OSF Healthcare Develops Telehealth Protocols for Sepsis Treatment

OSF Healthcare and Northwestern University have developed a protocol for using telehealth to treat patients with sepsis in rural hospitals.

Using a four-year, $750,000 grant from the Agency for Healthcare Research and Quality, the Peoria, IL-based health system partnered with Northwestern and the University of Illinois College of Medicine at Peoria’s Jump Simulation program to develop a toolkit that addresses how a telemedicine care can be used in a small Emergency Department or ICU to connect with specialists to help treat patients dealing with severe sepsis and septic shock.

The research may provide a model for hub-and-spoke telemedicine networks like eICUs that help small and rural hospitals treat acute care patients on-site.

William Bond, MD, an emergency department physician and Jump Simulation’s director of research, says the program’s goal is to "better connect patients in the ER to caregivers in the telehealth realm who would eventually be overseeing their care in the intensive care unit at those sites.

“It helps make that transition earlier and helps to create a layer of back-up and extra monitoring to make sure we're meeting all the sepsis care goals," he said in a press release issued by OSF Healthcare. "They can monitor the patient's vitals. They can have their eyes on the patient and can see them start to just kind of get confused and then (eICU critical care nurses) can alert the nurse in the next room, 'I'm concerned about your patient in the next room, can you go in and check on them?'"

The program targets sepsis, which affects more than a million patients in America each year – killing as much as 40 percent of them through septic shock – and costs the healthcare system roughly $54 billion.

Small hospitals often don’t have the expertise to identify sepsis in its early stages, when it can be treated.

Patients "can appear OK or not as severe when they enter emergency rooms and then go downhill really fast,” said Kim Cooley, RN, the program’s research coordinator. “If you don't initiate certain treatments within certain time frames after they start to go downhill, then they could die.”

With a telemedicine cart that includes audio-visual communications and a link to specialists – in this, case, an eICU in Peoria – rural caregivers can turn to those specialists for remote patient monitoring and guidance.

In the program, OSF Healthcare created a simulation toolkit, using a trained actor, to map out what would and should happen during a telehealth session. Researchers then surveyed participants to evaluate the effectiveness of the simulation.

"During the simulation, they were able to practice introducing that telehealth cart to the patient so that takes some of the stress and awkwardness away if you can practice in a somewhat lifelike situation but you're not practicing on a patient the first time," Cooley said, noting it gives providers the confidence to use telehealth and care for more patients rather than transporting them to a larger hospital.

Bond said the research may pave the way for more simulation toolkits, allowing health systems like OSF Healthcare to better plan and launch telehealth partnerships with remote providers.

"We are fortunate to have a virtual hospital next to our real hospital (OSF Saint Francis Medical Center), or at the right time we can test it at the bedside, because there are many factors that simply can't be replicated,” he said. “So, those process tests can be incredibly revealing and can find issues that you might not think would be the barriers or facilitators to the adoption of that technology in practice."