Current state, challenges, and opportunities
Digital health technologies hold immense potential to transform the management of pediatric sepsis. These innovations can enhance early detection, streamline treatment protocols, and improve patient outcomes globally.
However, to fully realize these benefits, there are several challenges to be addressed.
In a series of four papers on pediatric sepsis published on The Lancet Digital Health, authors explore the global landscape of digital solutions in pediatric sepsis, highlighting recent technological advancements that are driving the creation of innovative applications.
Current State of Digital Solutions
Digitization of pediatric sepsis care is progressing globally, offering impactful solutions across the care continuum—from initial presentation and treatment to long-term follow-up. Accurate capture of pediatric sepsis incidence is essential for understanding disease burden and optimizing healthcare system coding and billing. The Global Burden of Disease study highlighted that combining infection criteria with organ dysfunction metrics provides more precise global sepsis incidence estimates.
Digital tools for pediatric sepsis primarily focus on early detection and monitoring. The availability of Electronic Health Record (EHR) data and the straightforward operationalization of sepsis as an infection with life-threatening organ dysfunction have led to standardized coding scripts. These scripts help identify sepsis in children and adults by scanning routine healthcare data.
Wearable devices and mobile applications track vital signs and alert healthcare providers to early signs of sepsis. These technologies have shown promise in clinical trials, reducing the time to diagnosis and improving survival rates.
However, most digitization efforts have occurred in large academic pediatric institutions within well-resourced settings, with limited implementation in low-resource environments. Even in better-resourced settings, most digital applications rely on static, rule-based decision support rather than dynamic AI models.
Clinical Decision Support Systems (CDS): enhancing recognition and optimizing care
CDS tools are essential in improving clinical decision-making by delivering timely, relevant information to healthcare providers. In pediatric sepsis, CDS includes clinical guidelines, EHR order sets, alerts, best practice recommendations, and data dashboards.
Most tools focus on rule-based algorithms for early sepsis detection, especially in emergency departments, with some utilizing machine learning for sepsis prediction. However, despite widespread informal use, few hospitals have published data on these tools, and rigorous evaluations are scarce.
Studies indicate that while some CDS tools improve detection accuracy, their impact on patient outcomes is less clear, with potential benefits not always reflected in measurable results.
Digital CDS tools hold significant promise for improving pediatric sepsis care in low- and middle-income countries (LMICs), where healthcare resources are limited.
Efforts to integrate CDS tools into medical devices and leverage low-cost, high-quality monitoring solutions are underway, but challenges such as regulatory hurdles, data privacy concerns, and the need for robust training systems remain significant barriers.
Precision Medicine, AI and Digital Technology
The heterogeneity in pediatric sepsis presents a challenge for precision medicine, which aims to classify patients into phenotypes for targeted therapy. Machine learning algorithms have been used to identify sepsis phenotypes based on clinical data, showing potential for improving outcomes. However, translating these findings into real-time clinical practice is challenging, particularly in resource-limited settings. There is a need for low-cost, scalable digital tools for real-time profiling and precision medicine approaches that can be deployed globally.
Recent advances in AI and healthcare technology are opening new possibilities for pediatric sepsis care. Traditional AI models, which require large datasets, are being supplemented by general-purpose AI systems that can adapt to new tasks with minimal data.
These models could integrate patient data with biomedical literature to provide clinicians with tailored recommendations.
Key Challenges
- Data Integration and Interoperability: Integrating data from various sources remains a significant hurdle. EHRs, wearable devices, and mobile apps often operate on different platforms, making seamless data sharing difficult. Standardizing data formats and ensuring interoperability can enhance the effectiveness of digital solutions.
- Accuracy and reliability Machine learning models require large, diverse datasets to accurately predict sepsis. Limited access to high-quality data hampers the development of reliable algorithms. Collaborations between healthcare institutions can facilitate data sharing and improve model accuracy.
- User Adoption and Training: Healthcare providers may resist adopting new technologies due to a lack of training or familiarity. Comprehensive training programs and user-friendly interfaces can encourage adoption and ensure effective use of digital tools.
- Ethical and Privacy Concerns: Collecting and analyzing patient data raises ethical and privacy issues. Robust data protection measures and clear guidelines are essential to address these concerns and build public trust.
- Resource Constraints: Implementing digital solutions requires significant financial and technical resources. Low-resource settings may struggle to adopt these technologies. International support and funding can help bridge this gap and ensure equitable access to digital health innovations.
Opportunities for Improvement
- Enhanced Collaboration: Collaboration between technology developers, healthcare providers, and policymakers can drive innovation and address existing challenges. Joint efforts can lead to the development of more effective and user-friendly digital solutions.
- Focus on Low-Resource Settings: Tailoring digital health technologies to the needs of low-resource settings can improve pediatric sepsis care globally. Affordable and scalable solutions can ensure that all children, regardless of their location, receive timely and effective treatment.
- Continuous Monitoring and Feedback: Implementing continuous monitoring systems can provide real-time feedback to healthcare providers. This approach can help refine treatment protocols and improve patient outcomes over time.
- Policy and Regulation: Clear policies and regulations can guide the ethical use of digital health technologies. Establishing standards for data protection, interoperability, and user training can facilitate the widespread adoption of digital solutions.
Digital health technologies offer promising avenues to improve pediatric sepsis care. Addressing the current challenges and leveraging opportunities can pave the way for a future where digital solutions play a central role in saving young lives.
