Becker's Hospital Review

167 FINANCE CMO / CARE DELIVERY Electronic Alert in Pediatric ER Ups Severe Sepsis Detection by 13% By Anuja Vaidya R esearchers from Children's Hos- pital of Philadelphia examined the sensitivity and specificity of an electronic alert system intended to help clinicians identify severe sepsis cases among children in the emergen- cy room. They published their findings in Annals of Emergency Medicine. The researchers studied a two-step sepsis trigger tool — an electronic alert combined with a "sepsis huddle." The huddle included a pediatric emergen- cy medicine physician and nurse who evaluated the child at the bedside. They reviewed EHR data for 182,509 ER visits from June 2013 to May 2014. Of the total number of ER visits stud- ied, 86,037 were before the electron- ic sepsis alert implementation and 96,472 were afterward. The electronic sepsis alert increased ER sepsis detection from 83 percent to 96 percent. Overall, 0.3 percent of patients were treated for severe sepsis within 24 hours. "Implementation of the electronic sepsis alert was associated with im- proved recognition of severe sepsis," study authors concluded. n 4 Patients Infected With Hepatitis C Due to New York Physician's Allegedly Poor Infection Control Practices By Brian Zimmerman T he New York State Department of Health is advising patients who received an infusion, injection or blood draw at Tomorrow Medicine's two locations in West- chester County to be tested for hepatitis C, hepatitis B and HIV. New York Commissioner of Health Howard Zucker, MD, ordered the owner of the clinics, Timothy Morley, DO, to cease practicing medicine for violating public health laws and failing to produce records pertaining to a state and local investigation. Local health officials initiated the inves- tigation after four patients treated at Dr. Morley's practice tested positive for the same strain of hepatitis C. "Dr. Timothy Morley's medical license was suspended fol- lowing the discovery of a series of inappropriate infection control practices and concerns regarding the preservation, preparation, handling and administration of medication," said the state health department Monday. "The order to immediately cease operation … was issued out of concern that further lapses in infection control practices could put additional patients at risk." Brad Hutton, New York's deputy commissioner of public health, told The Journal News more than 20 people sought testing as of Tuesday afternoon. "We think hundreds [may have been exposed] based on the current volume at the practice," Mr. Hutton told the publication. n Study: To Track Sepsis, Clinical Datasets Are More Reliable Than Claims By Jessica Kim Cohen U sing medical claims patterns, analysts have observed an increase in sepsis incidence in recent years. However, clinical data may more accurately reflect these trends, in part because claims information is affected by changing diagnosis and coding practices over time, according to a study pub- lished in JAMA. e researchers — led by Chanu Rhee, MD, a population medicine researcher at Harvard Medical School and Harvard Pilgrim Health Care Institute, both in Boston — compared national sepsis incidence estimates using EHR data to those based on medical claims data between 2009 and 2014. To estimate sep- sis incidence with EHRs, they collected clin- ical data from 2,901,019 patients across 409 hospitals. Here are three of their findings. 1. e researchers identified 173,690 sepsis cases from the cohort of 2,901,019 patients, representing a 6 percent incidence. 2. Using clinical data, researchers determined sepsis incidence remained relatively stable between 2009 and 2014. However, using claims data, incidence increased by 10.3 per- cent during the timeframe. 3. Clinical data indicated a decline in hospital deaths and no significant change in patients discharged to hospice. Claims data indicated a significant decrease in both hospital deaths and discharge to hospice. e researchers concluded detailed clini- cal data from EHRs were more sensitive to identifying sepsis trends than claims-based information. "e findings also suggest that EHR-based clinical data provide more ob- jective estimates than claims-based data for sepsis surveillance," the study authors con- cluded. n

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