A patient safety screening tool can improve early detection of the infections, with the potential to save thousands of lives. Microsoft partner Accent on Integration has rolled out a patient
safety screening tool at Vanderbilt University Medical Center that can
improve early detection of hospital-acquired infections, with the
potential to save thousands of lives.
Sepsis is the body's systemic response to infection, which in severe
cases can cause organ failure and death. It's estimated that
750,000 people die each year from sepsis, said Randy Fusco, chief
technology officer and strategist for Microsofts U.S. health care
provider industry unit.
Normally, it's difficult to draw a direct correlation between a
technology implementation and an improvement in the quality of patient
care, Fusco said, since improved patient outcomes as a result of
technology are so difficult to measure. However, in this instance,
he said the positive impact of the tool on patient outcomes was obvious
within the first few months.
The tool has been piloted in Vanderbilt's 23-bed neurological care
unit, said Jeff McGeath, vice president and CTO for AOI. As of April
18, the technology had detected 14 patients with sepsis, McGeath said.
"If sepsis is identified early and proper treatment is given within
one hour of detection, your survival rate is something like 80
percent," he said.
However, if detection is delayed more than six hours or a
misdiagnosis is made, survival rates drop to about 42 percent, he said.
This tool is designed to be installed in an intensive care unit, and
provides a set of indicators that alert caregivers of complications and
adverse affects following surgery or hospital procedures. Tracking
and screening for these indicators allow for early detection of
patients who are at risk for sepsis, and then dictates treatment
protocols for those patients based on independent treatment
recommendations from the Surviving Sepsis Campaign and the Institute
for Healthcare Improvement, Fusco said.
"It's often hard for caregivers to spot patterns in the chaos of an
ICU, where you're getting flooded with test results, blood work
results, vitals monitoring constantly," McGeath said.
Having a tool that can screen for patterns and alert caregivers
early is crucial for providing quality care, and can mean the
difference between a patient who survives the infection and one who
does not.
The tool, built on Microsoft Office Sharepoint Server and the .Net
framework with automated workflow capabilities, pulls patient vital
signs and clinical information from various ICU monitoring systems and
aggregates patient data into an electronic form. Most of the
patient data is pre-populated, and caregivers are only faced with
entering select clinical information on the patient's former status,
current status and their mental alert status, Fusco said.
While patient safety is top of mind, hospitals are also faced with
the staggering costs of treating hospital-acquired infections like
sepsis, McGeath and Fusco said. Currently, treating sepsis
accounts for 40 percent of a hospital's total ICU expenditures, or
about $16.7 billion in the United States, McGeath said.
"That figure makes it easy to bring this tool in front of a [chief
financial officer] and sell it," he said, adding that the Centers for
Medicare and Medicaid passed a ruling in August 2007 that curbs
payments to hospitals for patients with certain hospital-acquired
infections like sepsis.
McGeath also said the Patient Screening Safety Tool could be
implemented in almost any hospital, and used to track and screen for a
variety of conditions and diseases. The Patient Screening Safety
Tool, Sepsis Module, was only the first iteration, he said.
Vanderbilt's implementation has been in place since early February,
and the hospital is working on presenting the technology as a formal
case study for publication in the New England Journal of Medicine,
Fusco and McGeath said.
Editor's Note: The New England Journal of Medicine states that if treatment is given
within 1 hour of diagnosis, survival rates are about 80 percent, and
if treatment is delayed more than 6 hours, survival rates drop to 42
percent. This information was incorrectly reported in a previous
version of this story.
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