Every year, more than 1.5 million Americans develop sepsis, an illness that occurs when the body exhibits an extreme reaction to an infection. It’s an elusive and stubborn condition that causes 250,000 deaths annually. “Sepsis is difficult to diagnose, and if not treated early, is associated with high mortality rates,” says Dr. Matthias Merkel, medical director of adult critical care and chief medical capacity officer at Oregon Health & Science University in Portland, Oregon. The difficulty of diagnosis — which requires careful clinical interpretation of symptoms — is why OHSU decided to work with GE Healthcare to create an app to lower sepsis risk in hospitals.
The project follows a broader partnership to develop a “mission control center” at OHSU to better track patient information and outcomes, making hospital stays safer and more efficient.
Last year, in collaboration with GE Healthcare, OHSU opened a control center that uses artificial intelligence to help manage care coordination between an academic health center connected to the university and the two community hospitals that make up the OHSU network. The three different institutions had three different systems for tracking electronic medical records, or EMRs; the challenge for GE Healthcare was to pull in multiple streams of patient data in real time to deliver successful outcomes.
Since implementing the control room, the center has increased the number of patients who have been transferred to neighboring community hospitals, creating space for those who are in need of the critical care services offered only at OHSU and resulting in a reduction in the number of declined transfer patients and approximately 520 patients successfully transferred to community hospitals.
That success galvanized OHSU to use its AI-bolstered tech to tackle other big hospital challenges: namely sepsis. “Some of these sepsis cases develop in the course of a few hours,” Merkel explains. “The patient’s heart rate goes up, it might be interpreted as pain, they get pain treatment, blood pressure drops, the patient spikes a fever — all of these are patterns we see after surgery because of its trauma to the body. In a large quantity of patients, it’s normal — but for some patients, these are the developing signs of sepsis.”
With a new sepsis app — expected to launch in December — patients’ risk for developing the condition will be assessed as soon as they enter the hospital, when they’ll be assigned a sepsis risk score, to be entered into each patient’s EMR. The idea, Merkel says, is “to help us catch sepsis before it strikes.” If the score is above a certain threshold, it will display on the app (otherwise known as a tile) in mission control, indicating that the patient may have or is at risk for sepsis. That will cue the “mission controller” to make sure the bedside nurse is taking the appropriate actions.
“If the nurse is concerned that the patient may be at risk, she alerts the sepsis response team, which immediately evaluates the patient and communicates with the provider,” says Kerrie Hauge, a senior manager for GE Healthcare Partners. “If the patient is positive for sepsis, that puts them in another section of the tile in which certain actions will occur based on the patient’s condition. The tile watches to see, for example, if blood cultures have been ordered within a certain time period, or whether antibiotics have been administered. If not, the tile flags an alert.”
Unlike other solutions that track sepsis in patients only within a single department, like the ICU, GE Healthcare’s app will track the sepsis load across the entire hospital. And all patient data that could indicate sepsis risk is presented outside of the EMR — where it might otherwise be buried in layers of information.
“I appreciate having the capabilities to help me not miss something, because sepsis can happen to patients who are here for a medical problem anywhere in the hospital,” Merkel says. “This will add a safety layer to what we currently rely on at the front line, pushing us to recognize the signs and act.”
Top image: GE Healthcare Partners senior manager Kerrie Hauge inside the new control room at OHSU in Portland, Oregon.