Medical Device Daily

A new clinical decision support tool from Royal Philips Electronics (Amsterdam, the Netherlands) may help hospital clinicians make crucial care decisions, including early detection of severe sepsis, one of the most difficult problems facing hospital healthcare providers. In particular, a difficult and highly critical monitoring problem.

The company has introduced its Philips ProtocolWatch, an application available on Philips IntelliVue patient monitors that applies data to evidence-based care protocols.

ProtocolWatch is the first application to deliver customer-specific care protocols on the patient monitor screen, according to Philips. ProtocolWatch responsively uses monitoring measurements to offer relevant screening and treatment information from evidence-based care guidelines.

In its initial release, ProtocolWatch brings the care guidelines developed by the Surviving Sepsis Campaign (SSC), published in the New England Journal of Medicine in 2001, to the Philips IntelliVue patient monitoring platform. The SSC protocol defines the physiological parameters that indicate the onset of severe sepsis. Because ProtocolWatch is built into the patient monitor, it can use the patient's vital signs to help clinicians screen for this deadly condition.

"Sepsis is a real big problem, it progresses very quickly," Karen Giuliano, PhD, RN, clinical research scientist at Philips, told Medical Device Daily.

Severe sepsis is a condition in which the body's immune response to an infection spirals out of control, leading to organ dysfunction and death. It is the leading cause of death in non-coronary intensive care units. Complicating efforts to improve care, the symptoms of sepsis can appear similar to other conditions, resulting in diagnoses that can come too late, according to Philips.

Giuliano said there has been a lot of work done in the past five to 10 years for the treatment of sepsis, but not a lot has been done to help clinicians identify it early.

"That's where we thought patient monitoring could come into play because clearly the clinician can't stand there [at the patient's bedside] all day, they're very busy. The purpose of a patient monitor is to be there when the clinician can't be," she said. "That's why it makes a lot of sense to put this application into a monitor."

Once one of the parameters that act as an early warning sign for sepsis reaches the limits defined by the SSC protocol, a ProtocolWatch window appears on the monitor screen. This window prompts clinicians to check for other clinical signs of severe sepsis.

For example, the window might ask which of the following conditions are both present and new to the patient, followed by a check list of conditions such as an abnormal temperature, an acutely altered mental status, chills with rigors, or hyperglycemia in absence of diabetes. If these signs are not present, ProtocolWatch resumes screening in the background.

"If your patient doesn't meet the criteria [for sepsis] it stays in the background and you never know it's on," Giuliano said.

If a clinician diagnoses a patient with severe sepsis, ProtocolWatch launches the Sepsis Resuscitation Bundle, displaying a checklist of interventions recommended by the SSC Sepsis Protocol. Because timing is critical when treating sepsis, ProtocolWatch also displays a timer. Once the Sepsis Resuscitation Bundle has ended, ProtocolWatch provides recommendations from the SSC Sepsis Management Bundle.

"It walks the clinician through," Giuliano added.

Giuliano said the ProtocolWatch is designed to support the clinician through the process, suggesting interventions based on the care protocols but without taking over.

Eventually the company plans to add more evidenced-based care protocols to the ProtocolWatch, but for now the sepsis screening is the first.

David Russell, VP of marketing for Philips, also points out that physicians have overwhelming amounts of raw data to deal with.

"Medical technology can provide endless numbers of data points. But beyond merely providing that accumulation of data, at Philips we're designing clinical decision support systems to provide clinicians a clearer picture of what's happening with a patient, turning data into clear, pertinent information and even providing guidance through clinical protocols," Russell said.

Philips also released the IntelliVue MP5, a compact, full-featured patient monitor for in-hospital patient transport.

Philips IntelliVue MP5 provides a suite of clinical decision support tools common to IntelliVue monitors and makes them available in transport and telemetry settings. These include a variety of screen trends that visually present the story of a patient's monitoring data over time, the company said.

For example, Horizon Trends can display the past 30 minutes to 12 hours of measurements as a line graph related to a baseline, which can be a start or target value. The current measurement is a single prominent bar in relation to the baseline, with an arrow indicating the overall direction of the past 10 minutes of measurements. These and other screen trends can help clinicians rapidly identify significant changes in patient status, saving crucial time.

The IntelliVue MP5 provides the same functionality as higher-acuity IntelliVue monitors in a compact, lightweight, affordable unit ideal for transport and flexible care, according to the company. The system features touch screen operation, and an 8.4-inch screen displaying up to four waveforms. Its wired and wireless networking capability, sturdy housing and varied mounting options suit it to mobility, Philips said.

In addition, with Telemetry as a Parameter (TAAP), the MP5 displays monitoring data collected by telemetry devices so that clinicians can read a patient's vital signs without having to go to the central station.

The MP5 connects to the IntelliVue Clinical Network for secure, reliable data transmission among patient monitors, telemetry, bedside devices, clinical information systems, and the central station. For patients in transit within the hospital, the networked MP5 allows clinicians at the central station to monitor parameters, alarms, and trends remotely.

Philips makes diagnostic imaging and patient monitoring systems, energy-efficient lighting, personal care and home appliances, as well as consumer electronics.