Press release

HCA Healthcare Using Algorithm Driven Technology to Detect Sepsis Early and Help Save 8,000 Lives

Sponsored by Businesswire

HCA Healthcare (NYSE: HCA), a leading healthcare provider with 185
hospitals and approximately 2,000 sites of care in 21 states and the
United Kingdom, today announced it has developed an algorithm driven,
real-time system to more quickly identify patients with sepsis and help
save lives. HCA Healthcare’s Sepsis Prediction and Optimization of
Therapy, or SPOT, technology so far has been used with 2.5 million
patients and, in conjunction with the use of evidence-based clinical
interventions, has helped save an estimated 8,000 lives in the last five

Sepsis is an overwhelming infection that can lead to total body failure,
and approximately 270,000 Americans die from it each year, making it
more deadly than breast cancer, prostate cancer, and AIDS combined,
according to Sepsis Alliance. Additionally, it is the No. 1 cause of
death in non-cardiac intensive care units in all hospitals and the 11th
leading cause of death overall in the U.S. Because the symptoms of
sepsis are similar to those of many other illnesses, diagnosing it can
be very challenging; however, studies have shown with early recognition
followed by aggressive treatment, patient survival can increase
significantly because sepsis mortality increases by 4 to 7 percent every
hour it goes undetected.

“With sepsis, minutes matter, and just as we’ve improved safety in our
homes with smoke detectors that ‘sniff out’ possible fire, HCA
Healthcare’s SPOT technology now helps detect sepsis earlier,
accelerating treatment, improving the care provided to our patients and
thereby saving lives,” said Dr. Jonathan Perlin, HCA Healthcare’s chief
medical officer and president, clinical services group.

HCA Healthcare’s SPOT, which uses the popular dog name because it sniffs
out sepsis in a way humans cannot, is an algorithm and alert system for
the early detection of sepsis. Created by HCA Healthcare clinical and IT
experts using data from millions of hospitalizations, SPOT continuously
monitors vital signs, lab results, nursing reports and other data that
can inform treatment, and recognizes critical data points in patients’
electronic health records. HCA Healthcare’s SPOT links algorithmic
sepsis detection with clinical workflow and quickly alerts care teams to
important, often subtle changes in a patient’s condition so they can
take appropriate action.

“If you or your loved one were in the hospital, what would you want from
the perfect clinician? You would want them focused on you, and only you,
24 hours a day. You want them analyzing every new piece of lab data when
it is created, and you want them to understand the implications of that
data and the relationships between the different pieces of data,” said
Dr. Perlin. “SPOT is designed to monitor available data every moment of
every day, and when combinations of lab data that are consistent with
sepsis are detected, the system responds by alerting clinicians so they
can more quickly intervene with potentially life-saving treatment for
you or your loved one.”

Because HCA Healthcare’s SPOT algorithm was informed by data from 31
million annual patient care episodes, it is highly sensitive and
precise. It detects signs of potential sepsis humans cannot see, while
excluding instances when humans inaccurately suspect sepsis.

“Studies about sepsis show that the sooner we can act, and act
effectively, the more likely the patient is to survive. SPOT is
a technology and workflow that helps us catch sepsis early and more
likely prevent catastrophe,” said Dr. Michael
Nottidge, critical care medical director at HCA Healthcare’s TriStar
Centennial Medical Center. “SPOT does not make decisions, but it monitors
in the background and brings vital, accurate and up-to-date information
to the people who do make decisions.”

Sabrina Burkdoll, a registered nurse with HCA Healthcare’s Menorah
Medical Center in Overland Park, Kansas, experienced the benefits of
SPOT firsthand during a recent bout with pneumonia. After two days at
home on antibiotics, Burkdoll was getting worse, not better, and came to
the Menorah ER with shortness of breath and a fever. ER staff diagnosed
her with sepsis and began treating her and monitoring her, while
starting the process of admitting her; however, before she was moved to
an inpatient room, SPOT detected that the sepsis had quickly progressed
to septic shock, a dangerous condition that can lead to organ failure
and death. SPOT alerted the care team who confirmed this and took quick
action. Burkdoll would stay in the hospital for three days, but the
timely SPOT alert helped Menorah caregivers effectively treat her
condition and prevent a transfer to the ICU.

“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,”
said Burkdoll. “I am so grateful for the quick response, because without
it, I’m not sure I would have survived. Speaking from personal
experience, SPOT is a life-saving tool, and I know our patients are in
better hands because we have it.”

SPOT is the first of many initiatives across HCA Healthcare to leverage
data at-scale and in real-time to drive both discovery and improvement
as a natural outgrowth of patient care. HCA Healthcare’s clinical
and data science teams expect to continue to improve the algorithm,
combining real-world experiences and outcomes with techniques of machine
learning and artificial intelligence to enhance clinical effectiveness.
Building upon the SPOT technology employed in the inpatient setting, HCA
Healthcare is developing “SPOT-ER,” which HCA plans to begin deploying
in emergency rooms this year. HCA Healthcare also has plans to use
machine learning to more quickly detect other critical or
life-threatening conditions such as shock in trauma patients,
post-operative complications, and early signs of deterioration in all
patients. The opportunity to improve care through clinical informatics
and machine learning is substantial, and HCA Healthcare is leveraging
its scale to do so.

HCA Healthcare is a learning health system that uses the significant
data it collects from approximately 31 million annual patient care
episodes to inform and improve the care it provides to patients. HCA
Healthcare’s national clinical data warehouse, which receives
information from the electronic health record, is the heart of HCA’s
data ecosystem, providing the ability to aggregate and analyze data
streams in real time and feed tools like SPOT that, in turn, provide
actionable information to caregivers.

This information architecture also supports HCA Healthcare’s efforts to
drive continuous learning and improvement, and was the basis for the
renowned REDUCE MRSA trial, a three-arm, comparative effectiveness study
involving 43 cluster-randomized hospitals and nearly 75,000 patients. In
just 18 months, the study demonstrated a 44 percent all-cause reduction
of potentially life-threatening bloodstream infections among intensive
care unit patients by employing a “universal decolonization” strategy.
The learning model also underpins a recent study, known as the ABATE
Infection (Active BAThing to Eliminate infection) Trial, conducted
exclusively at HCA Healthcare hospitals. The study found an antiseptic
wash achieved a 31 percent reduction in bloodstream infections and
nearly a 40 percent reduction in antibiotic-resistant bacteria among
non-ICU patients with central line catheters and lumbar drains. The
Centers for Disease Control was engaged in both REDUCE
and ABATE,
and universal decolonization in the ICU is now recognized worldwide as a
best practice.

About HCA Healthcare

Nashville-based HCA Healthcare is one of the nation’s leading providers
of healthcare services, comprising 185 hospitals and approximately 2,000
sites of care, including surgery centers, freestanding ERs, urgent care
centers, and physician clinics, in 21 states and the United Kingdom.
With its founding in 1968, HCA Healthcare created a new model for
hospital care in the United States, using combined resources to
strengthen hospitals, deliver patient-focused care and improve the
practice of medicine. HCA Healthcare has conducted a number of clinical
studies, including one that demonstrated that full-term delivery is
healthier than early elective delivery of babies and another that
identified a clinical protocol that can reduce bloodstream infections in
ICU patients by 44 percent. HCA Healthcare is a learning health system
that uses its more than 31 million annual patient encounters to advance
science, improve patient care and save lives. Please click
to connect with HCA Healthcare on social media.

All references to “Company,” “HCA” and “HCA Healthcare” as used
throughout this document refer to HCA Healthcare, Inc. and its