Article

Innovation isn’t Enough When it Comes to Patient Deterioration

Sepsis continues to kill, in spite of the progress made by sepsis awareness and prevention campaigns. A 2018 data analysis found that the number of patients with hospital-associated sepsis most likely to progress to septic shock had risen by 10 percent over a three-year period, resulting in a 20 percent spike in treatment costs since 2015.Amid the ever-increasing amount of data—and substantial organizational efforts and investments in health information systems and technology—many hospitals still struggle to use and interpret patient data in meaningful ways.2 And, when data are unclear, not patient-specific, nor timely, clinicians and care teams may miss the signs of early deterioration.

Data Systems Must Communicate the Clinical Story

New, innovative software systems are on hospitals’ radar screens. According to Health Growth Partners, a healthcare financial advisory firm, in 2017, U.S. health IT spending surpassed $7.1 billion.However, successful software implementation is dependent on multiple variables, including hospital resources, IT capabilities, effective data management, interoperability across settings of care, and, perhaps most importantly, clinician engagement.

Reaching Across Hospital Settings

These variables matter because sepsis in its early stages can be difficult to identify and differentiate from other conditions. This has led to the development of an array of alerts and monitoring tools for leveraging EMR data; primarily in emergency departments (EDs) and intensive care units (ICUs).4 However, data-driven systems need to be able to detect and communicate signs of deterioration across all hospital settings, not just among high acuity patients, in order to trigger a timely response. Studies show that a significant number of patients develop sepsis in hospital wards outside the ICU and ED—and that rapid detection and response can be essential to preventing septic shock from occurring among patients who show signs of early deterioration 5

Moving Beyond Innovation

Creating an integrated, 24/7 digital platform that is sensitive and specific to the signs of deterioration, that can liberate care teams from the “noise” of EMR data—and is a reliable source of clinical information that propels action--is an investment and commitment that well goes beyond an innovative software idea. Such a system must also protect patient information, comply with standards of regulators, provide customer support – and do it all to scale.

Keeping patients – and their data – safe

In developing this type of digital platform, it is not only important to keep patients safe, but their data as well. That involves working with “white hat hackers.” These experts work and act like “the bad guys,” but they’re on the side of the solutions developers who’ve enlisted them. Software solutions developed as part of the collaboration between GE Healthcare and Roche Diagnostics are tested by these experts to detect any gaps in security, giving to the team the opportunity to close those same gaps. Beyond making the application physically secure, cybersecurity standards look to prepare for the eventual and inevitable disaster by placing onion-like layers around the outside of the tool as well as a hard shell around each of its individual components. Then disasters are “rehearsed” again and again because cybersecurity is a never-ending process.

Compliance is critical

The job of a regulator with the United States Food & Drug Administration (USFDA) and other regulatory bodies is to ask themselves every day, “How can I protect the public interest as it relates to healthcare?”

GE Healthcare works with regulators and provides them with information they need to do their jobs well. It’s a process that goes from user needs all the way to the eventual product, considering the needs of the user: Is it a nurse? A physical therapist? A physician? What do they care about? Perhaps it's response time or battery time on a mobile device. Then, engineers listen to those user needs to create design inputs and sets of specifications to meet – and ideally, exceed – user need.

Ultimately, the product must undergo repeated testing and checking – and continuous documentation, which provides evidence that keeps the developer accountable.  And, if things do go wrong, the documentation allows the developer to go back and discover possible misses and then continuously improve the product.

Caring for customers who care for patients

An innovative product is only valuable if it works – and keeps working. That’s where customer service comes in, replete with well-trained people who know how to respond to a range of products. These employees also need to be able to know when, where and how to deploy an expert in the field for customer support. Field experts and engineers become critical to the equation; they must be well-versed in not only the specific technology but also in health care and patient information; in the latest technologies and in the web with regard to big data, big data science, cybersecurity and patient trust.

Taking it to scale

One benefit of employing people around the globe is the perspective it provides. It reminds of the necessity of ensuring global scale. Not only does a product being developed need to work 24 hours a day, seven days a week and 365 days a year, it also needs to work in each country for which it’s use is intended.

Only when an idea gets all the necessary support – cybersecurity, compliance and customer care -- to scale, can it truly be called a successful innovation.

References

  1. Margin of Excellence: Lowering the Incidence and Severity of Hospital-Associated Sepsis, Premier, Inc. March 2019. https://www.premierinc.com/newsroom/press-releases/premier-inc-analysis-hospital-associated-sepsis-decreased-by-15-from-2015-2018Accessed December 11, 2019. 
  2. EHRs: The Challenge of Making Electronic Data Usable and Interoperable, Pharmacy &Therapeutics, September 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565131/Accessed December 11, 2019.
  3. Health IT Spending Last Year Prioritized EMRs, Becker’s Hospital Review, January, 2018, https://www.beckershospitalreview.com/healthcare-information-technology/health-it-spending-last-year-prioritized-emrs.html Accessed December 12, 2019. 
  1. Sepsis As 2 Problems: Identifying Sepsis at Admission and Predicting Onset in The Hospital Using an Electronic Medical Record–Based Acuity Score, Journal of Critical Care, April 2017. https://www.sciencedirect.com/science/article/pii/S0883944116302775?via%3DihubAccessed December 13, 2019. 
  2. Sepsis Outside Intensive Care Unit: The Other Side of The Coin, Infection, April 2014. https://www.researchgate.net/publication/264676463_Sepsis_outside_intensive_care_unit_the_other_side_of_the_coinAccessed December 13, 2019.

 

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