HCA Healthcare
May 16, 2019

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Brett Kelman, Nashville Tennessean

The largest hospital company in the United States will soon expand a program that uses computer algorithm to detect sepsis in patients faster than any human doctor or nurse.

HCA Healthcare, which is headquartered in Nashville but owns more than 180 hospitals in 21 states, said Wednesday it would expand the sepsis detection algorithm into hospital emergency rooms later this year.

Previously, the program has been used throughout HCA’s inpatient care, where it has routinely detected sepsis about eight to 10 hours before clinicians ever could, said Dr. Jonathan Perlin, HCA's chief medical officer.

"This is really critical because time is life," Perlin said. "Every hour of earlier detection increases your chance of survival up to 8%."

Sepsis is a life-threatening condition where the human body overreacts to an infection, releasing chemicals into the bloodstream that are intended to fight the infection but can damage organs instead. Sepsis is most dangerous if it progresses to septic shock, which can cause rapid drops in blood pressure and even death. Sepsis and septic shock are among the most common causes of death in the nation.

HCA began development of the Sepsis Prediction and Optimization of Therapy algorithm, or SPOT, in 2016 and spread the program into nearly all of its hospitals last year. The program constantly monitors electronic medical records and lab data for subtle changes in a patient’s condition that can signify sepsis. So far, SPOT has been used to monitor about 2.5 million patients, and HCA estimates the program has saved as many as 8,000 lives.

Recently, one of those lives belonged to one of their own.

In a news release, HCA detailed how SPOT recently helped in the treatment of one of its nurses, Sabrina Burkdoll, who was hospitalized with sepsis at an HCA hospital in Kansas.

The computer algorithm was the first to detect that Burkdoll’s sepsis had progressed into septic shock. The timely diagnosis help prevent the condition from worsening, and instead of going to the intensive care unit, Burkdoll was out of the hospital in three days.

“As a nurse, I understand sepsis, but as a patient I didn’t fully realize what was happening to me and how dire the situation had become,” Burkdoll said in the HCA release. “I am so grateful for the quick response, because without it, I’m not sure I would have survived.”

In Nashville, the SPOT program was introduced at HCA's flagship hospital, TriStar Centennial, about one year ago. Since then, the algorithm has alerted clinicians to a septic patient nearly every day, often hours sooner than they would have been detected otherwise, said Dr. Michael Nottidge, who leads hospital's critical care team.

Nottidge said the algorithm is especially helpful because, although the onset of a heart attack or a stroke are dramatic and easy to notice, sepsis begins quietly, then builds into a dangerous “crescendo.”

“Quite often, people don’t hear the music until it’s fully playing,” Nottidge said. “And that’s why having a sentinel always watching, to pick up on it early on, is so helpful.”

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Brett Kelman is the health care reporter for The Tennessean. He can be reached at (615) 259-8287 or by email.