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Sepsis Watch is a deep learning clinical decision support system developed at Duke University Health System to provide early warning of sepsis risk in hospitalized patients. It is notable as the first deep learning model to be integrated into routine clinical care in the United States.
Sepsis Watch was developed between 2016 and 2018 by a team at the Duke Institute for Health Innovation (DIHI), led by Mark Sendak, MD, MPP, in collaboration with clinical staff at Duke University Hospital. The system uses real-time electronic health record data to generate risk scores for patients at risk of sepsis up to 36 hours before clinical presentation. Development took approximately two and a half years and involved close collaboration with emergency department physicians and rapid response nurses to design the clinical workflow around the model's output.
The system went live at Duke University Hospital on November 5, 2018, marking the first time a deep learning model had been integrated into routine clinical care in the United States. Within six months of deployment, Duke University Hospital reached the top decile of performance on the Centers for Medicare and Medicaid Services SEP-1 sepsis bundle compliance measure, having doubled its prior compliance rate.[1]
Following the pilot at Duke University Hospital, Sepsis Watch was subsequently implemented at Duke Regional Hospital and Duke Raleigh Hospital. The DIHI team published a Model Facts label for Sepsis Watch in npj Digital Medicine in March 2020, providing a standardized transparency framework for AI tools in clinical settings, similar in concept to nutrition facts labels for food products.[2] This work later informed the Office of the National Coordinator for Health Information Technology's HTI-1 Final Rule on algorithm transparency.
A peer-reviewed implementation study was published in JMIR Medical Informatics in 2020 documenting the real-world integration process, workflow design, and clinical outcomes.[3]
Despite federal funding to accelerate commercialization, Sepsis Watch had been deployed at only two health systems a decade after its initial development. Mark Sendak cited this limited diffusion as a primary motivation for founding Vega Health in 2025, a company focused on distributing and implementing clinically validated AI tools across health systems.[4]
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