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Decisio White Paper

CONCLUSION

CONCLUSION Decisio Health produces a visual surveillance system that is designed to provide bedside decision support to clinicians. This system can be used for a wide variety of clinical tracking purposes. This white paper discussed its use during a recent implementation in an academic medical setting designed to identify the incidence of sepsis, a common infection among hospitalized patients in the United States, and to facilitate rapid treatment. Health of Populations We demonstrated that use of DECISIOInsight ® was significantly positively associated with decreased time to antibiotic administration (p=0.05) as well as the incidence of severe sepsis (p=0.08). Even with less than a year’s worth of data, we observed a significant reduction in mortality from sepsis (p=0.05). Experience of Care As measured by length of stay (LOS), which is a stressful time for patients, we noted a significant reduction (p=0.03, p=0.05) in both overall hospital LOS (22% reduction) and ICU LOS (25%). Cost of Care Our clinical partners calculated an initial cost savings equal to $28.2 million per annum, largely due to a reduction in length of stay. Clinician Experience We’re proud to report that our clinical partners are using DECISIOInsight ® , which is helping them to adhere to the Surviving Sepsis guidelines and to improve the quality of care they provide. This is being done on their terms, according to their own needs and preferences. March 2018 DECISIO | decisiohealth.com 14

REFERENCES 1. Rivers E, Nguyen B, Havstad S et al. (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377 2. Mayo Clinic. (2018). Sepsis. Available at: https://www.mayoclinic.org/diseasesconditions/sepsis/symptoms-causes/syc-20351214 3. CDC. (2017). Making Health Care Safer: Think Sepsis. Time Matters. Available at: https://www.cdc.gov/sepsis/datareports/index.html 4. Society of Critical Care Medicine. (n.d.) History: Surviving Sepsis Campaign. Available at: http://www.survivingsepsis.org/About-SSC/Pages/History.aspx 5. Song, J.E., Kim, M. H., Jeong, W.J., Oh, D.h., Kim, Y. C., Kim, E. J., Joeng, S.J., Ku, N.S., Kim, J.M. & Choi, J.Y. (2016). Mortality Risk Factors for Patients with Septic Shock after Implementation of the Surviving Sepsis Campaign Bundles. Infection and Chemotherapy, 48(3), 199-208. doi: 10.3947/ic.2016.48.3.199 Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5048001/ 6. Leisman, D., Zemmel D’Amore, J., Gribben, J., Ward, M.F., Masick, K., Bianculli, A., Bradburn, K., D’Angelo, J., & Doerfler, M. (2017). Early sepsis bundle compliance for non-hypotensive patients with intermediate versus severe hyperlactemia. American Journal of Emergency Medicine, 35, 811-818. 7. Society of Critical Care Medicine. (n.d.) 3-Hour Bundle. Available at: http://www.survivingsepsis.org/SiteCollectionDocuments/Bundle-Three-Hour- SSC.pdf 8. Khan, P. & Divatia, J.V. (2010). Severe sepsis bundles. Indian Journal of Critical Care Medicine, 14(1), 8-123. doi: 10.4103/0972-5229.63028 Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2888324/ 9. Lee, S.M. & An, W.S. (2016). New clinical criteria for septic shock: serum lactate level as new emerging vital sign. Journal of Thoracic Disease, 8(7), 1388-1390. doi: 10.21037/jtd.2016.05.55 10. University of Oxford. (2014). HealthTalk Online: Intensive care patient experiences. Available at: http://www.healthtalk.org/peoples-experiences/intensivecare/intensive-care-patients-experiences/emotional-experiences-icu 11. Diamond, F. (2011, May 1). ‘High Quality Saves Money’, Or so the Story Goes. Managed Care. Available at: https://www.managedcaremag.com/archives/2011/5/%E2%80%98high-qualitysaves-money%E2%80%99-or-so-story-goes 12. Bodenheimer, T. & Sinsky, C. (2014). From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider. Annals of Family Medicine, 12, 573-576. doi: 10.1370/afm.1713 March 2018 DECISIO | decisiohealth.com 15

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