Microsoft's Patient Safety Screening Tool has been first used in the screening of sepsis in hospitals around the world. But, the modular infrastructure of the PSST solution means that it can be customized to help providers screen and treat other diseases as well. Accent on Integration is a Microsoft solutions partner that has worked with Microsoft to deploy this solution at Vanderbilt University Medical Center (VUMC). "After deploying the PSST for Sepsis solution, we plan to reuse every bit of this infrastructure to create a PSST for other acquired diseases," says Jeff McGeath, CTO, Accent on Integration. "It will simply be a matter of redefining the screening questions and plugging those new modules into the database."
Microsoft has identified three other modules for this solution that it plans to develop with its partners and customers to help providers increase patient safety, reduce costs, and streamline workflow. They are: Methicillin-Resistant Staph Aureus (MRSA), Urinary Tract Infections, and Deep Vein Thrombosis (DVT).
Patient Safety Screening Tool for Sepsis
More than 750,000 cases of severe sepsis are diagnosed each year in the United States alone with the rate of severe sepsis expected to increase to 1 million cases a year by 2010 due to an aging population. Treating sepsis accounts for nearly 40 percent of all intensive care unit (ICU) costs. In fact, in 2001, hospital expenses for patients with severe sepsis totaled over U.S. $16.7 billion.
Add to these statistics the August 2007 ruling by the Center for Medicaid and Medicare Services (CMS) to limit payment to hospitals for certain preventable, hospital-acquired infections. Sepsis -- along with other acquired infections like pneumonia, urinary tract infections, and methicillin-resistant staphylococcus aureus infections -- is slated to be added to the list of conditions covered by this ruling in 2009. This means the burden of the cost of treating sepsis could shift substantially to providers. And if private insurance companies, which typically model their guidelines after CMS, come out with similar policies the burden will be compounded.
Clearly there is a need to find new ways to help providers reduce the incidences and severity of sepsis in order to save lives and money.
A powerful solution to help providers screen and treat sepsis
"If we detect sepsis early enough and apply the right treatment protocols, we can significantly improve the outcome for our patients," says Michael Higgins, MD, chair of the Department of Anesthesiology and executive medical director for Perioperative Services at Vanderbilt University Medical Center (VUMC). "Early detection and appropriate intervention are critical."
Microsoft offers a solution that helps with just that. The Patient Safety Screening Tool (PSST) for Sepsis equips providers with powerful workflow tools to help them detect morbidities early and consistently administer evidence-based practices based on guidelines from the Surviving Sepsis Campaign and Institute for Healthcare Improvement (IHI), which have teamed up to achieve a 25 percent reduction in sepsis mortality by 2009. Built on the Microsoft platform using solutions such as Microsoft Office InfoPath, SharePoint Server 2007, Windows Server 2008 and SQL Server, PSST for Sepsis can also incorporate a facility's specific best practices and is designed to support the way clinicians work, seamlessly integrating with existing systems.
For example, when staff admit a patient to the ICU, they can use an electronic form from the PSST for Sepsis solution - often from the same application they use to admit the patient - to screen the patient for diagnostic indicators of sepsis. To streamline the process and save staff's valuable time, some of the information is pre-populated, such as demographic information from the admissions interface and lab values and vital signs from the lab and patient monitoring interfaces.
A physician can then quickly review the results and if the patient is not at risk, staff will be prompted to screen the patient again in three days. If the patient is at risk, the patient is administered an evidence-based treatment protocol from the IHI. These aggressive treatment protocols, also known as bundles, have been shown to lower mortality rates by 30 percent for severely septic patients and by 50 percent for patients who are at risk but have not yet developed the disease . PSST for Sepsis helps providers track a patient's progress by bringing vital information together in one place and providing reminders and alerts - which can be sent to pagers, email or other devices -- that help clinicians more consistently comply with the guidelines from the IHI.
Vanderbilt University Medical Center expects to improve patient outcomes and lower ICU costs
"The early alerts generated by the PSST for Sepsis solution will help us to intervene more quickly and aggressively when a patient shows signs of becoming pre-septic or severely septic," says Leland Lancaster, MD, director of commercial development, Department of Anesthesiology at Vanderbilt University Medical Center (VUMC), where they are implementing PSST for Sepsis and plan to use the real-time bedside monitoring, automated patient screening tools, and pre-populated patient screening forms. "The seamless integration of the PSST for Sepsis solution with our existing infrastructure plays an important role. Minutes can mean the difference between life and death for our patients, so the faster we get information the sooner we can intercede."
In fact, in just the first four weeks of the PSST for Sepsis solution pilot implementation at VUMC, it enabled proactive intervention in eight cases helping VUMC staff to take immediate care measures. "We anticipate that early detection of sepsis will shorten hospitalization time and reduce other resources required for treating severe sepsis," says Higgins."This should result in lower ICU costs."
