October 28, 2011
Fighting sepsis with health IT
Sepsis, which used to be called blood poisoning, is a life-threatening disease that arises when the body’s response to infection injures its own tissue and organs. It affects nearly 750,000 Americans annually, resulting in a mortality rate of almost 29%. Recognition of potentially septic patterns within the first two hours of their appearance is vital to the survival of the patient.
developed the St.
John Sepsis agent in order to help clinicians recognize these patterns and get
patients the treatment they need. Heartland Health
in St. Joseph, Mo., was one of the first health care organizations to begin
using the agent. Joe Boyce, CMIO at Heartland Health, recently shared some
insight on why his organization decided to use the agent, and the benefits
they’ve seen to this point.
early detection enable Heartland Health to better treat, and even prevent,
Sepsis signs can be subtle, but automated monitoring of key
elements can help identify problems hours earlier. Scrubbing a few hours off
antibiotic administration for a septic patient can save organs and lives. This
is a proven alert, the precursor of many in the field of clinical decision
support. Basically, rules makes it “ok” for the nurse to call the
physician with a consistent, coherent, scripted message, which makes it better
for all involved – physicians, nurses, and most importantly, patients.
How will the
St. John Sepsis agent help Heartland standardize care for septic and suspected
The agent lets the tireless computer monitor the patient and
alert human caregivers for consideration of a patient who may be on the brink. With
the huge data load we are asking new clinicians to process, the computer
“having my back” is essential for consistent, safe care. Someday soon, it will
be malpractice not to have these systems in place.
Heartland currently have a sepsis monitoring system in place today? If
so, how much time was/is spent researching, developing and maintaining the
entire alert protocol? What are the comparison metrics regarding the
sensitivity and specificity of the alerts?
We had previously done an ED sepsis look, and that helped us
understand the benefit and complexity of the rule build and
information/alerting process. Rules are just half of it – notifying the right
caregiver and making the right response easy is also key.
foresee a financial impact (positive or negative) due to additional diagnosis
capture, based off of the St. John Sepsis early warning alerts?
We have already shown ROI from our ED rule in improved
coding and earlier discharge.
What led your
organization to work with Cerner and use the St. John sepsis agent?
We jumped at the opportunity, given the clear benefits of
centralization for rule development, scalability, support and much larger
volumes of comparison data across multiple clients. This is just the beginning
for centralized CDS.