Pilot Deployment of ePNa Into Epic EHR (ePNa-Epic)

Inclusion Criteria: For the baseline database and assessment of clinical outcomes, all data will be pulled from the Epic Clarity data warehouse. 2500 patients that presented to the Vanderbilt and Wilson county EDs who are >= 18 years old will be identified by ICD-10 codes for pneumonia or acute respiratory failure or sepsis with secondary pneumonia codes for the baseline database. An additional 2500 patients that presented to the Vanderbilt and Wilson county EDs who are >= 18 years old will be identified by having had conventional PA (posteroanterior) and lateral or portable CXRs (chest X-rays), independent of ICD-10 codes. During the one year pilot trial, patients seen in the 2 EDs, who are >= 18 years old will be identified by ICD(International Classification of Diseases)-10 codes for pneumonia or acute respiratory failure or sepsis with secondary pneumonia codes (estimated to comprise 1800 patients). Exclusion Criteria: For all above patients: Patients seen with a history of recent trauma. Subsequent episodes of pneumonia from the same patient within the study period. Patients directly admitted to hospice/comfort care. Patients admitted to a non-study hospital for further care. Patients transferred from outside hospitals. For the groups selected by ICD-10 pneumonia codes, an additional exclusion is: • Patients without radiographic evidence of pneumonia or with clear radiographic evidence for an alternative diagnosis.