Digital Alert System Cuts Odds of Sepsis-Related Mortality

November 21, 2019
Michaela Fleming

The sepsis alert system works by monitoring changes in patients’ temperatures, heart rates, and glucose levels, and notifying clinicians of abnormalities through electronic health records.

Sepsis is a serious and life-threatening condition that accounts for approximately 46,000 deaths each year in the United Kingdom.

If diagnosed early, the condition can be treated effectively with antibiotics, but sepsis is difficult to spot because symptoms are similar to that of other illnesses such as influenza. To combat this, Cerner Corporation developed a digital sepsis alert system that was introduced and implemented in 2016 at Imperial College Health Care NHS Trust’s hospitals in the United Kingdom.

In a new study, published in Journal of the American Medical Informatics Association, a team of investigators led by faculty from Imperial College London evaluated the system’s efficacy in reducing length of stay and death.

The sepsis alert system works by monitoring changes in patients’ temperatures, heart rates, and glucose levels. If these rates fall outside of the range of safety, the system automatically notifies clinicians to investigate further. The notification is delivered through a pop-up warning in the electronic health record or dashboard, which highlights any patient with an active alert upon opening the record.

In addition to the automatic alerts, the Imperial College Healthcare team designed a multidisciplinary care plan which is launched in the electronic health record upon the clinician’s confirmation of a sepsis diagnosis.

From there, the care team is prompted to determine optimal treatment methods and ensure that the patient receives antibiotics within 1 hour, which is in-line with national targets.

As part of the evaluation, the authors of the report analyzed more than 27,000 hospital stays of patients who triggered the alert system between May 2018. These patients were admitted into emergency departments or acute or hematology wards St. Mary’s Hospital, Charing Cross Hospital, and Hammersmith Hospital, all of which are part of the Imperial College Healthcare NHS Trust.

The investigators observed that patients who triggered the automatic alert had 24% lower odds of in-hospital death and a 35% increased chance of receiving timely antibiotics when compared to patients for whom the digital alert system was not implemented for.

Additionally, they determined that admitted patients had a 4% lower chance of stay in the hospital for more than 7 days than patients with similar symptoms who received standard of care.

The authors suggest through implementing this system it has been easier to alert clinicians to deteriorating conditions in patients and as a result, investigations and treatment plans have been implemented more quickly.

“Often digital systems are implemented but research on their performance is not done” Kate Honeyford, PhD, from the Global Digital Health Unit at Imperial College London and lead author of the research said in a press release. “Our study shows for the first time that robust analysis of a digital alert system was associated with improvements in outcomes for patients and the system presents an opportunity to improve care for patients who may have sepsis.”

In the future, the study team will conduct a larger study involving more NHS hospitals to determine if the results are consistent in a large study population.