- The recent death of film and TV actress Patty Duke is shining the spotlight on sepsis, a life-threatening condition that can be detected with mHealth technology.
The Centers for Disease Control and Prevention defines sepsis as “the body’s overwhelming and life-threatening response to infection which can lead to tissue damage, organ failure, and death,” and says it’s hard to predict, diagnose and cure. It affects about 1 million Americans and kills about 200,000 each year, more than AIDS, breast cancer and prostate cancer combined, and costs the nation’s healthcare system roughly $54 billion to treat.
Sepsis requires a quick diagnosis. Every hour of delayed care worsens outcomes by 6 percent, and about 30 percent of those who lapse into septic shock end up dying. mHealth platforms offer the ability to alert healthcare providers as soon as any symptoms are detected.
mHealth companies and health systems are targeting sepsis with mobile monitoring platforms designed to identify the condition at its earliest stages, and others are developing mobile-accessible clinical decision support platforms and even games designed to help clinicians identify sepsis as soon as possible.
This week, EarlySense, an Israeli developer of contact-free continuous monitoring systems, announced that its sensor platform now has “multi-parameter alert capability.” The company’s technology, encased in a pad that’s placed under a hospital bed mattress, can now continuously measure a patient’s heart rate, respiratory rate and motion, updating twice a second, so that clinicians can spot changes almost immediately.
"Non-ICU patients are at risk for a variety of complications during hospitalization and early warning signs are often subtle and not easily detected," Avner Halperin, the company’s CEO, said in a press release. "By providing healthcare professionals with continuous data and timely indication of change through our multi-parameter alert, precious time can be saved enabling early detection and treatment of sepsis as well as other potential adverse events."
According to the Society of Critical Care, sepsis might be present in a patient if two of the following three signs are detected: an elevated respiratory rate of 22, a heart rate above 90 and a temperature above 101 or below 96.8. Newer guidelines add altered mental state and a systolic blood pressure of 100 mm HG or less as possible signs of sepsis.
In 2013, Newton-Wellesley Hospital in Newton, Mass., became one of the first hospitals to test the EarlySense platform (the company has a U.S. office in nearby Waltham). Hospital and company officials said the sensor system – about the size of a legal pad – helped detect several trending emergencies before they became critical, including patients reacting to medications.
“The ability to find patients early in deterioration has enormous potential to improve patient safety," David Bates, director of Harvard Medical School's Center for Patient Safety Research and Practice, which conducted clinical trials on the technology, said at the time. "One of the reasons that EarlySense has been so successful is that not only are the sensors accurate, but they have developed approaches to sift through the alarms so that when one is delivered there is a high chance that there is an important clinical change, and the nurses have learned to take these alerts seriously.”
Several companies offer sensor platforms for health system use. Among them is Sensiotec, an Atlanta-based company that markets the Virtual Medical Assistant (VMA), a briefcase-sized pad that fits under a hospital bed and sends patient data in real-time to clinicians. Another company, Welch Allyn, last year unveiled the Connex Spot Monitor, a wireless device designed to capture patient vital signs from devices at the bedside and send them to clinicians as well as the electronic medical record.
This past December, OSF Healthcare in Peoria, Ill., leveraged a $750,000 Agency for Healthcare Research and Quality (AHRQ) grant to launch a simulation training program, using IT-enhanced mannequins to train rural clinicians on the early symptoms of septic shock. And just down the road in St. Louis, Mercy Health’s newly opened Virtual Care Center boasts a first-of-its-kind telesepsis remote monitoring program that reportedly cuts mortality by more than 50 percent and reduces costs by some $8,000 per patient.
Intermountain Health in Salt Lake City approached the issue a bit differently, noting that sepsis is sometimes caused by the clinicians. The health system developed a watch for doctors, nurses and caregivers that triggers an alert when the wearer moves from one room to another, prompting him or her observe certain protocols.
“The watch detects motion and it knows when a wearer goes from room to room,” Karl West, Intermountain’s chief information security officer, said in a 2014 interview with mHealth News. “As soon as I leave a room, I need to be aware that I should be washing my hands. So the watch has a color-based alarm that goes off as I change rooms. Now the watch instead of being green is red, and based on a period of time, we also change that to yellow to give clinicians the indication that they should be washing their hands for sepsis control.”
The effort to educate clinicians on the warning signs of septic even produced a video game.
In 2012, researchers at Stanford’s School of Medicine created Septris, an online game modeled after Tetris that teaches clinicians how to identify sepsis and treat septic shock.
“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. “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.”