CDS app slashes sepsis mortality rates in half
February 23, 2015 in Medical Technology
When Wolters Kluwer Health set out to reduce sepsis incidents, mortalities and readmissions, the vendor hypothesized that clinical decision support could prove most useful.
And after conducting research at 50 hospitals, Wolters Kluwer determined that it would take more than just CDS. The application had to include three tenets: change management, alerts that are both highly-sensitive and highly-specific in nature, and the ability to deliver evidence-based CDS at the point of care.
POC Advisor came from that work and Wolters Kluwer has been building the app in partnership with John Muir Health in the San Francisco Bay Area and Huntsville Hospital in Huntsville, Ala.
Now, with HIMSS15 approaching, POC Advisor is moving out of Wolters Kluwer’s innovation lab and into the early adopter phase, according to Steven Claypool, MD, Wolters Kluwer vice president of clinical development and informatics.
At the conference, Wolters Kluwer will share the results of a pilot with Huntsville during which the hospital dropped sepsis mortality by more than 50 percent and reduced 30-day readmission rates by 30 percent, according to Jocelyn Craighead, the hospital’s director of quality. Length-of-stay is also trending downward though data proving that statistically significant is not yet available
Craighead attributes the success in part to the real-time integration of vital signs and labs straight into Huntsville’s computer systems. From there, the alerts are pushed right out to handheld device.
The application is built on HTML 5 so it will work in most modern browsers. POC Advisor essentially extracts data out of a customer’s EHR and into Wolters Kluwer’s cloud. From there, more than 200 algorithms that Claypool describes as “really, really advanced” analyze the data against a given patients underlying medical conditions – treating factors such as heart, lung or liver disease differently – and then sends alerts to point of care, whether it lands in a smartphone, tablet or even a pager.
“Allowing nurses to receive and act on that information as appropriate has been the biggest benefit,” Craighead says.
While Huntsville initially piloted the software in two respiratory care units and its general medicine overflow area, Craighead says the hospital has “a strategic rollout plan starting in March,” to move it into other medical services lines.
The software for sepsis is what Wolters Kluwer intends to be the first of many and the obvious conditions for which it might make sense expand include diabetes, pneumonia, heart failure, and so on.
“Now that we’re ready to move to the early adopter phase, we want a couple more sites to prove the concept,” Claypool says. After that it shouldn’t take long to make it more widely-available. “At HIMSS15 we’ll let people know it’s coming but we don’t have a specific date yet.”