SPOT: How HCA Healthcare is “sniffing out” sepsis early

Jonathan Perlin, MD, president of clinical services and chief medical officer at HCA Healthcare, calls sepsis an “overwhelming infection” that can lead to severe organ failure and even death. He says the key to survival is early recognition and aggressive treatment.

“It’s a medical emergency that should be treated as aggressively as a heart attack or stroke,” Dr. Perlin said. “At HCA Healthcare, we’re pleased to be able to rally the data of more than 28 million patients every year to help control sepsis, one of the most challenging diagnoses inflicted on patients, and ultimately, better inform patient improvements and outcomes.”

Sepsis: An Industry Concern

Each year, sepsis affects more than 26 million people worldwide. Approximately 270,000 Americans die from the infection each year, making it more deadly than breast cancer, prostate cancer, and AIDS combined.

“Essentially, sepsis turns the body’s own immune system against itself,” Dr. Perlin said. “And while frail individuals with serious chronic illness may be at greatest risk, sepsis can occur in previously healthy individuals, too. If not detected early, the patient can die very quickly.”

The rate of mortality overall in the country due to sepsis is significant, he noted.

• Sepsis is the 11th leading cause of death in the U.S.;
• ninth leading cause of death in all hospitals;
• third leading cause of death in all intensive care units (ICU), and
• leading cause of death in non-cardiac ICUs.

For every hour of a delayed sepsis diagnosis, it increases the chance of death between 4 and 7 percent.

What HCA Healthcare is doing

HCA Healthcare affiliated hospitals are now using artificial intelligence (AI) and algorithms based on patient vital signs, labs, nursing reports, and other data to help identify sepsis approximately 18 hours earlier than the best clinicians.

The organization’s data scientists created a technology called S-P-O-T (Sepsis Prediction and Optimization of Therapy) to “sniff” out the first signs of sepsis.

“It’s no coincidence that we call the technology ‘SPOT’ – a common name for a child’s dog – because it really does act as our sepsis sniffer,” Dr. Perlin explained. “The whole point is for it to sniff smoke and put the “fire” out before it becomes catastrophic. With SPOT, we’re identifying at least one-third more cases of sepsis that would not previously have come to caregivers’ attention until it was too late.”

HCA Healthcare uses SPOT to continually analyze and monitor patients in HCA Healthcare hospitals.

What that means for the patient

If your loved one was in the hospital, what would you want from a caregiver?  “You’d want their full attention 24/7 year-round,” Dr. Perlin answered. “That means watching one person, knowing their labs and what each lab means.”

“Unfortunately, it doesn’t work that way,” he added. “A clinician cannot be with the patient and at the computer reviewing the data the moment it’s created. But the computer can be programmed to follow that information 24/7/365.”

How does SPOT work

Hospital computers, through “machine learning”, are trained by ingesting millions of data points on which patients do and do not develop sepsis. Those computers monitor clinical data every second of a patient’s hospitalization.  When a pattern of data consistent with sepsis risk occurs, it will signal with an alert to trained technicians who call a “code sepsis.”

The bedside nurse responds, begins evaluating the patient, and if sepsis is not “ruled out,” treatment begins immediately.

“SPOT is operating with 100 percent sensitivity, that is, all true sepsis positives have been identified,” he said, “allowing caregivers to fully focus on those patients who need intensive monitoring and support.”

SPOT saves

More than 5,500 lives have been saved over the last three years as a result of the stop severe sepsis program, the national standard that relies on detecting sepsis at the cusp of deterioration, and HCA Healthcare’s new technology SPOT.

“The doctors and nurses tell us there were some patients SPOT detected that we would’ve known about,” Perlin said. “More importantly, it told us time and again those patients we didn’t appreciate that were headed towards sepsis.”

HCA Healthcare celebrated in August 1 million patients followed by SPOT.

September is National Sepsis Awareness Month. Visit here to learn more about sepsis.

HCA Healthcare 50th Anniversary
In 1968, HCA Healthcare was conceived by two physicians and an accomplished business leader — Dr. Thomas Frist Sr., Dr. Thomas Frist Jr., and Jack Massey. This year, HCA Healthcare celebrates its golden anniversary and the culture of caring established by our three founders 50 years ago. To help us celebrate our 50th year, we’ll share stories here that reflect HCA Healthcare’s mission – above all else, the care and improvement of human life – and our pledge to improve life and make history for the next 50 years and beyond.