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An AI tool that analyzes nurses' data and notes detected when patients in the hospital were deteriorating nearly two days earlier than traditional methods and reduced the risk of death by over 35%, found a year-long clinical trial of more than 60,000 patients led by researchers at Columbia University. The new AI tool, CONCERN Early Warning System, uses machine learning to analyze nursing documentation patterns to predict when a hospitalized patient is deteriorating before the change is reflected in vital signs, allowing for timely, life-saving interventions. In the study, CONCERN shortened the average hospital stay by more than half a day and led to a 7.
5% decrease in risk of sepsis. Patients monitored by CONCERN were roughly 25% more likely to be transferred to an intensive care unit compared to those who had usual care. Nurses are particularly skilled and experienced in detecting when something is wrong with patients under their care.
When we can combine that expertise with AI, we can produce real-time, actionable insights that save lives." Sarah Rossetti, lead author of the study and associate professor of biomedical informatics and nursing at Columbia University The findings were published today in Nature Medicine . CONCERN reflects nurses' concerns Nurses often recognize subtle signs that a patient is deteriorating, such as pallor change or small changes in mental status.
But their concerns, noted in a patient's electronic health record, may not cause immediate intervention, such as transfer to an intensive care unit. Related Stories T-shirt monitor helps patients recover at home after urological surgery Personalized home visits significantly reduce hospital admissions for older adults with frailty Indiana lawmakers seek to forbid hospital monopolies, but one merger fight remains CONCERN analyzes when nurses identify and respond to these small, but meaningful changes, by looking at nurses increased surveillance of patients, including frequency and time of assessments,, in a model that generates hourly, easy-to-read risk scores to support clinical decision-making. "The CONCERN Early Warning System would not work without the decisions and expert opinions of nurses' data inputs," said Rossetti.
"By making nurses' expert instincts visible to the entire care team, this technology ensures faster interventions, better outcomes, and ultimately, more lives saved." Columbia University Irving Medical Center Rossetti, S. C.
, et al . (2025). Real-time surveillance system for patient deterioration: a pragmatic cluster-randomized controlled trial.
Nature Medicine . doi.org/10.
1038/s41591-025-03609-7 ..
