Becker's Clinical Quality & Infection Control

8 INFECTION CONTROL Early warnings, few false alerts: What physicians want out of AI sepsis detection tools By Nika Schoonover A new artificial intelligence sepsis detection system had an 89 percent adoption rate by physicians and nurses, higher than other legacy tools, which typically garner a 10 percent adop- tion rate, a study published July 21 in Nature Medicine found. e Targeted Real-Time Early Warning System, which catches sepsis symptoms earlier than traditional methods, was initially developed at Baltimore-based Johns Hopkins and was commercialized by Bayesian Health. Suchi Saria, PhD, founder and CEO of Bayesian Health, led the research on the study in collaboration with a group of researchers from Johns Hopkins University. e team also partnered with Epic and Cerner, two of the largest electronic health system providers. More than 4,000 clinicians from five hospitals used the AI during the study in treating 590,000 patients, and the system reviewed 173,931 pre- vious patient cases. Bayesian Health is also partnering with LifeBridge Health to help deploy the system. One of the reasons for the increased physician adaptability, clinicians say, is a decrease in the number of false alerts for a single patient. "One in 3 times there's a real possibility that that patient is in trouble, as opposed to all of the other automated detection problem processes … where the alerts were delivered and it was only 1 in 30 or 40," said Neri Cohen, MD, PhD, president of the Center for Healthcare Innovation and a cardiothoracic surgeon. e system also allows for greater collaboration with clinicians and of- fers more visibility into why the alert was delivered, Dr. Cohen said. "e reason that it's working is not just the AI being delivered within the physician's workflow, it's being delivered in a way that is a collaborative colleague to the clinician. … It's just like getting a consultation from someone else; you get the data that is going into what has generated that alert. So the clinician gets the opportunity to evaluate the quality of that alert," Dr. Cohen said. e system works in the background and monitors the hospital's entire patient population. When a patient shows markers for deterioration, the system flags the patient in the EHR. e provider interacts with the application and, whether the alert is accurate or not, the system learns from each interaction. "at's what this is all about. is is about building trust," Dr. Cohen added. In 82 percent of sepsis cases, the system was accurate nearly 40 percent of the time, according to a press release. Previous electronic tools caught fewer cases and were only accurate 2 to 5 percent of the time. "It's absolutely crucial for treatment to start early. But for treatment to start early, diagnosis has to be early. at's the hard part. I mean, the hard part isn't knowing what to do when someone has sepsis, it's ac- tually recognizing that it's sepsis," said Michael Shabot, MD, founding partner of Relia Healthcare Advisors and former system chief clinical officer of Houston-based Memorial Hermann Health System. ough sepsis is always discovered, the difficulty for physicians is being able to catch it fast enough. With the current standard of care, sepsis kills 30 percent of the people who develop it. "Our problem is that we have a real tough time recovering patients and the death from sepsis is from failure to recover, not because we don't know what to do. … ere are very few things that are le in medicine where there is an acknowledged sustained 30 percent mortality," Dr. Cohen said. "Sepsis still carries the highest mortality for inpatients and still carries Infection preventionists' health took hit amid pandemic: 4 findings By Mackenzie Bean T he pandemic has put a significant toll on infection prevention professionals working in hospitals and other healthcare settings nationwide, according to a study published July 13 in the American Journal of Infection Control. To understand the pandemic's physical and mental toll on infection prevention professionals, researchers from the Ohio State University in Columbus and the Association for Professionals in Infection Control and Epidemiology surveyed a random sample of 926 APIC members between July and August 2021. Four survey findings: 1. Seventy-four percent of infection control professionals said COVID-19 has adversely affected their mental health, and 60 percent said the pandemic hurt their physical health. 2. Sixty-five percent reported burnout, 21.5 percent reported depression and 29.8 percent reported anxiety. 3. Few infection control professionals met recommended guidelines for sleep (34.1 percent), physical activity (18.8 percent) and fruit and vegetable intake (7.3 percent). 4. Infection preventionists who had shorter shift lengths and more workplace wellness support reported better well-being outcomes than those with longer shifts and no workplace wellness support, study authors said. n

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