How a Sepsis Alert Affects Sepsis Performance & What You Need to Understand for Improved Sepsis Outcomes
By Tim Kuebelbeck, Chief Customer Officer, Ambient Clinical Analytics
Left untreated, sepsis can be described as a runaway train for a patient’s immune system response to an infection, rapidly developing into a life-threatening medical event. Time is critical to ensure the proper clinical therapies are delivered in the appropriate timeframe. Minutes can be the difference between tissue damage, amputation, long term organ damage, and death--or returning to a normal life. This makes an effective sepsis alert extraordinarily important in a hospital or health system. According to the Sepsis Alliance, sepsis kills 270,000 Americans annually, is the number 1 cost driver in hospitalizations, and is the primary cause for readmission in hospitals. Globally, sepsis accounts for 20% of all deaths.
...Even the most vigilant humans get tired, make mistakes, and miss subtle patterns¹. Designing and implementing a sepsis alert system in your hospital or health system is crucial to early detection and in ensuring mistakes and missed cues are minimized. There are two different types of a sepsis alert; an Indicative Algorithm sepsis alert and a Predictive (AI / Machine Learning) sepsis alert. Retrospective studies demonstrate that machine learning models can accurately predict sepsis and septic shock onset. Vetted clinical studies at the bedside are needed to assess both predictive and indicative algorithm effects on patient-relevant outcomes.
Ambient Clinical Analytics and Cohere Med are excellent examples of a clinically vetted indicative sepsis alert and a predictive sepsis alert. Ambient has an end to end sepsis alert patient tracker board called Sepsis DART™ that was clinically vetted with Mayo Clinic and includes a indicative sepsis alert algorithm that is customizable by each health system, and even customizable by unit. Sepsis DART™ is an FDA CLASS II approved solution. Cohere has an predictive artificial intelligence sepsis alert algorithm called Deep Sepsis that was clinically vetted at Duke Health and is built on 32 million points of patient data for early detection of sepsis. Ambient and Cohere have a formal relationship. That relationship allows Cohere’s Deep Sepsis AI algorithm to operate in Ambient’s Sepsis Dart™ solution along with Ambient’s customizable indicative sepsis alert algorithms for clients who choose to utilize machine learning inside of Sepsis DART™.
Specificity and sensitivity are a crucial part of an effective sepsis alert. If a sepsis alert has low specificity, which causes a high false alert ratio, then physicians and nurses may start to ignore the sepsis alert over time. Conversely, if the sensitivity is too low, the sepsis alert may not cast a wide enough net to catch the majority of your sepsis cases.
A warning to anyone researching a vendor that provides a sepsis alert solution, there are multitudes of claims by companies to the efficacy of their sepsis alert algorithm in terms of sensitivity and specificity, but few have scientific, clinical, peer reviewed, and published studies to back it up. Ambient has several peer reviewed published articles with Mayo Clinic that scientifically proves the efficacy of their sepsis alert solutions as does Cohere with Duke Health.
Another cautionary note, a sepsis alert, although very important, is a tiny portion of the entire sepsis solution. Solving sepsis is not an algorithm race. In addition, health systems continue to deploy non-FDA cleared algorithmic EHR electronic sepsis alert solutions that have proven to be ineffective, rather than deploy FDA cleared sepsis alert solutions. Sepsis alert solutions that are clinically vetted and FDA cleared will facilitate accurate and early sepsis detection and more importantly, drive delivery of the sepsis bundle within the appropriate time windows. Carrying pocket sepsis bundle cards, using egg timers and other manual labor-intensive approaches is never the answer, and neither is a non-FDA cleared EHR deployed sepsis alert solution. Delivering appropriate care requires a multidisciplinary approach utilizing a communication platform like Sepsis DART™. CMS data have shown that since implementation, organizations that follow all the steps have significantly lower mortality rates for patients diagnosed with severe sepsis and septic shock².
The current health system model of deploying a non-FDA cleared EHR sepsis alert solution drives a U.S. national average of 49% bundle compliance for sepsis³. Which is why health systems lose enormous amounts of money on treating sepsis patients. To be clear this means that less than 50% of patients or less than 1 in 2 patients with sepsis receive appropriate treatment. It also highlights the massive failure by hospitals and health systems in using non-FDA approved sepsis alert solutions and that the current strategy needs to be fixed. In the U.S. we have one of the greatest healthcare systems in the world, and for sepsis patients we are failing in over half of that population when it comes to sepsis treatment, we must do better and it all starts with an effective sepsis alert.
For more information on how you can drive sepsis improvement in your organization with Ambient Clinical Analytics please contact tim.kuebelbeck@ambientclinical.com.
About Ambient Clinical Analytics - As an industry leader, Ambient is supporting leading healthcare systems and has done so since its founding in 2013. Our solutions are designed by clinicians to be easy-to-use by every caregiver in your organization and are configured to be up and running rapidly. We are trusted by a community of high-performing healthcare providers across the United States. Our solutions are powerful real-time point-of-care and remote patient monitoring healthcare platforms designed to deliver data visualization, communication, and analytics based clinical decision support solutions.
Ambient’s AWARE™ solution is an exceptionally secure, high-performance, FDA Class II approved and CE Marking certified Software as a Medical Device (SaMD) platform. Ambient’s Sepsis DART™ solution is also an FDA Class II approved and CE Marking certified. Sepsis DART™ has been accepted into the Patient Safety Movement’s Actionable Patient Safety Solutions (APSS) #9 for Sepsis. Ambient has achieved ISO 13485:2016 certification, an internationally recognized quality standard specific to the medical device industry. The ISO 13485 standard sets out the requirements for a quality management system specific to the medical device industry. Ambient is also deploying the AWARE™ family of solutions, to help manage COVID-19. Ambient’s Virtual ICU platforms are ideal for dealing with current and possible future outbreaks. For more information, visit https://ambientclinical.com.
Left untreated, sepsis can be described as a runaway train for a patient’s immune system response to an infection, rapidly developing into a life-threatening medical event. Time is critical to ensure the proper clinical therapies are delivered in the appropriate timeframe. Minutes can be the difference between tissue damage, amputation, long term organ damage, and death--or returning to a normal life. This makes an effective sepsis alert extraordinarily important in a hospital or health system. According to the Sepsis Alliance, sepsis kills 270,000 Americans annually, is the number 1 cost driver in hospitalizations, and is the primary cause for readmission in hospitals. Globally, sepsis accounts for 20% of all deaths.
...Even the most vigilant humans get tired, make mistakes, and miss subtle patterns¹. Designing and implementing a sepsis alert system in your hospital or health system is crucial to early detection and in ensuring mistakes and missed cues are minimized. There are two different types of a sepsis alert; an Indicative Algorithm sepsis alert and a Predictive (AI / Machine Learning) sepsis alert. Retrospective studies demonstrate that machine learning models can accurately predict sepsis and septic shock onset. Vetted clinical studies at the bedside are needed to assess both predictive and indicative algorithm effects on patient-relevant outcomes.
Ambient Clinical Analytics and Cohere Med are excellent examples of a clinically vetted indicative sepsis alert and a predictive sepsis alert. Ambient has an end to end sepsis alert patient tracker board called Sepsis DART™ that was clinically vetted with Mayo Clinic and includes a indicative sepsis alert algorithm that is customizable by each health system, and even customizable by unit. Sepsis DART™ is an FDA CLASS II approved solution. Cohere has an predictive artificial intelligence sepsis alert algorithm called Deep Sepsis that was clinically vetted at Duke Health and is built on 32 million points of patient data for early detection of sepsis. Ambient and Cohere have a formal relationship. That relationship allows Cohere’s Deep Sepsis AI algorithm to operate in Ambient’s Sepsis Dart™ solution along with Ambient’s customizable indicative sepsis alert algorithms for clients who choose to utilize machine learning inside of Sepsis DART™.
Specificity and sensitivity are a crucial part of an effective sepsis alert. If a sepsis alert has low specificity, which causes a high false alert ratio, then physicians and nurses may start to ignore the sepsis alert over time. Conversely, if the sensitivity is too low, the sepsis alert may not cast a wide enough net to catch the majority of your sepsis cases.
A warning to anyone researching a vendor that provides a sepsis alert solution, there are multitudes of claims by companies to the efficacy of their sepsis alert algorithm in terms of sensitivity and specificity, but few have scientific, clinical, peer reviewed, and published studies to back it up. Ambient has several peer reviewed published articles with Mayo Clinic that scientifically proves the efficacy of their sepsis alert solutions as does Cohere with Duke Health.
Another cautionary note, a sepsis alert, although very important, is a tiny portion of the entire sepsis solution. Solving sepsis is not an algorithm race. In addition, health systems continue to deploy non-FDA cleared algorithmic EHR electronic sepsis alert solutions that have proven to be ineffective, rather than deploy FDA cleared sepsis alert solutions. Sepsis alert solutions that are clinically vetted and FDA cleared will facilitate accurate and early sepsis detection and more importantly, drive delivery of the sepsis bundle within the appropriate time windows. Carrying pocket sepsis bundle cards, using egg timers and other manual labor-intensive approaches is never the answer, and neither is a non-FDA cleared EHR deployed sepsis alert solution. Delivering appropriate care requires a multidisciplinary approach utilizing a communication platform like Sepsis DART™. CMS data have shown that since implementation, organizations that follow all the steps have significantly lower mortality rates for patients diagnosed with severe sepsis and septic shock².
The current health system model of deploying a non-FDA cleared EHR sepsis alert solution drives a U.S. national average of 49% bundle compliance for sepsis³. Which is why health systems lose enormous amounts of money on treating sepsis patients. To be clear this means that less than 50% of patients or less than 1 in 2 patients with sepsis receive appropriate treatment. It also highlights the massive failure by hospitals and health systems in using non-FDA approved sepsis alert solutions and that the current strategy needs to be fixed. In the U.S. we have one of the greatest healthcare systems in the world, and for sepsis patients we are failing in over half of that population when it comes to sepsis treatment, we must do better and it all starts with an effective sepsis alert.
For more information on how you can drive sepsis improvement in your organization with Ambient Clinical Analytics please contact tim.kuebelbeck@ambientclinical.com.
About Ambient Clinical Analytics - As an industry leader, Ambient is supporting leading healthcare systems and has done so since its founding in 2013. Our solutions are designed by clinicians to be easy-to-use by every caregiver in your organization and are configured to be up and running rapidly. We are trusted by a community of high-performing healthcare providers across the United States. Our solutions are powerful real-time point-of-care and remote patient monitoring healthcare platforms designed to deliver data visualization, communication, and analytics based clinical decision support solutions.
Ambient’s AWARE™ solution is an exceptionally secure, high-performance, FDA Class II approved and CE Marking certified Software as a Medical Device (SaMD) platform. Ambient’s Sepsis DART™ solution is also an FDA Class II approved and CE Marking certified. Sepsis DART™ has been accepted into the Patient Safety Movement’s Actionable Patient Safety Solutions (APSS) #9 for Sepsis. Ambient has achieved ISO 13485:2016 certification, an internationally recognized quality standard specific to the medical device industry. The ISO 13485 standard sets out the requirements for a quality management system specific to the medical device industry. Ambient is also deploying the AWARE™ family of solutions, to help manage COVID-19. Ambient’s Virtual ICU platforms are ideal for dealing with current and possible future outbreaks. For more information, visit https://ambientclinical.com.
- Strickland, Eliza, Hospitals Roll Out AI Systems to Keep Patients From Dying of Sepsis, IEEE Spectrum, October 19, 2018
- HHS.gov, Largest Study of Sepsis Cases among Medicare Beneficiaries Finds Significant Burden, HHS.gov, February 14, 2020
- Castellucci, M., Just 49% of hospitals follow CMS’ sepsis treatment protocols, Modern Healthcare, July 27, 2018