- An Illinois health system is using a $750,000 federal grant to develop a telemedicine platform to reduce severe sepsis and septic shock at rural hospitals.
Peoria-based OSF Healthcare is using the Agency for Healthcare Research and Quality (AHRQ) grant to launch an in situ simulation program, which would use IT-enhanced mannequins to train rural clinicians on the early symptoms of septic shock. The clinicians would then be taught how to use the network’s telemedicine platform to video-conference with specialists.
The three-year project will be led by the JumpTrading Simulation & Education Center, a collaboration of OSF Healthcare and the Illinois College of Medicine at Peoria, with assistance from Northwestern University. It builds upon OSF Healthcare’s bundled care program for sepsis treatment.
In a blog on the JumpTrading site, Dr. Emilie Powell, an ER physician and health services researcher at Northwestern who has worked frequently with OSF Healthcare, and Dr. William Bond, director of simulation research at JumpTrading, said the project could go a long way toward improving clinical outcomes at small and remote hospitals throughout the country.
“OSF wants to ensure accurate application of these bundles in rural emergency departments by using telemedicine,” they said. “The idea is for rural clinicians to consult with specially trained critical care medical staff over videoconferencing as they treat patients presenting with sepsis. Transitions of care to the ICU may also be improved.”
“If we can validate the use of simulation to incorporate new technologies to improve care, we can use this idea to target other time-sensitive critical conditions like stroke, acute heart conditions, pediatric critical care, and trauma,” they concluded.
Sepsis affects more than 1 million hospital patients each year and requires a quick diagnosis. Studies have shown that every hour of delayed care worsens outcomes by 6 percent, while upwards of 30 percent of those who lapse into septic shock end up dying. It costs the nation’s healthcare system roughly $54 billion to treat.
The concept of using virtual care to combat sepsis isn’t new. The St. Louis-based Mercy Health system listed it as “the top problem confronting healthcare systems” when officials opened the Mercy Virtual Care Center earlier this year. Billed as the world’s first fully virtual hospital, it boasts a telesepsis program that reportedly cuts mortality by more than 50 percent and reduces costs by some $8,000 per patient.
It has even piqued the interest of mHealth game designers. In 2012, researchers at California’s Stanford School of Medicine created Septris, an online game modelled after Tetris that teaches physicians how to identify and treat sepsis.
“This is another mode of learning,” game-player Eric Gluck, MD, who specializes in critical care medicine, internal medicine and pulmonary disease at Chicago’s Swedish Covenant Hospital, said in an mHealth News story. “The idea of a game model, where a physician gets to solve problems and then gets immediate feedback … is good. So much of medical learning is tedious.”
Another project launched in 2012 combined clinical decision support with mobile devices and change management programs. It was spearheaded by the Altos Group, a Reston, Va.-based consulting firm that works with healthcare providers to implement change management programs, and bolstered by decision support tools from Wolters Kluwer Health.
"Sepsis is the top preventable cause of death in hospitals,” Julie A. Kilger, the Altos Group’s project manager, said when the project was launched. “And while hospitals have been proactive in their efforts to reduce its devastating and often fatal consequences, sepsis rates remain unacceptably high because traditional approaches fail to address the human factors involved in early detection and proper treatment.”
Powell and Bond say those human factors are especially prevalent in small, rural hospitals. And that’s where a telemedicine program may hold the most value.
“It sounds easy in theory, but in reality it’s difficult to execute new technology like telehealth in rural EDs,” they said. “This can be due to constant changes in patient volume, types of conditions, and the variability in clinician expertise with the new technology and staffing. We’re asking medical personnel to change their workflow for the benefit of patients. This is where we hope simulation will be valuable.”