Sepsis a Deadly Complication of Covid-19 is Making Sepsis Detection & Sepsis Alert Technology More Important Than Ever
By Bill Hockstedler, Ambient Clinical Analytics – Vice President, Strategic Development
As I write this, I am hoping that I see the COVID-19 pandemic in the rearview mirror soon. Not only are therapies helping those stricken with this deadly virus, there are now several promising vaccines that will start to become available soon. The topic of sepsis detection should be at the top of every provider’s mind especially with the onset of the influenza season. Symptoms like a cough, fever, and shortness of breath could be signs of influenza or COVID-19. As many as 80% of sepsis deaths could be prevented with rapid diagnosis and treatment. However, in part due to poor compliance with best practices, in the United States alone, approximately 270,000 people die from Sepsis every year. With the uptick in influenza and spike in COVID-19 both leading to increased sepsis cases, it is likely time for your hospital to rethink your EMR/EHR based approach to sepsis detection protocols and evaluate an end-to-end sepsis detection and treatment solution. Start-to-finish sepsis detection and treatment tools are extremely effective at early identification, early intervention, and timely delivery of the appropriate bundle elements. Furthermore, providing complete sepsis detection and delivery of treatment gives health systems the ability to tune algorithms to a location and the unit level allowing hospitals to run multiple algorithms in one hospital. Unit specific algorithms make high false positives and false alerts a thing of the past and restores a physician’s and nurses’ faith in the sepsis detection system.
For those who survive sepsis, one of the most prevailing comments is they can’t believe how sick they were. Outcomes and long-term disabilities from failure to fire a timely sepsis alert and drive treatment include death, amputations of legs and fingertips, organ dysfunction, and increased odds of cognitive impairment. If a sepsis detection and treatment system recognize and drives early intervention and timely treatment, many patients would not lose their limbs and fingertips, and if they survived, many more would not be facing a much lower quality of life. Healthcare providers can and must do more than is currently being done in hospitals to drive an appropriate sepsis alert that then drives the treatment protocols. Many attempts to use an existing EHR for the sepsis alert have been tried and all that I am aware of have failed. We often see a mild uptick in bundle compliance using the current EMR/EHR technologies that allow for greater specificity and sensitivity. But the simple truth is, without exception, we see the sepsis outcomes and CMS bundle compliance results quickly go back to where they were before the health system invested in and embarked on an expensive and time-consuming EHR effort.
Innovative healthcare providers have recognized that an EHR sepsis alert is not enough to improve outcomes and recognize that reliance on EHR’s alone is limiting. Candidly, EHR based sepsis detection is not woven into the clinician’s workflow in a useful and meaningful way and never will be. To fix this, the EHR must be complemented with technology that is designed to support the physician and nurse with intuitive interactions and with patient data that empowers both physicians and nurses to intervene early and drive care beyond bundle compliance. In other words, sending the appropriate sepsis alert to the appropriate person and at the appropriate time. The ability to see septic patients through the eyes of an intensivist using FDA Class II sepsis detection and sepsis alert solutions drastically improves the care processes and outcomes provided to patients. Information is only beneficial if it can be accessed and consumed in a way that does not disrupt, but rather compliments, a physician’s decision-making process. Sepsis DART™ (Detection and Response Tool) makes good on the promise of the digital future by integrating physician’s and nurse’ care process into EHR workflows. Fixing the root cause of clinical under-performance requires understanding the real-world care process and assimilating into that care process. We are starting to see not just the innovative health systems but also smaller hospitals abandoning their EHR sepsis detection efforts and deploying sepsis detection and treatment products like Sepsis DART™ that provides a fully developed solution that drives the entire care process.
A major lagging indicator of poor clinical performance is an elevated cost of care, and excellent clinical outcomes are typically followed by indications of a lower cost of care. There are several sources and articles over the years that prove this. Specific to sepsis treatment, according to a recent article in HFMA small hospitals experience net margin losses of ~$9.9M and larger hospitals experience a net margin loss of ~$33.9M on sepsis treatment. A fully FDA compliant solution deployed in a hospital will deliver bundle compliance into the high 70th to mid 80th percentile in under 30 days (versus 49% on average today), not to mention change the financial picture for hospitals. Even more important, deploying an FDA compliant sepsis detection or remote patient monitoring solution will drive massive positive change for patient outcomes in your organization.
Educating the general public is also an important element of sepsis detection. Helping potential septic patients recognize and act on the illness early is crucial to sepsis detection. Also, just as important is further education of care providers that COVID-19 and influenza can and will lead to sepsis. A recent survey found that only one-third of U.S. adults are aware that sepsis is a potential complication of COVID-19. In addition, only 15% of U.S. adults can identify all four common signs and symptoms of sepsis, and one-quarter do not know any of the symptoms.
On September 21, 2020, the American Medical Association added the following to their website: “Surviving severe COVID-19 means surviving viral sepsis. And while there is little published data on long-term outcomes of severe COVID-19, what is known is that recovering from sepsis caused by other pathogens is a long and difficult process that includes, among other things, increased odds of cognitive impairment and functional limitations—even down to inability to bathe, toilet or dress independently.”
Ambient’s Sepsis DART™ (Detection and Response Tool) is an FDA Class II approved remote patient monitoring solution that is designed to encompass all three of the critical focus areas. Sepsis DART™ has a patient tracker board that provides automatic sepsis surveillance and at-a-glance awareness of patient status, enabling the remote monitoring of large numbers of patients simultaneously. Sepsis DART™ also uses smart alerts that directly notify care givers of a potential sepsis development in a patient and using smart escalation it continues to notify care givers until someone on the team takes action. Sepsis DART™, most importantly, graphically tracks the delivery of the sepsis care bundle (as appropriate for that patient) while providing reminders where elements of the bundle may be in jeopardy of not being delivered correctly or in a timely fashion.
If you would like to learn more about Sepsis DART™ and how it positively affects sepsis detection and treatment in your organization, watch the following educational webinar featuring University of Alabama Birmingham Medicine.
https://attendee.gotowebinar.com/recording/2166666138769220355
About Ambient Clinical Analytics
As I write this, I am hoping that I see the COVID-19 pandemic in the rearview mirror soon. Not only are therapies helping those stricken with this deadly virus, there are now several promising vaccines that will start to become available soon. The topic of sepsis detection should be at the top of every provider’s mind especially with the onset of the influenza season. Symptoms like a cough, fever, and shortness of breath could be signs of influenza or COVID-19. As many as 80% of sepsis deaths could be prevented with rapid diagnosis and treatment. However, in part due to poor compliance with best practices, in the United States alone, approximately 270,000 people die from Sepsis every year. With the uptick in influenza and spike in COVID-19 both leading to increased sepsis cases, it is likely time for your hospital to rethink your EMR/EHR based approach to sepsis detection protocols and evaluate an end-to-end sepsis detection and treatment solution. Start-to-finish sepsis detection and treatment tools are extremely effective at early identification, early intervention, and timely delivery of the appropriate bundle elements. Furthermore, providing complete sepsis detection and delivery of treatment gives health systems the ability to tune algorithms to a location and the unit level allowing hospitals to run multiple algorithms in one hospital. Unit specific algorithms make high false positives and false alerts a thing of the past and restores a physician’s and nurses’ faith in the sepsis detection system.
For those who survive sepsis, one of the most prevailing comments is they can’t believe how sick they were. Outcomes and long-term disabilities from failure to fire a timely sepsis alert and drive treatment include death, amputations of legs and fingertips, organ dysfunction, and increased odds of cognitive impairment. If a sepsis detection and treatment system recognize and drives early intervention and timely treatment, many patients would not lose their limbs and fingertips, and if they survived, many more would not be facing a much lower quality of life. Healthcare providers can and must do more than is currently being done in hospitals to drive an appropriate sepsis alert that then drives the treatment protocols. Many attempts to use an existing EHR for the sepsis alert have been tried and all that I am aware of have failed. We often see a mild uptick in bundle compliance using the current EMR/EHR technologies that allow for greater specificity and sensitivity. But the simple truth is, without exception, we see the sepsis outcomes and CMS bundle compliance results quickly go back to where they were before the health system invested in and embarked on an expensive and time-consuming EHR effort.
Innovative healthcare providers have recognized that an EHR sepsis alert is not enough to improve outcomes and recognize that reliance on EHR’s alone is limiting. Candidly, EHR based sepsis detection is not woven into the clinician’s workflow in a useful and meaningful way and never will be. To fix this, the EHR must be complemented with technology that is designed to support the physician and nurse with intuitive interactions and with patient data that empowers both physicians and nurses to intervene early and drive care beyond bundle compliance. In other words, sending the appropriate sepsis alert to the appropriate person and at the appropriate time. The ability to see septic patients through the eyes of an intensivist using FDA Class II sepsis detection and sepsis alert solutions drastically improves the care processes and outcomes provided to patients. Information is only beneficial if it can be accessed and consumed in a way that does not disrupt, but rather compliments, a physician’s decision-making process. Sepsis DART™ (Detection and Response Tool) makes good on the promise of the digital future by integrating physician’s and nurse’ care process into EHR workflows. Fixing the root cause of clinical under-performance requires understanding the real-world care process and assimilating into that care process. We are starting to see not just the innovative health systems but also smaller hospitals abandoning their EHR sepsis detection efforts and deploying sepsis detection and treatment products like Sepsis DART™ that provides a fully developed solution that drives the entire care process.
A major lagging indicator of poor clinical performance is an elevated cost of care, and excellent clinical outcomes are typically followed by indications of a lower cost of care. There are several sources and articles over the years that prove this. Specific to sepsis treatment, according to a recent article in HFMA small hospitals experience net margin losses of ~$9.9M and larger hospitals experience a net margin loss of ~$33.9M on sepsis treatment. A fully FDA compliant solution deployed in a hospital will deliver bundle compliance into the high 70th to mid 80th percentile in under 30 days (versus 49% on average today), not to mention change the financial picture for hospitals. Even more important, deploying an FDA compliant sepsis detection or remote patient monitoring solution will drive massive positive change for patient outcomes in your organization.
Educating the general public is also an important element of sepsis detection. Helping potential septic patients recognize and act on the illness early is crucial to sepsis detection. Also, just as important is further education of care providers that COVID-19 and influenza can and will lead to sepsis. A recent survey found that only one-third of U.S. adults are aware that sepsis is a potential complication of COVID-19. In addition, only 15% of U.S. adults can identify all four common signs and symptoms of sepsis, and one-quarter do not know any of the symptoms.
On September 21, 2020, the American Medical Association added the following to their website: “Surviving severe COVID-19 means surviving viral sepsis. And while there is little published data on long-term outcomes of severe COVID-19, what is known is that recovering from sepsis caused by other pathogens is a long and difficult process that includes, among other things, increased odds of cognitive impairment and functional limitations—even down to inability to bathe, toilet or dress independently.”
Ambient’s Sepsis DART™ (Detection and Response Tool) is an FDA Class II approved remote patient monitoring solution that is designed to encompass all three of the critical focus areas. Sepsis DART™ has a patient tracker board that provides automatic sepsis surveillance and at-a-glance awareness of patient status, enabling the remote monitoring of large numbers of patients simultaneously. Sepsis DART™ also uses smart alerts that directly notify care givers of a potential sepsis development in a patient and using smart escalation it continues to notify care givers until someone on the team takes action. Sepsis DART™, most importantly, graphically tracks the delivery of the sepsis care bundle (as appropriate for that patient) while providing reminders where elements of the bundle may be in jeopardy of not being delivered correctly or in a timely fashion.
If you would like to learn more about Sepsis DART™ and how it positively affects sepsis detection and treatment in your organization, watch the following educational webinar featuring University of Alabama Birmingham Medicine.
https://attendee.gotowebinar.com/recording/2166666138769220355
About Ambient Clinical Analytics
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- - 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 healthcare platforms designed to deliver data visualization, communication, and analytics based clinical decision support solutions.
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- 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™ product 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.