How telemedicine can transform sepsis care in long-term facilities

Carolyn S. Fogleman, RN
Quality Improvement Nurse, Sound Physicians Telemedicine

Long-term care and assisted living residents are among the highest-risk groups for one of healthcare’s most persistent threats: sepsis. Because residents living in these facilities often have underlying health issues, early recognition and intervention are critical. But it can be challenging—especially during evenings and weekends, when on-site clinical coverage is sometimes more limited.

Why sepsis demands a new approach

Despite promising treatment advances, sepsis is still widespread, contributing to more than 750,000 hospitalizations and over 215,000 deaths in the U.S. each year¹.

Many long-term care and assisted living residents live with multiple chronic conditions and weakened immune systems that sometimes mask classic sepsis symptoms. This places them at greater risk for developing severe sepsis. When compared with patients living independently, residents experience:

• Seven times higher rates of severe sepsis²
• Nearly double ICU admission rates—40 percent compared to 21 percent³
• Over double the mortality rate—37 percent compared to 15 percent⁴

So, how do we help clinicians more effectively reverse these trends?

We bridge the gap with telemedicine

We’ve seen firsthand how telemedicine can transform sepsis care and improve the quality of life for patients in long-term care settings. Our telemedicine clinicians are available the moment concerns arise, so residents don’t have to wait for the next scheduled visit or risk an emergency transfer.

Telemedicine consults help fill any gaps in care during evenings and weekends. Through a virtual assessment, our clinicians can note any changes with residents, even subtle ones, that may indicate sepsis—a shift in mental status, a low-grade fever, or early skin breakdown—and recommend next steps. Not only does this serve the health and well-being of residents, but it also helps ease the on-call load for medical directors.

Clinician collaboration, person-centered care

For the patient, —with nurses, physicians, and family members coming together in a shared virtual space to set goals and make informed decisions around treatment. And administrators and medical directors get peace of mind with after-hours access to care, without the additional expense of on-call, in-person staffing.

Early intervention, better outcomes

Perhaps the most effective way to manage a resident with sepsis is to catch it early. Telemedicine provides prompt access to care—and helps ensure better compliance with treatment protocols. Studies show that when telemedicine is integrated into their care, residents see more timely administration of antibiotics and fluids, along with more appropriate antibiotic use.

Beyond the obvious upside of early detection on treatment, a resident’s quality of life also benefits. Treatment that begins in the person’s home facility vs. the hospital—including labs, cultures, and starting antibiotics—helps reduce the patient’s stress as well as the risks associated with a hospital stay.

Looking ahead

While sepsis remains a formidable challenge, technology—in particular, the ability to provide care via telemedicine—is reshaping the way we respond. Earlier detection through telemedicine—along with supportive, collaborative care and treatment provided to patients in their place of residence vs. the hospital—we’re giving long-term care residents a better chance for recovery. And we’re also helping to set a stronger foundation for high-quality care at long-term care facilities.

References

¹Incidence and Trends of Sepsis in US Hospitals Using Clinical vs Claims Data

^{2, 3, 4} Impact of Older Age and Nursing Home Residence on Clinical Outcomes of U.S.
Emergency Department Visits for Severe Sepsis