With EHR-based sepsis detection, Epic and Cerner have different approaches
Recent improvement in hospital surveillance technology for sepsis detection is leading to longer lives, according to a new report from KLAS that examined monitoring tools from blue-chip EHR vendors and smaller standalone products.
About 69 percent of the 95 providers polled say the IT systems have led to improved patient safety outcomes, according to KLAS, with some reporting a 50 percent drop in mortality. Other benefits included lower treatment costs, shorter lengths of stay and fewer readmissions. Still, 23 percent said it was too early in their rollout of the surveillance and treatment systems to have reliably reportable results.
Perhaps unsurprisingly, Epic and Cerner together represent the largest customer base for sepsis technology – with more clients than than all other vendors combined.
Customers of both EHR giants say their surveillance tools have led to improved patient outcomes, including mortality reductions. But KLAS noted that the two vendors have quite different strategies for helping hospitals detect septic and pre-septic patients.
Cerner's "always-on algorithm and related alerting are easily deployed and available for free" to its customers, according to the report, while an advanced analytics and dashboard module are available for a fee.
Epic's Best Practice Alerts, meanwhile, are made available free to customers. But KLAS reports that those providers that are live or in-process with Epic's sepsis functionality say "implementing and integrating it into current workflows requires significant in-house effort."
Other big-name EHR vendors have limited market share: MEDITECH recently developed a sepsis tool for its 6.x platform, but KLAS says awareness about it is low. Allscripts doesn't have sepsis-specific technology, but will help its clients customize their systems with other tools.
Among the offerings that could help do that are specialty infection control and surveillance modules from vendors such as Wolters Kluwer and VigiLanz. The report quotes one CMIO's high marks for the former, whose POC Advisor tool "pulls data out of our EHR to an engine with all of these rules and then shoots alerts to mobile devices," he said. "We are giving needed information to providers at the point of care no matter where they are," he said. "We get more of a real-time perspective versus the retrospective chart reviews that we would get three to six months later."
Other less common approaches include deploying analytics from vendors such as Health Catalyst and LogicStream. Beyond real-time alerting, those companies "leverage their analytics to provide retrospective views of clinical effectiveness and spur effective end-user change management," according to KLAS. "Customers appreciate Health Catalyst's strong partnership and focus on customer success, while LogicStream clients extoll the flexibility and usefulness of their reports."
Still, the report shows that, all things being equal, hospitals would prefer to use their EHR vendor when possible, noting that Epic and Cerner are both seen as relatively more competitive on infection control than their competitors. Meanwhile, "most traditional market mainstays in infection control and surveillance have not leveraged their market presence or technology to help more than a few customers combat sepsis, and few providers look to other third-party vendors."
In addition to providers with surveillance tools in place, KLAS also polled more than 100 providers who had yet to install sepsis-detection technology: 53 percent are considering either a new EHR module or in-house developed add-on using their existing platform; 19 percent are considering third-party tech and 28 percent aren't yet in the market.