Digital tools assist in the fight against sepsis

Digital Health
13 September 2019

Patients with life-threatening sepsis will be identified faster and treated more effectively thanks to several projects which harness the power of digital healthcare tools.

Friday 13 September is World Sepsis Day, bringing focus to a medical emergency in which the body responds so severely to an infection that it starts to attack and injure its own tissues and organs.

Moves are underway to deploy state-wide in 2020 a ‘sepsis alert’ into the electronic medical record (EMR), to assist clinicians to identify those at risk of the illness beyond the ED waiting room, using established decision-support methodologies.

Building on the CEC’s SEPSIS KILLS program, eHealth NSW will link an electronic sepsis alert to clinical decision support in the EMR, to ensure that patients with sepsis are recognised early and treated urgently with intravenous antibiotics.

Clinical Lead and Emergency physician Dr Amith Shetty said: “The numerous risk factors and often undifferentiated presentations of serious infections mean that novel digital platforms are great tools for collecting and synthesising this information better.”

Trialled in Western Sydney Local Health District, this project is a collaboration between eHealth NSW and the Clinical Excellence Commission (CEC).

“This electronic alert will support clinicians to rapidly identify patients who have sepsis, allowing them to commence treatment sooner,” said CEC Director Systems Improvement Dr Harvey Lander.

Thanks to the SEPSIS KILLS program, NSW Health staff have almost halved the time it takes for sepsis patients to start life-saving antibiotic treatment. Since its introduction, the median time to start antibiotics has dropped to 59 minutes in 2018 from 104 minutes in 20111.

This has helped many patients, including those particularly vulnerable to sepsis – the very young, the very old, those with chronic illnesses and those who have a weakened or impaired immune system.

At-risk patients awaiting treatment in emergency departments (EDs) will also be pinpointed more quickly and effectively via PathWay, an Internet of Things (IoT)-based tool which allows real-time connectivity of medical devices with clinical information systems.

A collaboration between eHealth NSW and NSW Health Pathology, this 18-month proof of concept project aims to avoid unnecessary delays in identifying sepsis, as slower time to treatment increases a patient’s risk of death, serious morbidity and other long-term disabilities.

“The PathWay project will use the factors that clinical experts identify as indicative of sepsis – then take things to the next level,” said Lachlan Rudd, Director of Data and Analytics at eHealth NSW.

“An artificial intelligence (AI) algorithm will combine this knowledge with data in the EMR to understand the nuance of what sepsis looks like for NSW Health patients.

“Building a tool around this algorithm will allow our ED clinicians to better catch and treat sepsis for patients in the waiting room, where due to the hectic nature of emergency departments, clinicians are unable to physically observe all patients at all times.”

What is sepsis – and what are the signs?

  • One of the world’s leading causes of death in hospital patients, sepsis can present in any patient, in any clinical setting.
  • Sepsis symptoms to be alert for in very unwell adult patients with an infection include muscle pain, shivering, breathlessness, confusion or not passing urine for more than a day.
  • If a child is unwell with an infection, alert symptoms include very high or very low temperature, very fast breathing, confusion, a ‘fit’ or convulsion, mottled skin, lethargy, not feeding, and repeated vomiting.

1. Clinical Excellence Commision: Sepsis Recognition, Resuscitation and Referral

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