healthspin
North Oaks Health System harnessing
predictive modeling to save lives from sepsis
22
Sepsis is a medical emergency that can lead
to tissue damage, organ failure and even death.
It is a complication of an existing infection
left untreated or not treated appropriately or
in a timely fashion. Each year, sepsis leads to
death for a quarter of a million Americans and
causes two percent of all hospital admissions
nationwide, according to the Centers for
Disease Control and Prevention (CDC).
Anyone, anywhere can have an infection that
becomes septic, but children, senior adults and
chronically ill individuals are most at risk.
Clinicians and computer analysts at North
Oaks Health System in Hammond, La. have
innovated a tool that harnesses the power of
Epic’s electronic health record technology and
predictive modeling to save lives from sepsis.
In just one year, the sepsis mortality rate at
North Oaks has dropped by nearly 18 percent
compared with the previous year since the
implementation of this model, according to Dr.
Herbert Robinson, chief health information
officer for North Oaks Health System.
“If left untreated, septic patients will die.
So treatment must begin within the first few
hours of onset to offer the greatest chance of
survival,” Robinson explains. “That’s why
from the time patients arrive at our hospitals,
we evaluate them carefully and then constantly
monitor their clinical course to detect any
developing signs or symptoms of sepsis. We do
this so that appropriate and timely interventions
can occur.”
The team at North Oaks is using a
computerized tool, called a Clinical Care
Advisory (CCA), to help notify caregivers of
patients at risk for sepsis based on information
in the patient’s medical record. The CCA
runs on a “predictive model” in the patient’s
electronic health record looking for signs and
symptoms of sepsis.
“By embedding machine learning into
the existing workflow, minutes can be saved,”
explains Seth Hain, Epic’s director of analytics
and machine learning. “As data flows into the
chart, the algorithm looks for patterns indicating
the early onset of sepsis. Then the results are
put directly in front of clinicians, giving them
the cue to intervene earlier and help patients.”
Once a patient arrives in the emergency
room, the CCA sweeps the patient’s health
information every 15 minutes, monitoring
more than 80 different data points, to generate
a sepsis risk score. If the patient’s score reaches
a certain threshold, the clinicians get a warning
that the patient may be becoming septic. The
patient is then evaluated more closely, and
the CCA recommends the best treatments for
sepsis. This process continues throughout the
patient’s hospital stay, allowing doctors and
nurses to make decisions to implement life-
saving treatments at the earliest possible time.
“Patients are now receiving antibiotics about
25 percent faster — or 30 minutes sooner —
than they were before CCA. Combined with
the clinical expertise of our doctors and nurses,
our approach is saving lives,” Robinson affirms.
“Our goal is to make this new tool more
accessible to community health systems like
North Oaks by ensuring the setup and statistical
validation are efficient and easy to use,” says
Hain. “North Oaks was able to set up the
model quickly, allowing them to focus on the
outcomes.”
The most frequently identified germs that
cause infections that lead to sepsis include
staphylococcus, E. coli and some types
of streptococcus, according to the CDC.
Symptoms can include one or any combination
of the following:
· Confusion or disorientation
· Shortness of breath
· High heart rate
· Fever or shivering or feeling very cold
· Extreme pain or discomfort
· Clammy or sweaty skin.
Robinson encourages anyone who suspects
sepsis or has an infection that’s not getting
better or is getting worse to seek immediate
medical attention.