Healthcare Reform

Ministry of National Guard Health Affairs: Leveraging Predictive Analytics and EHR Data for Prediction and Early Detection of Sepsis

A patient checking in with a healthcare professional.

The Kingdom of Saudi Arabia’s Ministry of National Guard Health Affairs (MNGHA), a publicly funded and Joint Commission International-certified healthcare delivery system, serves some 1.3 million people, including Saudi National Guard service members and their families. A 3,720-bed enterprise, MNGHA offers outpatient services like primary and specialized healthcare, with a current capacity of about 3.2 million patient visits each year. Its healthcare professional workforce is large and diverse, comprising 13,000 multi-specialty physicians, nurses and allied healthcare providers from more than 45 countries.

MNGHA’s healthcare digital reform journey began in 2016 when the hospital system sought to meet HIMSS’ EMRAM Stage 6 requirements at its King Abdulaziz Medical City – Riyadh (KAMC-R). MNGHA KAMC-R later became the first hospital in the world to achieve Stage 7 in four different models, making it one of the most mature digitally enabled care systems in the world.

Sepsis is a life-threatening condition that occurs when the body has an extreme inflammatory response to an infection, triggering a cascade of multi-systemic organ failures. It kills 11 million people each year worldwide and causes severe illness and long-term disability among millions more. Sepsis is a common problem in Saudi Arabia. In one study, 699 patients were admitted with sepsis and septic shock in an eight-month period in 2013 from the emergency department to KAMC-R, with a mortality rate of 17%. Still, two factors contributed significantly to reduce the mortality rate and severity of sepsis: early detection and early treatment.

KAMC-R’s clinical and information technology teams saw an opportunity to detect early warning signs of sepsis for better treatment. The IT team made a positive impact by using digital technology, real-time monitoring data and clinical decision support tools for continuous patient surveillance. The result was a user-friendly, fit-for-purpose, scalable and sustainable solution that leverages internal knowledge and resources and was built in-house at a low cost.

KAMC-R implemented the project in a stepwise approach that started in December 2019 and was completed by the end of 2021. MNGHA made this investment in digital technology to enable greater efficiency and delivery of services, with a goal of reducing sepsis death by 25%. In fact, preliminary analysis of the mortality data of 54,965 patients showed that the alert system exceeded that metric and has resulted in a reduction of sepsis mortality by 30%.

Using technology to augment and inform clinical surveillance and intervention reduced human error, allowed clinicians to focus on patient care and ensured sustainability of improved outcomes in patient care delivery. Implementing this project within a research framework provides a robust methodology and unbiased, evidence-based assessment of outcomes.