Tele-Sepsis™, Using Remote Patient Monitoring for Sepsis as a Service
By Tim Kuebelbeck, Chief Customer Officer at Ambient Clinical Analytics
Today’s Telehealth & Telemedicine Approach
Today’s solutions in telemedicine are typically thought of as remote viewing and video office visits to allow nurses and physicians to “see” patients who are not in their direct physical location. Many early solutions have been developed to simply see the patient and allow for billing. Nevertheless, many health organizations don’t understand telehealth is much larger than that and expands far beyond the ‘front door’. Sophisticated telemedicine solutions aid in uniting patients with physicians and nurses to provide and monitor care, regardless if the patient is at home or physically inside a hospital. At Ambient Clinical Analytics (ACA), we have developed DART™ (Detection and Response Tool) to do exactly that and more. Early telehealth tools allow for clinicians to only see the patient, sophisticated tools like DART™ provide early detection and monitor the delivery of care process using remote patient monitoring to ensure nothing slips through the cracks. Your solution providers must be able to offer the technology for inhouse and remote patient monitoring as well as a full-service outsourced Sepsis as a Service staffing model.
Currently the market thinks about virtual care as a front door to the health system. However, it is time we start to think differently about how we approach virtual care because it’s not just a ‘front door’ to a healthcare system. It is much more than that. A CEO of a major healthcare organization in Minneapolis recently said, “The technology exists to completely transform the way health care is done but the infrastructure is so deeply rooted that it makes change difficult. We’re just at the beginning of true transformation in this industry. It’s been stagnant for way too long.”
At ACA we couldn’t agree more. Virtual care is not a difficult way to deliver care, in fact it’s readily available and in many instances, it’s increasingly the best way to deliver care once a patient is already past your ‘front door’ and inside your healthcare system. If healthcare leaders are going to transform healthcare delivery, they must start looking at and deploying some of these existing technologies. Those technologies must be seamless, protected, and integrated into existing workflows so that our patients are provided with the best experience and outcomes. Providing care to patients shouldn’t be hard and ACA makes it easy by helping you monitor and engage with your patients at the right time and right place.
With the COVID-19 pandemic, the requirement for telehealth solutions to curtail the spread of infectious diseases is more evident than ever. Prior to COVID-19 telehealth and remote patient monitoring saw relatively slow growth. True telehealth platforms will not only provide a means to communicate between patient and clinicians. It will also help with early detection, drive the clinical process to make sure appropriate care is delivered, and ensure that care occurs in a timely fashion. Solutions capable of driving the clinical process will deliver improved outcomes. With sophisticated solutions like DART™ the capacity for providers to care for patients remotely is reducing the spread of disease, preserving PPE, and delivering better continuity of care and thus quality of care.
Using Remote Patient Monitoring for Sepsis as a Service (Tele-Sepsis™)
While DART™ can be used for early detection and monitoring of any clinical issue a patient could experience, ACA chose to first apply the technology to sepsis. ACA has many clients successfully monitoring and treating septic patients using the solution. While deploying Sepsis DART™ in hospital systems across the U.S. this year, ACA saw three effective response models, depending on the quality systems, management processes, and investment levels at the hospital.
Any of these three models by themselves or combined, coupled with the right automated sepsis surveillance solution (like Sepsis DART™) will yield substantial patient outcome improvements and cost reductions. The model that will work for an individual health system will depend on the system design and workflow of each hospital, and there are many differences, especially in the quality of the staffing, information electronically available, and the investment made in centralized functions like sepsis response and central incidence management.
Because of the difference in staffing capacity, staffing quality, and investments at hospitals and health systems, ACA now offers a full service, end to end Tele-Sepsis™ program for remote patient monitoring and sepsis as a service.
Tele-Sepsis™ or Sepsis as a Service
This brings us to the newest innovation and maybe one of the most important for solving sepsis in every facility across the United States. Tele-Sepsis™ and remote patient monitoring vendors need to provide Sepsis as a Service or Tele-Sepsis™. With many hospital and health system organizations unable to fund the investment to create a centralized Clinical Control Tower environment or the inability to staff sepsis surveillance teams 24/7, it is important to pick a sepsis detection solution (like Sepsis DART™) that allows for Sepsis as a Service or Tele-Sepsis™. Companies like Ambient can provide outsourced onsite and/or remote patient monitoring for sepsis through their Clinical Control Tower technology. A services model for a Tele-Sepsis™ or a sepsis as a service program should include the following:
Delivering Care and Quality Beyond the Bundle Elements
This brings us to the last component, which is delivering care and the sepsis bundle elements within the appropriate time windows. Beyond driving early intervention, it is critical that your sepsis detection solution has sepsis patient tracker board functionality that provides automatic sepsis surveillance and at-a-glance awareness of patient status, enabling bedside and remote monitoring of large numbers of patients simultaneously. Tele-Sepsis™ solutions must also employ smart notifications that directly notify the right care givers at the right time of a potential sepsis development in a patient and using smart escalation, continue to notify care givers via a smart sepsis alert until someone on the team takes the appropriate action. Unlike EHR’s, Sepsis DART™ does all of this and most importantly, graphically tracks the delivery of the sepsis care bundle (as appropriate for that patient) while providing both smart sepsis alert notification and reminders where elements of the bundle may be in jeopardy of not being delivered correctly or in a timely fashion.
Summary
It is evident that despite improvements in modern statistical techniques and machine learning approaches, sepsis alert performance has not improved much in the past decade. This lack of improvement can be attributed to many constraints in a health system such as the EHR, lack of budget, lack of expertise, and many others. Over the years and especially in 2020, at ACA we have learned that in recognizing and treating sepsis there are four elements critical to sepsis surveillance, improved clinical outcomes, and reduced mortality for effected patients regardless of if your using Tele-Sepsis™ internally or if your using outsourced sepsis as a service.
For more detailed information on how you can solve sepsis 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 healthcare platforms designed to deliver life-saving solutions using data visualization, communication, and analytics based clinical decision support.
Ambient’s AWARE™ and Sepsis DART™ solutions are exceptionally secure, high-performance, FDA Class II approved and CE Marking certified Software as a Medical Device (SaMD) platforms. 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.
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Today’s Telehealth & Telemedicine Approach
Today’s solutions in telemedicine are typically thought of as remote viewing and video office visits to allow nurses and physicians to “see” patients who are not in their direct physical location. Many early solutions have been developed to simply see the patient and allow for billing. Nevertheless, many health organizations don’t understand telehealth is much larger than that and expands far beyond the ‘front door’. Sophisticated telemedicine solutions aid in uniting patients with physicians and nurses to provide and monitor care, regardless if the patient is at home or physically inside a hospital. At Ambient Clinical Analytics (ACA), we have developed DART™ (Detection and Response Tool) to do exactly that and more. Early telehealth tools allow for clinicians to only see the patient, sophisticated tools like DART™ provide early detection and monitor the delivery of care process using remote patient monitoring to ensure nothing slips through the cracks. Your solution providers must be able to offer the technology for inhouse and remote patient monitoring as well as a full-service outsourced Sepsis as a Service staffing model.
Currently the market thinks about virtual care as a front door to the health system. However, it is time we start to think differently about how we approach virtual care because it’s not just a ‘front door’ to a healthcare system. It is much more than that. A CEO of a major healthcare organization in Minneapolis recently said, “The technology exists to completely transform the way health care is done but the infrastructure is so deeply rooted that it makes change difficult. We’re just at the beginning of true transformation in this industry. It’s been stagnant for way too long.”
At ACA we couldn’t agree more. Virtual care is not a difficult way to deliver care, in fact it’s readily available and in many instances, it’s increasingly the best way to deliver care once a patient is already past your ‘front door’ and inside your healthcare system. If healthcare leaders are going to transform healthcare delivery, they must start looking at and deploying some of these existing technologies. Those technologies must be seamless, protected, and integrated into existing workflows so that our patients are provided with the best experience and outcomes. Providing care to patients shouldn’t be hard and ACA makes it easy by helping you monitor and engage with your patients at the right time and right place.
With the COVID-19 pandemic, the requirement for telehealth solutions to curtail the spread of infectious diseases is more evident than ever. Prior to COVID-19 telehealth and remote patient monitoring saw relatively slow growth. True telehealth platforms will not only provide a means to communicate between patient and clinicians. It will also help with early detection, drive the clinical process to make sure appropriate care is delivered, and ensure that care occurs in a timely fashion. Solutions capable of driving the clinical process will deliver improved outcomes. With sophisticated solutions like DART™ the capacity for providers to care for patients remotely is reducing the spread of disease, preserving PPE, and delivering better continuity of care and thus quality of care.
Using Remote Patient Monitoring for Sepsis as a Service (Tele-Sepsis™)
While DART™ can be used for early detection and monitoring of any clinical issue a patient could experience, ACA chose to first apply the technology to sepsis. ACA has many clients successfully monitoring and treating septic patients using the solution. While deploying Sepsis DART™ in hospital systems across the U.S. this year, ACA saw three effective response models, depending on the quality systems, management processes, and investment levels at the hospital.
- Upon sepsis alert remind all responsible team members
- Upon sepsis alert remind all responsible team members PLUS sepsis response teams
- Clinical control tower or clinical command center model for Tele-Sepsis™ and remote patient monitoring
Any of these three models by themselves or combined, coupled with the right automated sepsis surveillance solution (like Sepsis DART™) will yield substantial patient outcome improvements and cost reductions. The model that will work for an individual health system will depend on the system design and workflow of each hospital, and there are many differences, especially in the quality of the staffing, information electronically available, and the investment made in centralized functions like sepsis response and central incidence management.
Because of the difference in staffing capacity, staffing quality, and investments at hospitals and health systems, ACA now offers a full service, end to end Tele-Sepsis™ program for remote patient monitoring and sepsis as a service.
Tele-Sepsis™ or Sepsis as a Service
This brings us to the newest innovation and maybe one of the most important for solving sepsis in every facility across the United States. Tele-Sepsis™ and remote patient monitoring vendors need to provide Sepsis as a Service or Tele-Sepsis™. With many hospital and health system organizations unable to fund the investment to create a centralized Clinical Control Tower environment or the inability to staff sepsis surveillance teams 24/7, it is important to pick a sepsis detection solution (like Sepsis DART™) that allows for Sepsis as a Service or Tele-Sepsis™. Companies like Ambient can provide outsourced onsite and/or remote patient monitoring for sepsis through their Clinical Control Tower technology. A services model for a Tele-Sepsis™ or a sepsis as a service program should include the following:
- Monitoring the sepsis surveillance solution using a clinical command center technology such as Sepsis DART’s Clinical Control tower
- Working with the bed-side clinical teams in identifying and treating sepsis patients after a sepsis alert fires
- Provide training for sepsis response teams
- Managing the smart sepsis notification and smart escalation process to ensure treatment is in compliance with CMS bundle targets
- Lead sepsis related quality improvement projects for the hospital
- Develop process standards that meet best medical practices and regulatory requirements for supporting sepsis detection treatment and corresponding training modules
- Set-up a staffing program to include clinicians that have experience in treating sepsis patients
Delivering Care and Quality Beyond the Bundle Elements
This brings us to the last component, which is delivering care and the sepsis bundle elements within the appropriate time windows. Beyond driving early intervention, it is critical that your sepsis detection solution has sepsis patient tracker board functionality that provides automatic sepsis surveillance and at-a-glance awareness of patient status, enabling bedside and remote monitoring of large numbers of patients simultaneously. Tele-Sepsis™ solutions must also employ smart notifications that directly notify the right care givers at the right time of a potential sepsis development in a patient and using smart escalation, continue to notify care givers via a smart sepsis alert until someone on the team takes the appropriate action. Unlike EHR’s, Sepsis DART™ does all of this and most importantly, graphically tracks the delivery of the sepsis care bundle (as appropriate for that patient) while providing both smart sepsis alert notification and reminders where elements of the bundle may be in jeopardy of not being delivered correctly or in a timely fashion.
Summary
It is evident that despite improvements in modern statistical techniques and machine learning approaches, sepsis alert performance has not improved much in the past decade. This lack of improvement can be attributed to many constraints in a health system such as the EHR, lack of budget, lack of expertise, and many others. Over the years and especially in 2020, at ACA we have learned that in recognizing and treating sepsis there are four elements critical to sepsis surveillance, improved clinical outcomes, and reduced mortality for effected patients regardless of if your using Tele-Sepsis™ internally or if your using outsourced sepsis as a service.
- Early sepsis detection. Ideally this should be automated with sepsis surveillance happening in the background so the potential development of sepsis can be brought to the attention of a provider or nurse while they are providing care to their patients. Subtle changes may be taking place in the patient’s condition, and often the care team can become very focused on the current problem(s) they are dealing with and might miss the onset of sepsis.
- Early sepsis intervention. Detecting sepsis in a patient is great but does absolutely no good unless a provider steps in, reviews the patient’s case, and declares that the patient does indeed have sepsis, and then begin to institute treatment.
- Timely delivery of all required sepsis care elements. The treatment bundle for sepsis is well defined, and when delivered comprehensively within the defined time windows, provides remarkable improvements in not only the survivability of sepsis, but also in reductions of total care and length of hospitalization for patients who acquire sepsis. They (bundles) induced more consistent and timely application of evidence-based care and reduced practice variability.
- The ability to provide outsourced remote patient monitoring for Tele-Sepsis™ or sepsis as a service. Not all hospitals have access to budget or staffing to fully solve the sepsis issue in their organization. This is why it is so important that you have access to subject matter experts and outsourced end to end sepsis staffing and technology.
For more detailed information on how you can solve sepsis 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 healthcare platforms designed to deliver life-saving solutions using data visualization, communication, and analytics based clinical decision support.
Ambient’s AWARE™ and Sepsis DART™ solutions are exceptionally secure, high-performance, FDA Class II approved and CE Marking certified Software as a Medical Device (SaMD) platforms. 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.
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