Artificial Intelligence for Sepsis Management

Article provided by Dubai Health Authority

A new protocol using Artificial Intelligence to detect hospital-acquired infections (HAIs) and pre-empt sepsis early to prevent fatalities arising due to this condition has been launched by Dubai Health Authority (DHA) across all its hospitals. It is the first-of-its-kind in the MENA region.

The AI system is incorporated with the DHA’s Electronic Medical Record (EMR) or Salama system to predict sepsis using Modified Early Warning Scores (Mews) and Laboratory testing to save lives.Sepsis is the body’s overwhelming response to infection, which can lead to tissue damage, organ failure and death.

When a person gets sepsis, the body goes into sepsis or septic shock. Although in many instances, lives are saved by using existing and proven protocols, worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction etc.

Dr. Younis Kazim, CEO of Dubai Healthcare Corporation

Almost 90 per cent of septic patients present to clinics and hospitals from the community. Hospitals and clinics also have the potential to infect people, especially immunocompromised and geriatric patients.

Sepsis is a medical emergency that requires urgent attention and rapid treatment for survival. According to the Sepsis Alliance report, “Mortality from sepsis increases eight per cent for every hour that treatment is delayed. As many as 80 per cent of sepsis deaths could be prevented with rapid diagnosis and treatment.”

“Given the importance of early intervention in saving lives, we developed this system using international benchmarks to develop protocols in place that promote early intervention and management to save lives,” said Dr. Younis Kazim, CEO of Dubai Healthcare Corporation. “The system uses AI technology that is linked to the DHA’s Electronic Medical Record System. The AI algorithm reviews the progress of the patient and links variables together to identify patterns that indicate a patient may be developing a severe infection. When the nursing staff enters into the EMR the vital signs (pulse, temperature etc.), the system calculates a score. This scoring system is Mews. This is an international evidence-based tool that monitors the vital signs to flag changes if the patient is getting sicker. This score is then linked to recent laboratory results. If this score is 3 or above an automatic warning comes to the nurse and the physician that this patient is at risk of sepsis.”

Dr. Kazim added that the Sepsis Management Workflow was developed by a team comprising both clinical staff from all DHA hospitals and technical staff, who worked together from January 2018 to identify the components of the system required and to build these actions within the Salama EMR.

How will the initiative work?

Once the automatic warning is fired, the nurse contacts the physician urgently. Once the physician reviews the patient, they click on this warning and a set of orders is provided instantly to the physician. These orders include:

– Nursing instructions

–  Laboratory tests

–  Medications

–  Intravenous fluids

This allows the first hour of treatment to start immediately.

Early symptoms of sepsis:

–  Fever and chills

–  Very low/very high body temperature

–  Decreased urination

–  Rapid pulse

–  Rapid breathing

–  Nausea and vomiting

–  Diarrhoea

Benefits of the system:

–  Early identification of patients with suspicion of sepsis as the EMR automatically identifies the patients becoming sicker and notifies both nursing and medical staff to take action

–  Early start of sepsis management

–  Improvement of sepsis outcome due to early identification and treatment

–  Establishment of sepsis registry

According to Dr. Kazim, smart technologies not only help improve patient care but also help improve the overall efficiencies and management systems of healthcare entities. DHA has also been working on the use of AI enabled workflows in Radiology with Agfa HealthCare, since the past two years.