Sepsis digital alert system could save lives says NHS

By Dr. Ananya Mandal, MDAug 19 2019

According to the NHS, many lives across the country could be saved with the new and improved digital alert system for possible cases of sepsis at hospitals.

Sepsis is a form of severe infection that can take over the whole body and this may overwhelm the immune system of the body that attempts and often fails to contain the infection. The spread of the infection across the blood stream of the patient and the hyperactive immune system often leads to damage to the major organs of the body and this could result in multi organ failure.

Sepsis, bacteria in blood. 3D illustration showing rod-shaped bacteria in blood with red blood cells and leukocyte. Image Credit: Kateryna Kon / Shutterstock

According to the World Health Organization (WHO), over 30 million people across the world are diagnosed with sepsis and 6 million die of sepsis and related complications annually. According to the U.S. Centers for Disease Control and Prevention, CDC, sepsis is diagnosed in 1.7 million adults and it kills 270,000 in the United States annually. One third of all the hospital deaths are attributed to sepsis says the CDC. In England sepsis is diagnosed in 250,000 cases each year and of these at least 40,000 succumb to sepsis or its complications. Treatment at present involves treating and eliminating the source of infection with antibiotics and providing supportive care using oxygen and intravenous fluids.

The new technology used by NHS uses the data from patient’s blood pressure, heart rate and other factors to check on the progression of sepsis. These data are placed in an algorithm that can predict the development of the sepsis say the experts. If the algorithm detects possibility of sepsis, it activates an “alert and action” computer programme. This programme is part of the digital patient data recording system at the Berkshire, Liverpool and Cambridge hospitals.

According to Claire Burnett, clinical nurse specialist at the Royal Berkshire Hospital, wo helped develop the algorithm, “Previously we were using a paper screening tool, using the same algorithm but on paper. So, because we were already recording our observations, we were already recording our heart rate, blood pressures, temperatures all on a computer we were having to duplicate work. That's why these digital systems are really coming into their own because were using information that's already there to produce alerts very, very quickly - almost in real time.” She added, “Fast identification of sepsis and treatment provides much better outcomes for our patients so, we know if we identify sepsis quickly and we treat it really quickly our patients will have much better outcomes.”

According to a statement from Dr Simon Eccles, chief clinical information officer at NHSX, “The challenge for us is how to spot it early enough to really make a difference with treatment, and that's where this technology, these algorithms come in. To spot subtle deterioration that clinicians might have otherwise found in a busy environment they just wouldn't find as early as they could. The algorithm draws it to their attention, it says, you need to consider sepsis - start treatment now.” The NHSX is an organization that is helping the integration of this new digital technology into the patient care system of NHS.

The organization has tried the system as a pilot project in some of the major hospitals since last year and has shown that there is a significant impact of this technology in early detection and preventions of deaths due to sepsis. According to the numbers from NHS England, Cambridge alone has saved at least 64 lives and Liverpool has saved around 200 lives after this technology was tried. According to the NHS, Berkshire has shown a seventy percent rise in complete sepsis screening tools and markers by the health care professionals after introduction of the technology.

Dr Paul Fitzsimmons, the trust’s chief operating officer said, “We have seen a major impact on sepsis care with lives saved. In some cases it would have been impossible to make a diagnosis of sepsis without the help of our digital system. By providing automated sepsis alerts from clinical information from multiple sources, we are treating septic patients both faster and more effectively, helping our clinicians prioritise doing the right things first and reducing death rates in severe sepsis”.

The team of researchers hope that soon the technology would be installed at all the hospitals across the nation and this would help reduce the number of sepsis cases and deaths in the NHS hospitals.

Dr Ron Daniels, CEO of the UK Sepsis Trust, in a statement said, “Any kind of technology which assists clinicians in making prompt decisions when the warning signs of sepsis are detected should be embraced; with every hour that passes before the right antibiotics are administered the risk of death increases.”

Celia Ingham Clark, the medical director for clinical effectiveness at NHS England, in a statement said, “Sepsis is an extremely serious condition, but as part of the NHS Long Term Plan we have made huge improvements in spotting and treating it quickly, with more than nine in 10 people getting the checks they need. Now, with the help of innovative digital tools, the NHS is saving more lives by getting even better at identifying and treating sepsis. The systems at Liverpool, Cambridge and Berkshire are life-saving and as more hospitals adopt digital tools, thousands more families will be spared the harm and heartbreak of sepsis”.