and research centers.
Media contact: Alan Wolf