The Kansas Sepsis Project

Severe sepsis is a common cause of mortality, representing the most common cause of death in noncoronary ICUs (Bone et al. Chest. 1992;101[6]: 1644). Sepsis is rapidly increasing in incidence, projected to affect over 1,000,000 patients per year in the United States by 2020 (Angus et al. Crit Care Med. 2001;29[7]:1303-1310). Rural patients develop severe sepsis in similar proportion to urban patients, yet access to critical care services in rural areas is limited.

Telemedicine can help to bridge the gap between the mostly urban supply of intensivists and underserved rural patients and their local physicians (Marcin et al. J Pediatr. 2004;144[3]:375). Various techniques have been utilized to address this need, ranging from video consultation to teleICU, with reasonable evidence that such care is comparable to hands-on ICU care (Hersh et al. BMC Medical Informatics and Decision Making. 2001;1:5). To further explore uses of telemedicine in the specialty of critical care medicine, a CME/performance improvement project dealing with improving care of patients with sepsis in rural Kansas was implemented via the Eli Lilly Distinguished Scholar Award of The CHEST Foundation. An objective of the project is to empower rural physicians to appropriately care for their own patients with sepsis, as an alternative to real-time telemedicine consultation.

The Kansas Sepsis Project brings CME and performance improvement to rural Kansas areas via telemedicine in both educational and advisory roles. The project provides a novel method for rural medical practitioners to obtain CME credit while performing sepsis quality improvement projects that are eligible for maintenance of board certification. The overall goal of the project is to demonstrate a statewide reduction in sepsis mortality through widespread provider participation, paving the way for similar projects in other rural states.

Dr Lucas R. Pitts; and
Dr Steven Q. Simpson, FCCP,
NetWork Vice-Chair and Third Eli Lilly
and Company Distinguished Scholar in
Critical Care Medicine