By Sean Benson, vice president and general manager of Specialized Surveillance, Wolters Kluwer Health
Sepsis kills more than 44,000 people annually in the UK, a shocking figure that is more than the total number of combined deaths from breast, bowel and prostate cancer.
The potentially life-threatening condition, also known as blood poisoning or septicaemia, is triggered by an infection or injury. The body’s immune system goes into overdrive as it tries to fight the infection, which in turn can reduce blood supply to vital organs like the heart, brain and kidneys and, without rapid treatment, can lead to multiple organ failure and death.
As urgent as a heart attack
Guidance issued by the National Institute for Health and Care Excellence (NICE) last year said doctors should treat signs of possible sepsis as urgently as chest pains indicating a potential heart attack. Doctors, nurses and other caregivers should spot any symptoms of sepsis at an early stage, which can include fast breathing or a rapid heartbeat, high or low temperature, chills and shivering, and in later stages dizziness, disorientation, mottled skin and vomiting.
However, many patients get to the hospital too late. In 2015, a report by the independent health research organisation, National Confidential Enquiry into Patient Outcome and Death (NCEPOD), found that in more than 50% of sepsis cases, people seek healthcare at least 24 hours later than experts believe they should have done.
There is no simple test to identify sepsis early, so clinicians need help to be able to spot the signs that indicate sepsis more quickly and with greater accuracy.
Sepsis surveillance technology can help. Advances in point-of-care clinical decision support technology can help clinicians detect escalating conditions and intervene within the critical three-hour window. For patients with sepsis, this can make the difference between life and death.
However, while technology can provide an early-warning system, the volume of information required, combined with logistics of managing alerts, can make it a daunting task, with hit-and-miss results.
Technology that is poorly developed and deployed can quickly lead to ‘alert fatigue’, which can cause physician burnout. One study found that clinicians ignore point-of-care safety notifications 49 to 96 percent of the time.
As Wolters Kluwer Health was one of the first to pioneer sepsis surveillance technology, we understand the need for smarter tools that give clinicians accurate information to act on, fast. For technology to effectively provide a front-line defence, it needs to be highly precise, understand complex and fast-changing situations and accurately communicate to staff when they should intervene and how.
Tools like our smart surveillance tool POC Advisor and clinical decision support resource, UpToDate, are showing the way forward. In the U.S, a study by the Journal of the American Medical Informatics Association (JAMIA) found that POC Advisor accurately predicted cases and warned clinicians, helping to reduce sepsis mortality by 50% and patient re-admissions by more than 30%.
Meanwhile, UpToDate, used by over 1.3 million clinicians worldwide, has an unrivalled depth of peer-reviewed treatments recommendations, helping patients get the care they need. In cases where critical decisions need to be made within a tight time frame, an authoritative resource like this can save lives.
They can also save money. Mistakes made in managing sepsis are costing hospitals dearly, especially in the U.S. For example, in Minnesota, a jury recently awarded $20 million in the state’s largest wrongful death medical malpractice verdict, after a hospital failed to spot sepsis in a woman who died less than a week after giving birth.
Technology can prevent more tragic losses like this, but we need tools that are better designed for the job and fully integrated into clinicians’ workflow, supporting their decisions rather than clouding their judgement in potentially life-threatening moments.