The Rothman Index has been the subject of several publications in peer-reviewed medical journals. We have also presented at numerous scientific symposiums.
Frequently Asked Questions
For each variable we compute risk as a function of that variable. For example, a heart rate of 70 would add essentially zero risk, but a higher or lower heart rate would add increasing degrees risk. Risk is summed across the variables and scaled appropriately to compute the Rothman Index, which represents the total risk for that person at that time. It was empirically derived from 22,000 individuals records and originally validated on data from 25,000 records; it has subsequently been validated on a further 300,000 records.
Pain is not included because it was found to have no correlation with risk. Research shows that individuals who are very ill are often heavily medicated and therefore experience no pain, whereas a person with a less severe condition may have substantial pain.
Liability could decrease because of this tool. All of the information used is already part of the medical record. Since the tool is designed to bring trends to clinicians’ attention, they are less likely to be guilty of errors of omission. The Rothman Index does not prescribe any actions, but rather should be considered as clinicians apply their medical expertise and judgment.
It is important to understand that the value of the Rothman Index is in seeing trends in an individual’s condition not easily appreciated otherwise. In the majority of cases, caregivers are well aware of the situation and no extra attention is required. Most often a falling Rothman Index Score is associated with a case in which all are aware and responding appropriately. Sometimes, however, the clinician may not be aware of the individual’s deteriorating condition, particularly if it is changing very slowly. The Rothman Index can act as a safety net and improve communication between clinicians. Additionally, it may be just as important to recognize that a person is not improving as expected after surgery or a change in therapy, or that a person is progressing more quickly than expected.
The RI tool allows us earlier intervention which could save a trip to the ER. It lets us see gradual deterioration that may be missed by caregivers who see an individual everyday.
Yes, by being proactive rather than reactive, early intervention gives a better quality of life. This is our mission.
The graph summarizes a patient’s condition. It provides an objective vs. subjective view. It is a valuable tool to see what has happened to a patient and help in critical decision-making. It offers oversight capability for management to help with staffing, communication, etc. Nurses can talk to physicians remotely and make better decisions on behalf of the patient. It is a way to communicate with family members and aids in determining proper placement, e.g., when palliative care may be more appropriate.
Yes, it is applicable in home, independent living, assisted living and skilled nursing. By teaching individual or caregiver how to use the RI, they can go home and be tracked by the facility. The system is very user friendly and can be used via voice recognition detail or iPad, etc. It is reimbursable by Medicare.