Patent Publication Number: US-2021177338-A1

Title: Maternal-fetal sepsis indicator

Description:
BACKGROUND 
     The development of sepsis has been considered an underlying cause of 11% of maternal deaths, according to some studies. Sepsis is a significant contributor to fetal mortality and is attributed to other underlying conditions. Sepsis can result from an infection anywhere in the body in the presence of an infection with a Systemic Inflammatory Response Syndrome (SIRS) response. For example, sepsis can result from pneumonia, influenza, or urinary tract infections. When sepsis is diagnosed in a patient during pregnancy, or during labor the condition is referred to as “maternal-fetal sepsis”, indicating the condition of sepsis in the mother and the fetus. Maternal-fetal sepsis can be deadly to both the mother and the fetus. When a maternal patient (e.g., a mother) is affected by sepsis the same condition may be transferred to the fetus. Maternal-fetal sepsis can be life changing even to survivors, causing chronic pain, fatigue, organ dysfunction, and post-traumatic stress disorder. Early diagnosis and timely treatment can increase the likelihood of survival of maternal-fetal sepsis for the mother and/or fetus. 
     On account of these clinical risks, it is of considerable value to have the improved technologies, as described in the present disclosure, of detecting maternal-fetal sepsis and causing for display a visual indicator of a graphical object. Detecting maternal-fetal sepsis and generating a graphical object, as described in the improved technologies of the present disclosure, can help with timely treatment and early diagnosis. 
     SUMMARY 
     This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter. 
     In brief and at a high level, this disclosure describes, among other things, methods, systems, and computer storage media for detecting maternal-fetal sepsis and causing for display a visual indicator of a graphical object (e.g., a notification). Technologies described herein may be utilized to determine maternal-fetal sepsis from received patient information. In particular, technologies describe, in some aspects, displaying a maternal-fetal sepsis indicator when a sepsis condition is detected during pregnancy, or during labor. Technologies may be used to determine maternal-fetal sepsis and provide a graphical object of a patient&#39;s risk of the maternal-fetal sepsis. Improved notification is provided when a patient is determined to have the maternal-fetal sepsis condition. Some aspects cause for display a graphical object to indicate the presence of maternal-fetal sepsis condition to the mother and/or fetus. For example, on a graphical user interface (GUI) a first visual indicator of a graphical object in response to determining an actionable sepsis criteria and a risk assessment array have been satisfied. In some aspects, a second visual indicator of a graphical object may be displayed on the GUI in response to a first indication that a maternal patient and fetus are at risk of maternal-fetal sepsis. The risk of maternal-fetal sepsis defining at least a likelihood of being diagnosed with sepsis. The second visual indicator may be changed to a first visual indicator of the graphical object in response to a second indication based on a clinical diagnostic for the maternal patient. The visual indicator and graphical object may be identifiable to a clinician as a warning of a risk for maternal-fetal sepsis. In this way, maternal-fetal sepsis may be identified and a graphical object may be generated, facilitating timely treatment and early diagnosis of maternal-fetal sepsis. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The present invention is described in detail below and with reference to the attached drawing figures, wherein: 
         FIGS. 1A and 1B  depict aspects of an illustrative operating environment suitable for practicing an embodiment of the disclosure; 
         FIG. 2  is a flow diagram of an exemplary method of determining a risk of maternal-fetal sepsis, in accordance with aspects of the present invention; 
         FIGS. 3A-3B and 4-5  are an exemplary screen display of a visual indicator of a graphical object for maternal-fetal sepsis, in accordance with aspects of the present invention; 
         FIG. 6  is a flow diagram showing an example of a method for determining a risk of maternal-fetal sepsis and causing for display a visual indicator, in accordance with aspects of the present disclosure; 
         FIG. 7  is a flow diagram showing an example of a method of receiving an indication for maternal-fetal sepsis and providing a visual indicator, in accordance with aspects of the present disclosure; and 
         FIG. 8  is a flow diagram showing an example of determining a risk of maternal-fetal sepsis and causing for display a visual indicator, in accordance with aspects of the present disclosure. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     The subject matter of the present invention is described with specificity herein to meet statutory requirements. However, the description itself is not intended to limit the scope of this patent. Rather, the inventors have contemplated that the claimed subject matter might also be embodied in other ways, to include different steps or combinations of steps similar to the ones described in this document, in conjunction with other present or future technologies. Moreover, although the terms “step” and/or “block” may be used herein to connote different elements of methods employed, the terms should not be interpreted as implying any particular order among or between various steps herein disclosed unless and except when the order of individual steps is explicitly described. 
     As one skilled in the art will appreciate, aspects of the invention may be embodied as, among other things: a method, system, or set of instructions embodied on one or more computer-readable media. Accordingly, the aspects may take the form of a hardware embodiment, a software embodiment, or an embodiment combining software and hardware. In one embodiment, the invention takes the form of a computer-program product that includes computer-usable instructions embodied on one or more computer-readable media, as discussed further with respect to  FIGS. 1A-1B . 
     At a high level, this disclosure describes, among other things, methods, systems, and computer storage media for detecting maternal-fetal sepsis and causing for display a notification. In exemplary aspects, the visual indicator of a graphical object is caused for display in response to determining an actionable sepsis-specific criteria and the risk assessment array have been satisfied. The risk assessment array may be a patient&#39;s risk of maternal-fetal sepsis based on maternal patient information, for example, a higher temperature, elevated heart rate, and/or an elevated white blood cell count. The risk of maternal-fetal sepsis may be described with regard to the risk assessment array, defining a patient has at least a likelihood of being diagnosed with maternal-fetal sepsis. The risk assessment array may represent the presence of organisms associated with sepsis in the patient. If both the actionable sepsis-specific criteria and the risk assessment array are satisfied, a first visual indicator of a graphical object may be presented. In some aspects, the methods and systems may be implemented as a decision support computer application or tool for detecting maternal-fetal sepsis and causing for display a visual indicator of a graphical object. For example, when a risk of maternal-fetal sepsis is determined by the methods described herein, a visual indicator of a graphical object may be generated. 
     As previously explained, maternal-fetal sepsis has many health risks for any patient. Maternal-fetal sepsis can show similar symptoms pregnant patients. Maternal-fetal sepsis can be identified by higher than normal temperatures, elevated heart rate, and/or an elevated white blood cell count, but each of these items can be normal for pregnancy. If maternal-fetal sepsis is successfully identified in these cases, the condition can be overcome with timely treatment. However, studies have shown that 20 percent of mothers who did not receive antibiotics within the first hour of the onset of maternal-fetal sepsis have died along with their fetus, and those who survive end up with either an abortion or premature deliveries. Time is of the essence to identify and treat this condition. 
     To combat the problems with identifying maternal-fetal sepsis, it is important to notify a clinician of the risk of maternal-fetal sepsis. However, it is difficult to determine maternal-fetal sepsis based on one single test. Many factors relating to a patient&#39;s current condition and medical history may contribute to determining the patient is at risk of maternal-fetal sepsis. No tools exist for alerting a clinician of a patient&#39;s risk of maternal-fetal sepsis. Instead of a tool, a clinician may have to identify maternal-fetal sepsis using any information available from desperate systems. Further, a clinician may have to identify maternal-fetal sepsis using outdated information from the desperate systems. Without this information, clinicians often do not treat maternal-fetal sepsis until it is too late for the patient and/or the fetus. There exists a need to determine a patient&#39;s risk of maternal-fetal sepsis and provide a visual indicator of an object to notify a clinician of the patient&#39;s risk of maternal-fetal sepsis. 
     Accordingly, aspects of the present disclosure aim to determine a risk of maternal-fetal sepsis and cause for display on a graphical user interface a visual indicator of a graphical object (e.g., a notification). This process may include determining a patient has satisfied a risk assessment array or an actionable-sepsis-specific criteria has been satisfied. The identification of this risk of maternal-fetal sepsis can be beneficial to clinicians, who may recommend additional testing in response to the identified risk. In some aspects, the process may include changing a second visual indicator to a first visual indicator of the graphical object in response to satisfying the sepsis-specific criteria. The visual indicator of the graphical object or the change of the visual indicator can signal to a clinician the risk level of a patient and treat the patient accordingly. In some embodiments, the present invention also presents remedial actions to be performed by the patient. 
     Stated differently, aspects of the present disclosure are an improvement over prior art systems because they help identify a risk of maternal-fetal sepsis, determine actionable sepsis-specific criteria, and generate a notification for a clinician. With the present disclosure, a clinician can more quickly identify maternal-fetal sepsis and provide treatment, as described herein. 
     Specifically, aspects include receiving maternal patient information. This maternal patient information may correspond to a patient and may be from a source. In some aspects, maternal patient information may be from the patient&#39;s electronic medical record (EMR). In some aspects, the source may be an information system from a single medical organization or from a plurality of medical organizations. Based on the maternal patient information, a risk assessment array may be generated for the patient representing the patient&#39;s risk of maternal-fetal sepsis. For example, the risk assessment array may be based on the vitals of the patient. In some aspects, it may be determined the patient has satisfied the risk assessment array. A clinical diagnostic may be received for the patient representing the presence of organisms associated with maternal-fetal sepsis. An actionable sepsis-specific criteria may be determined to be satisfied based on the clinical diagnostic. In response to the determination the actionable sepsis-specific criteria and the risk assessment array have been satisfied, a first visual indicator of a graphical object may be caused for display on a GUI. 
     In another embodiment, indications may be received and a visual indicator may be generated according to the indication. Accordingly, a first indication that a maternal patient has satisfied a risk assessment array for the maternal patient&#39;s risk of maternal-fetal sepsis may be received. In response to the first indication, a second visual indicator of a graphical object may be caused for display on the GUI. A second indication may be received indicating an actionable sepsis-specific criteria has been met based on the clinical diagnostic for the maternal patient representing a presence of organisms associated with maternal-fetal sepsis in the maternal patient. The second visual indicator may be caused to change on the GUI in response to receiving the second indication. The second visual indicator may be caused to change to a first visual indicator of the graphical object. In some aspects, the second visual indicator caused to change to a first visual indicator may indicating receipt of the clinical diagnostic, for example the confirmation for presence of sepsis indicating organisms in the blood stream 
     As used throughout this disclosure, the term “graphical object” may be any item to notify a clinician of a risk of maternal-fetal sepsis. A graphical object may be an item, symbol, image, figure, pattern, word, phrase, or icon. In some aspects, a graphical object may be a pictorial representation of maternal-fetal sepsis and/or a phrase. 
     Throughout this document, the term “visual indicator” may be used to refer to the means of display of the graphical object. A visual indicator may display the graphical object with a size, shape, color, position or other characteristic of visual display. 
     Although the invention may be described with regard to maternal-fetal sepsis, it is contemplated that the present invention may only be applicable to detection of sepsis during pregnancy. As described, maternal-fetal sepsis is a dangerous condition which requires quick treatment to increase the odds of survival. Embodiments of the present invention may be identifiable to a clinician as a warning of a risk for maternal-fetal sepsis during pregnancy. In this way, maternal-fetal sepsis may be identified and a graphical object may be generated, facilitating timely treatment and early diagnosis of maternal-fetal sepsis in any patient, d, as described herein. 
     Referring now to the drawings generally, and more specifically, referring to  FIG. 1A , an aspect of an operating environment  100  is provided suitable for practicing an embodiment of this disclosure. Certain items in block-diagram form are shown more for being able to reference something consistent with the nature of a patent than to imply a certain component is or is not part of a certain device. Similarly, although some items are depicted in the singular form, plural items are contemplated as well (e.g., what is shown as one data store might really be multiple data stores distributed across multiple locations). But showing every variation of each item might obscure aspects of the invention. Thus, for readability, items are shown and referenced in the singular (while fully contemplating, where applicable, the plural). 
     As shown in  FIG. 1A , example operating environment  100  provides an aspect of a computerized system for detecting maternal-fetal sepsis and causing for display a visual indicator of a graphical object. For example, causing for display a visual indicator of a graphical object in response to determining an actionable sepsis-specific criteria and a risk assessment array have been satisfied. Environment  100  includes one or more electronic health record (EHR) (also referred to as electronic medical record) systems, such as hospital EHR system  160 , communicatively coupled to network  175 , which is communicatively coupled to computer system  120 . In some aspects, components of environment  100  that are shown as distinct components may be embodied as part of or within other components of environment  100 . For example, EHR systems  160  may comprise one or more EHR systems, such as hospital EHR systems, health information exchange EHR systems, ambulatory clinic EHR systems, psychiatry/neurology EHR systems. Such EHR systems  160  may be implemented in computer system  120 . Similarly, EHR system  160  may perform functions for two or more of the EHR systems (not shown). 
     Network  175  may comprise the Internet and/or one or more public networks, private networks, other communications networks, such as a cellular network, or similar network for facilitating communication among devices connected through the network  175 . In some aspects, network  175  may be determined based on factors such as the source and destination of the information communicated over network  175 , the path between the source and destination, or the nature of the information. For example, intra-organization or internal communication may use a private network or virtual private network (VPN). Moreover, in some aspects, items shown as being communicatively coupled to network  175  may be directly communicatively coupled to other items shown communicatively coupled to network  175 . 
     In some aspects, operating environment  100  may include a firewall (not shown) between a first component and network  175 . In such aspects, the firewall may reside on a second component located between the first component and network  175 , such as on a server (not shown), or reside on another component within network  175 , or may reside on or as part of the first component. 
     Aspects of EHR system  160  include one or more data stores of health records, which may be stored on storage  121 , and may further include one or more computers or servers that facilitate the storing and retrieval of health records. In some aspects, EHR system  160  may be implemented as a cloud-based platform or may be distributed across multiple physical locations. EHR system  160  may further include record systems that store real time or near real time patient (or user) information, such as wearable, bedside, or in-home patient monitors, for example. Although  FIG. 1A  depicts an exemplary EHR system  160  that may be used for storing patient information, it is contemplated that an embodiment may also rely on decision support application  140  and/or monitor  141  for storing and retrieving patient record information, such as information acquired from monitor  141 . 
     Example operating environment  100  further includes a provider user/clinician interface  142  communicatively coupled through network  175  to EHR system  160 . Although environment  100  depicts an indirect communicative coupling between user/clinician interface  142  and EHR system  160  through network  175 , it is contemplated that an embodiment of user/clinician interface  142  is communicatively coupled to EHR system  160  directly. An embodiment of user/clinician interface  142  takes the form of a GUI operated by a software application or set of applications (e.g., decision support application  140 ) on a computing device. In an embodiment, the application includes the PowerChart® software manufactured by Cerner Corporation. In an embodiment, the application is a Web-based application or applet. A healthcare provider application may display for a user/clinician the first and/or second visual indicator of the graphical object as described herein. Aspects of user/clinician interface  142  also facilitate accessing and receiving information from a user or healthcare provider about a specific patient or population of patients, including patient history; healthcare resource data; physiological variables (e.g., vital signs) measurements; time series; or other health-related information, and facilitates the display of results, recommendations, or orders, for example. 
     An embodiment of decision support application  140  comprises a software application or set of applications (which may include programs, routines, functions, or computer-performed services) residing on a client computing device, on one or more servers in the cloud, or distributed in the cloud and on a client computing device, such as a personal computer, laptop, smartphone, tablet, mobile computing device, front-end terminals in communication with back-end computing systems or other computing device(s), such as computing system  120  described below. In an embodiment, decision support application  140  includes a Web-based application or applet (or set of applications) usable to provide or manage user services provided by an embodiment of the invention. In an embodiment, decision support application  140  sends a recommendation or notification (such as a visual indicator of a graphical object) directly to user/clinician interface  142  through network  175 . In an embodiment, application  140  sends a notification of a risk of maternal-fetal sepsis to user/clinician interface  142 . In some aspects, application  140  includes or is incorporated into a computerized decision support tool, as described herein. Further, some aspects of application  140  utilize user/clinician interface  142 . For instance, in one embodiment of application  140 , an interface component, such as user/clinician interface  142 , may be used to facilitate access by a user (including a clinician/caregiver or patient) to functions or information on monitor  141 , such as operational settings or parameters, user identification, user data stored on monitor  141 , and diagnostic services or firmware updates for monitor  141 , for example. 
     In some aspects, application  140  and/or interface  142  facilitates accessing and receiving information from a user or health care provider about a specific patient, a set of patients, or a population according to the aspects presented herein. Such information may include historical data; health care resource data; variables measurements; time series; or other health-related information. Application  140  and/or interface  142  also facilitates the display of results, recommendations, or orders, for example. 
     Decision support application  140  may also be used for providing diagnostic services or evaluation of the performance of various aspects. As shown in example environment  100 , in one embodiment, decision support application  140 , or the computer system on which it operates, is communicatively coupled to monitor  141  via network  175 . In an embodiment, patient monitor  141  communicates directly (or via network  175 ) to computer system  120  and/or user/clinician interface  142 . In an embodiment, monitor  141  (sometimes referred to herein as an patient-interface component) comprises one or more sensor components operable to acquire clinical or physiological information about a patient, such as various types of physiological measurements, physiological variables, or similar clinical information associated with a particular physical or mental state of the patient. Such clinical or physiological information may be acquired by monitor  141  periodically, continuously, as needed, or as they become available, and may be represented as one or more time series of measured variables. It is also contemplated the clinical or physiological information about a patient or population of patients, such as the monitored variables, patient demographics, patient history, and/or clinical narratives regarding the patient, used according to the embodiment of the invention disclosed herein may be received from a patient&#39;s historical data in EHR system  160 , or from human measurements, human observations, or automatically determined by sensors in proximity to the patient. 
     An embodiment of monitor  141  stores user-derived data locally or communicates data over network  175  to be stored remotely. In an embodiment, decision support application  140 , or the computer system it is operating on, is wirelessly communicatively coupled to monitor  141 . Application  140  may also be embodied as a software application or app operating on a user&#39;s mobile device, as described above. In an embodiment, application  140  and monitor  141  are functional components of the same device, such as a device including a sensor, application, and a user interface. In an embodiment, decision support application  140  is in communication with or resides on a computing system that is embodied as a base station, which may also include functionality for charging monitor  141  or downloading information from monitor  141 . 
     Example operating environment  100  further includes computer system  120 , which may take the form of a server, which is communicatively coupled through network  175  to EHR system  160 , and storage  121 . Computer system  120  comprises one or more processors operable to receive instructions and process them accordingly and may be embodied as a single computing device or multiple computing devices communicatively coupled to each other. In one embodiment, processing actions performed by computer system  120  are distributed among multiple locations, such as one or more local clients and one or more remote servers and may be distributed across the other components of example operating environment  100 . For example, a portion of computer system  120  may be embodied on monitor  141  or the computer system supporting application  140  for performing signal conditioning of a measured patient variable. In one embodiment, computer system  120  comprises one or more computing devices, such as a server, desktop computer, laptop, or tablet, cloud-computing device or distributed computing architecture, a portable computing device, such as a laptop, tablet, ultra-mobile PC, or a mobile phone. 
     Aspects of computer system  120  include computer software stack  125 , which, in some aspects, operates in the cloud as a distributed system on a virtualization layer within computer system  120 , and includes operating system  129 . Operating system  129  may be implemented as a platform in the cloud and is capable of hosting a number of services, such as services  122 ,  124 ,  126 , and  128 , described further herein. Some aspects of operating system  129  comprise a distributed adaptive agent operating system. Aspects of services  122 ,  124 ,  126 , and  128  run as a local or distributed stack in the cloud, on one or more personal computers or servers, such as computer system  120 , and/or a computing device running interface  142  and/or decision support application  140 . In some aspects, user/clinician interface  142  and/or decision support application  140  operate in conjunction with software stack  125 . 
     Computation services  126  perform software operations such as determining an actionable sepsis-specific criteria and/or risk assessment array are satisfied. In an embodiment, computation services  126  and records/documents ETL service  124  include computer software services or computer-program routines. Computation services  126  also may include natural language processing services (not shown) such as Discern nCode™ developed by Cerner Corporation, or similar services. In an embodiment, computation services  126  include the services or routines that may be embodied as one or more software agents or computer software routines. 
     In some aspects, stack  125  includes file system or cloud-services  128 . Some aspects of file system/cloud-services  128  may comprise an Apache Hadoop and Hbase framework or similar frameworks operable for providing a distributed file system and which, in some aspects, provide access to cloud-based services, such as those provided by Cerner HealtheIntent®. Additionally, some aspects of file system/cloud-services  128  or stack  125  may comprise one or more stream processing services (not shown). For example, such stream processing services may be embodied using IBM InfoSphere stream processing platform, Twitter Storm stream processing, Ptolemy or Kepler stream processing software, or similar complex event processing (CEP) platforms, frameworks, or services, which may include the use of multiple such stream processing services (in parallel, serially, or operating independently). Some aspects of the invention also may be used in conjunction with Cerner Millennium®, Cerner CareAware® (including CareAware iBus®), Cerner CareCompass®, Cerner FetaLink+®, or similar products and services. 
     Example operating environment  100  also includes storage  121  (or data store  121 ), which, in some aspects, includes patient information for a candidate or target patient (or information for multiple patients), including raw and processed patient information; variables associated with patient recommendations; recommendation knowledge base; recommendation rules; recommendations; recommendation update statistics; an operational data store, which stores events, frequent item sets (such as “X often happens with Y”, for example), and item sets index information; association rulebases; agent libraries, solvers and solver libraries, and other similar information, including data and computer-usable instructions; patient-derived data; and healthcare provider information, for example. For example, storage  121  may include the maternal patient information, as described herein. 
     Additionally, it is contemplated the term “data” used herein includes any information that can be stored in a computer storage device or system, such as user-derived data, computer-usable instructions, software applications, or other information. In some aspects, storage  121  comprises data store(s) associated with EHR system  160 . Further, although depicted as a single storage store, storage  121  may comprise one or more data stores, or may be in the cloud. 
     Turning briefly to  FIG. 1B , there is shown one example embodiment of computing system  180  representative of a system architecture that is suitable for computer systems such as computer system  120 . Computing system  180  includes a bus  196  that directly or indirectly couples the following devices: memory  182 ; one or more processors  184 ; one or more presentation components  186 ; input/output (I/O) ports  188 ; input/output components  190 ; radio  194 ; and an illustrative power supply  192 . Bus  196  represents what may be one or more busses (such as an address bus, data bus, or combination thereof). Although the various blocks of  FIG. 1A  are shown with lines for the sake of clarity, in reality, delineating various components is not so clear, and metaphorically, the lines would more accurately be grey and fuzzy. For example, one may consider a presentation component, such as a display device, to be an I/O component. However, processors also have memory. As such, the diagram of  FIG. 1A  is merely illustrative of an exemplary computing system that can be used in connection with one or more aspects of the present invention. Distinction is not made between such categories as “workstation,” “server,” “laptop,” “hand-held device,” etc., as all are contemplated within the scope of  FIG. 1A  and reference to “computing system.” 
     Computing system  180  typically includes a variety of computer-readable media. Computer-readable media can be any available media that can be accessed by computing system  180  and includes both volatile and nonvolatile media, and removable and non-removable media. By way of example, and not limitation, computer-readable media may comprise computer storage media and communication media. Computer storage media includes both volatile and nonvolatile, removable and non-removable media implemented in any method or technology for storage of information, such as computer-readable instructions, data structures, program modules, or other data. Computer storage media includes, but is not limited to, RAM; ROM; EEPROM; flash memory or other memory technology; CD-ROM; digital versatile disks (DVD); or other optical disk storage, magnetic cassettes, magnetic tape, magnetic disk storage or other magnetic storage devices; or any other medium which can be used to store the desired information and which can be accessed by computing system  180 . Computer storage media does not comprise signals per se. Communication media typically embodies computer-readable instructions; data structures; program modules; or other data in a modulated data signal, such as a carrier wave or other transport mechanism and includes any information delivery media. The term “modulated data signal” means a signal that has one or more of its characteristics set or changed in such a manner as to encode information in the signal. By way of example, and not limitation, communication media includes wired media, such as a wired network or direct-wired connection, and wireless media, such as acoustic, RF, infrared and other wireless media. Combinations of any of the above should also be included within the scope of computer-readable media. 
     Memory  182  includes computer storage media in the form of volatile and/or nonvolatile memory. The memory may be removable, non-removable, or a combination thereof. Exemplary hardware devices include solid-state memory, hard drives, optical-disc drives, etc. Computing system  180  includes one or more processors that read data from various entities, such as memory  182  or I/O components  190 . Presentation component(s)  186  present data indications to a user or other device, for example, via a GUI. Exemplary presentation components include a display device, speaker, printing component, vibrating component, etc. 
     In some aspects, computing system  180  comprises radio(s)  194  that facilitates communication with a wireless telecommunications network. Illustrative wireless telecommunications technologies include CDMA, GPRS, TDMA, GSM, and the like. Radio(s)  194  may additionally or alternatively facilitate other types of wireless communications including Wi-Fi, WiMAX, LTE, or other VoIP communications. As can be appreciated, in various aspects, radio(s)  194  can be configured to support multiple technologies and/or multiple radios can be utilized to support multiple technologies. 
     I/O ports  188  allow computing system  180  to be logically coupled to other devices, including I/O components  190 , some of which may be built in. Illustrative components include a microphone, joystick, game pad, satellite dish, scanner, printer, wireless device, etc. The I/O components  190  may provide a natural user interface (NUI) that processes air gestures, voice, or other physiological inputs generated by a user. In some instances, inputs may be transmitted to an appropriate network element for further processing. An NUI may implement any combination of speech recognition; stylus recognition; facial recognition; biometric recognition; gesture recognition both on screen and adjacent to the screen; air gestures; head and eye tracking; and touch recognition (as described in more detail below) associated with a display of the computing system  180 . The computing system  180  may be equipped with depth cameras, such as stereoscopic camera systems, infrared camera systems, RGB camera systems, touchscreen technology, and combinations of these, for gesture detection and recognition. Additionally, the computing system  180  may be equipped with accelerometers or gyroscopes that enable detection of motion. 
     The architecture depicted in  FIG. 1B  is provided as one example of any number of suitable computer architectures, such as computing architectures that support local, distributed, or cloud-based software platforms, and are suitable for supporting computer system  120 . 
     Returning to  FIG. 1A , in some aspects, computer system  120  is a computing system made up of one or more computing devices. In some aspects, computer system  120  includes one or more software agents and, in an embodiment, includes an adaptive multi-agent operating system, but it will be appreciated that computer system  120  may also take the form of an adaptive single agent system or a non-agent system. Computer system  120  may be a distributed computing system; a data processing system; a centralized computing system; a single computer, such as a desktop or laptop computer; or a networked computing system. 
     Turning now to  FIG. 2 , a flow diagram of an exemplary method of determining a risk of maternal-fetal sepsis is provided and referred to generally as method  200 . In particular, example method  200  may be performed by one or more non-transitory computer storage media having computer-executable instructions embodied thereon that, when executed, perform a method for detecting maternal-fetal sepsis. In some aspects, the method  200  is suitable for implementation as a computer-performed decision support tool, or as an application for providing care to patients including for the treatment of maternal-fetal sepsis. 
     In accordance with method  200 , at block  202 , patient information is received for the patient. In some aspects, the patient information includes historical patient information, or current patient information. In some exemplary aspects, current patient information includes data relating to the patient&#39;s labs; vitals, diagnoses; and medications from prior encounters and from the current encounter (e.g., the current admission to a healthcare facility, or current period of receiving home healthcare services). The current encounter information may include a diagnosis and/or treatment (including medications administered or ordered and procedures performed or ordered). During the current encounter, the patient may be diagnosed or treated with a condition such as an infection. Current patient information may include lab results, including vital sign data. 
     In some aspects, patient information may include patient demographic data. Patient demographics may include age, sex, race, nationality, socioeconomic status, marital status, and/or employment status. This data may further include the patient&#39;s insurance information, such as the insurance provider and the type of plan. In some aspects, patient demographic information is not directly used to determine a risk of maternal-fetal sepsis. 
     This patient information may be received from different sources. For instance, in one embodiment, all patient information is received at block  202  from the patient&#39;s EMR. In other aspects, data relating to the patient&#39;s current condition and/or patient demographics may be received directly from a user, such as the patient or a care provider. For example, the care provider (e.g., clinician) may input patient information into a device. Some current patient information, such as patient variable values, may be received from one or more sensors or monitoring devices or directly from a laboratory running the laboratory procedures. Additionally, historical patient information may be received from the patients EMR and/or from insurance claims data for the patient. For example, EMR data from in-home care services, hospitals or any healthcare facility may be received. In an alternative embodiment, the patient&#39;s history may be received directly from the patient, such as during registration when the patient is admitted to a hospital or care facility for the current encounter or starting the current care services. 
     At block  204 , method  200  includes determining the patient is or was pregnant within a specified time interval. The determination may be based on the patient information received at block  202 . In some aspects, the patient may not be pregnant but the system may proceed to block  206 . As described herein, maternal-fetal sepsis can be an issue for patients during pregnancy, or during labor, the condition is referred to as “maternal-fetal sepsis”. Therefore, at block  204  the patient may be determined to be pregnant, or in labor. 
     At block  206 , the method  200  includes determining if a risk of maternal-fetal sepsis is identified. In some aspects, this may include determining a risk assessment array for the patient has been satisfied. In some aspects, block  206  may include generating a risk assessment array for the patient. The risk assessment array may include the patient&#39;s risk of maternal-fetal sepsis based on the maternal patient information. A patient&#39;s risk of maternal-fetal sepsis may be based on a symptom or condition indicative of maternal-fetal sepsis. A patient&#39;s risk of maternal-fetal sepsis may include vitals above a threshold. For example, the patient may have an elevated temperature (e.g., above a threshold) and/or an elevated white blood cell count (e.g., above a threshold). Other potential conditions for identifying a risk of maternal-fetal sepsis may be any information from the patient information. For example, a respiratory rate, blood pressure, peripheral capillary oxygen saturation (SpO2), or heart rate may be above a threshold. Maternal-fetal sepsis may be identified by computation service  126  (described in  FIG. 1A ) and determine the risk assessment array is satisfied. The risk assessment array may be satisfied if one or a plurality of conditions indicative of maternal-fetal sepsis are met, as described herein. 
     At block  208 , the method  200  includes receiving a clinical diagnostic for the patient. The clinical diagnostic may represent if the organisms associated with maternal-fetal sepsis are present in the patient&#39;s bloodstream. For example, the clinical diagnostic may be a laboratory result. 
     At block  210 , the method  200  includes receiving a clinical diagnostic for the patient, similar to block  208 . As illustrated, if at block  206  a risk of maternal-fetal sepsis is not identified, the method  200  may proceed to block  210 , including receiving a clinical diagnostic for the patient. If no clinical diagnostic is received, the method  200  may terminate. 
     At block  212 , the method  200  includes determining if an actionable sepsis-specific criteria has been satisfied. The actionable sepsis-specific criteria may be any indication a remedial action should be made to treat maternal-fetal sepsis in the patient i.e., mother and fetal. The actionable sepsis-specific criteria may be based on the clinical diagnostic received at block  208 . For example, in some aspects the actionable sepsis-specific criteria may be satisfied if the clinical diagnostic represents organisms associated with maternal-fetal sepsis are present in the patient&#39;s bloodstream. In some aspects, the computation service  126  (described in  FIG. 1A ) may determine the actionable sepsis-specific criteria has been satisfied. 
     At blocks  214  and  216 , the method  200  includes causing for display first and second visual indicators. The first and second visual indicators may be a second visual indicator of a graphical object, described herein. The first and second visual indicators are a visual indicator as described herein. Each of blocks  214  and  216  illustrate an exemplary first visual indicator  218  and an exemplary second visual indicator  220  of an exemplary graphical object  222 . The exemplary graphical object  222  is represented as an icon of a maternal-fetal sepsis related organism. The visual indicator of the graphical object may be caused for display as a notification or an alert. The visual indicator of the graphical object may indicate a risk of maternal-fetal sepsis. For example, and as described herein, the first visual indicator  218  may be illustrated when block  212  is satisfied, and the first visual indicator  218  may indicate an actionable sepsis-specific criteria has been satisfied. The second visual indicator  214  may be illustrated when block  212  is determined not to be satisfied, and the second visual indicator may illustrate that blocks  206  and/or  208  have been satisfied. 
     The first and second visual indicators are not the same visual indicator of the graphical object. In some aspects, each visual indicator may be a transformation and/or augmentation of the graphical object. In some aspects, each visual indicator may variegate the graphical object. For example, the first visual indicator may be a red color of the graphical object and the second visual indicator may be a yellow color of the graphical object. 
     At block  210 , if a clinical diagnostic is received, the method  200  may proceed to block  224 . Block  224 , similar to block  212 , may determine if an actionable sepsis-specific criteria has been satisfied. If no actionable sepsis-specific criteria has been satisfied, then the method  200  may terminate. Further, if an actionable sepsis-specific criteria has been satisfied, the method  200  may proceed to block  216 . 
     As illustrated in  FIG. 2 , the method  200  may receive patient information at block  202 , and proceed to determine the patient is pregnant at block  204 . At block  206 , a risk of maternal-fetal sepsis is identified in the patient. If a risk of maternal-fetal sepsis is identified at block  206 , the method  200  may proceed to block  214  to cause to display a second visual indicator and/or block  208  to receive a clinical diagnostic. 
     For example, if maternal-fetal sepsis is identified, the second visual indicator may be caused to be displayed. A clinician can view the second visual indicator and may more closely monitor the patient. The clinician, in response to the second visual indicator may even request a clinical diagnostic for the patient to confirm if an actionable sepsis-specific criteria has been satisfied. In this way, the method  200  can help identify maternal-fetal sepsis early and increase the odds of survival of the patient. 
     In some aspects, the method  200  may not execute blocks  214  or  216 . It may be determined at block  206  a risk of maternal-fetal sepsis was not identified in the patient and the method  200  may proceed to block  210  to receive a clinical diagnostic. If no clinical diagnostic is received, the method  200  may end without generating a first visual indicator  218  or a second visual indicator  220  of the graphical object  222 . Block  210  is different than block  208 , where if no clinical diagnostic was received at block  208 , the method  200  may execute block  214  and cause for display the second visual indicator. At block  210 , the method may not execute the second visual indicator. If a clinical diagnostic is received at block  210 , and at block  224  the actionable sepsis-specific criteria may be determined to be satisfied, the method may display the first visual indicator at block  216 . For example, if a patient has an undetected risk of maternal-fetal sepsis (e.g., not identified at block  206 ), but a diagnostic test is ordered, the system may cause for display the first visual indicator  218 . 
     If maternal-fetal sepsis is identified at block  206 , the second visual indicator may be caused to be displayed, and the method  200  may continue to block  208 . If a clinical diagnostic is not received at block  208 , the method  200  may still display the second visual indicator to notify a clinician a risk of maternal-fetal sepsis was identified at block  206 . If the clinical diagnostic is received at block  208 , an actionable sepsis-specific criteria may be determined at block  212 . Dependent on whether the actionable sepsis-specific criteria is satisfied, the method  200  may proceed to block  214  or  216 . 
     In some aspects, when blocks  206 ,  208 , and/or  212  execute block  214  to cause to display the second visual indicator, and an actionable sepsis-specific criteria is satisfied, the method  200  may execute block  216  subsequent to block  214 . For example, in some aspects the method  200  may determine a risk of maternal-fetal sepsis at block  206  and subsequently execute blocks  214  and  208 , described herein. In another example, the second visual indicator may be on the GUI. When block  216  is executed, block  216  may cause to change on the GUI the second visual indicator, generated by block  214 , to a first visual indicator of the graphical object. Stated differently, at block  216  on the GUI the second visual indicator may be changed to a first visual indicator of the graphical object. For example, changing on the GUI the second visual indicator to a first visual indicator may comprise a transformation of the graphical object. In another example, changing on the GUI the second visual indicator to a first visual indicator may comprise an augmentation of the graphical object. In yet another example, changing on the GUI the second visual indicator to a first visual indicator may comprise variegating the graphical object. In one embodiment, the second visual indicator may be a first color (e.g., yellow) and the first visual indicator may be a second color (e.g., red). 
     In some embodiments, the method  200  may execute additional blocks to cause for display additional information beyond the first or second visual indicators  218  and  220 . In some embodiments, and as described herein, the risk assessment array, patient information, clinical diagnostic, and/or remedial actions may be displayed simultaneously and/or in real time with the first or second visual indicators  218  and  220 . For example, the remedial actions may be displayed simultaneously with life-saving medical interventions, such as fluid resuscitation or vital organ support. 
     In some embodiments, the method  200  may execute additional blocks to remove the first or second visual indicators  218  and  220  from the GUI. For example, in some embodiments, the method  200  may determine pregnancy is no longer active in the patient, and the method  200  may not display the first or second visual indicators  218  and  220 . 
     As stated, in exemplary aspects, the first and second visual indicators of the graphical object may be caused to be displayed on a GUI. The GUI, in some aspects, may be displayed on a mobile device, monitor, or other display.  FIGS. 3A-3B and 4-5  are an exemplary screen display of a visual indicator of a graphical object for maternal-fetal sepsis, in accordance with aspects of the present invention. 
       FIG. 3A  illustrates an exemplary screen display  310 . A second visual indicator  314  of the graphical object  312  is shown on the exemplary screen display  310 . The second visual indicator  314  of the graphical object  312  may display an identified risk of maternal-fetal sepsis. Simultaneously displayed with the second visual indicator  314  is patient information  316 . In some aspects, the patient information  316  may be displayed in real time on the GUI with the second visual indicator  314  or a first visual indicator, described herein. 
     The patient information may include demographic information  318 , vitals  320 , and delivery data  322 . Demographic information  318  may include the patient&#39;s age, gender, ethnicity, and/or other sectors of a population. In some aspects the vitals  320  may be vitals from a current pregnancy of the patient. The vitals  320  may be any clinical measure. For example, and as illustrated in  FIG. 3A , vitals  320  include oral temperature, heart rate, respiratory rate, blood pressure, and/or SPO2 percentage. In some embodiments, patient information  316  may include delivery data  322 . Delivery data  322  may include specific information about delivery of a baby. For example, delivery data  322  may include an expected delivery date, length of pregnancy, effacement data, dilation percentage, and station. 
     The patient information  316  may satisfy a risk assessment array for the patient. In aspects, if the risk assessment array is satisfied, the second visual indicator  314  of the graphical object  312  may be caused for display. 
       FIG. 3B  illustrates an exemplary screen display  340 . A first visual indicator  342  of the graphical object  312  is shown on the exemplary screen display  340 . The first visual indicator  342  of the graphical object  312  may display the actionable sepsis-specific criteria and/or the risk assessment array have been satisfied. Simultaneously displayed with the first visual indicator  342  of the graphical object  312  is patient information  316  and a clinical diagnostic  344 . 
     The clinical diagnostic  344  illustrates one embodiment of the clinical diagnostic  344 , such as a lab result. The lab result illustrates bacteria are present in the patient&#39;s bloodstream. This clinical diagnostic  344  may satisfy the actionable sepsis-specific criteria. In this embodiment, in response to the actionable sepsis-specific criteria, the first visual indicator  342  of the graphical object  312  may have been caused for display. 
       FIG. 4  illustrates another exemplary screen display  400 . The screen display  400  includes a second visual indicator  402  of a graphical object  404 . The second visual indicator  402  of the graphical object  404  displays the risk assessment array may be satisfied, as described herein. Simultaneously displayed with the second visual indicator  402  of the graphical object  404  is patient information  406 . The patient information  406  includes data from an active pregnancy in a “current pregnancy” tab and a “contact information” tab. The exemplary screen display  400  may be displayed to a clinician, where the second visual indicator  402  of the graphical object  404  may alert the clinician of the patient&#39;s risk of maternal-fetal sepsis. 
       FIG. 5  illustrates another exemplary screen display  500 . The screen display  500  includes a second visual indicator  504  of a graphical object  502 . Simultaneously displayed with the second visual indicator  504  of the graphical object  502  is patient information  506 . The exemplary screen display  500  may be displayed to a clinician, where the second visual indicator  504  of the graphical object  502  may alert the clinician of the patient&#39;s risk of maternal-fetal sepsis. 
     Although in  FIGS. 4 and 5  a second visual indicator  402  and  504  is displayed, in some aspects a first visual indicator may be displayed when an actionable sepsis-specific criteria has been satisfied. Additional details regarding determining an actionable sepsis-specific criteria or a risk assessment array have been satisfied are discussed with respect to method  200  of  FIG. 2 . 
       FIG. 6  is a flow diagram showing an example of a method  600  for determining a risk of maternal-fetal sepsis and causing for display a visual indicator, in accordance with aspects of the present disclosure. Method  600  may be performed by any computing device (such as computing device described with respect to  FIGS. 1A and 1B ). 
     Initially, at block  610  maternal patient information corresponding to a patient is received. For example, the patient information may be received from a source. In one embodiment, the method  600  may include receiving, from a source, maternal patient information corresponding to a patient. Additionally or alternatively, the maternal patient information may comprise vitals from a current pregnancy of a patient. Additionally or alternatively, the maternal patient information may be vitals received in near real time from a current pregnancy of the patient. 
     At block  620 , the method  600  includes a risk assessment array for the patient based on the maternal patient information generated. For example, the method  600  includes generating a risk assessment array for the patient representing the patient&#39;s risk of maternal-fetal sepsis based on the maternal patient information. 
     At block  630 , the method  600  includes determine the patient has satisfied the risk assessment array. For example, the method  600  includes determining the patient has satisfied the risk assessment array. In some aspects, the risk assessment array may be determined to be satisfied if the maternal patient information is above a threshold. 
     At block  640 , the method  600  includes a clinical diagnostic for the patient representing the presence of organisms associated with maternal-fetal sepsis in the patient is received. For example, the method  600  includes receiving a clinical diagnostic for the patient representing the presence of organisms associated with maternal-fetal sepsis in the patient. In some aspects the clinical diagnostic may be a laboratory test result. 
     At block  650 , the method  600  includes an actionable sepsis-specific criteria has been satisfied based on the clinical diagnostic determined. For example, the method  600  includes determining an actionable sepsis-specific criteria has been satisfied based on the clinical diagnostic. In some aspects the clinical diagnostic may satisfy the actionable sepsis-specific criteria when the presence of organisms associated with maternal-fetal sepsis are found to be present in the patient&#39;s blood. 
     At block  660 , the method  600  includes cause for display on a GUI a first visual indicator of a graphical object. For example, causing for display on a GUI a first visual indicator of a graphical object in response to determining the actionable sepsis-specific criteria and the risk assessment array have been satisfied. Alternatively or additionally, the method  600  may further cause for display a second visual indicator of the graphical object in response to determining the patient has satisfied the risk assessment array. Additionally or alternatively, the first visual indicator of the graphical object is caused to change the second visual indicator of the graphical object on the GUI. In some aspects, further caused for display on the GUI is data representative of the clinical diagnostic. In some aspects the maternal patient information may be caused to simultaneously display the maternal patient information on the GUI. 
       FIG. 7  is a flow diagram showing an example of a method  700  of receiving an indication for maternal-fetal sepsis and providing a visual indicator. Method  700  may be performed by any computing device, such as computing device described with respect to  FIGS. 1A and 1B . 
     At block  710 , the method  700  includes receiving a first indication a maternal patient has satisfied a risk assessment array. For example, receiving a first indication a maternal patient has satisfied a risk assessment array for the maternal patient&#39;s risk of maternal-fetal sepsis based on a maternal patient information. In some aspects, as described, a risk assessment array may be determined to be satisfied by a remote system, server, service, or manually input into the system (e.g., a clinician may determine the risk assessment array is satisfied). Additionally or alternatively, the risk assessment array may be determined to be satisfied using the methods described in method  200  of  FIG. 2 . Additionally or alternatively, the maternal patient information may comprise vitals from a current pregnancy of the patient. 
     At block  720 , the method  700  includes cause for display on a GUI a second visual indicator of a graphical object. For example, causing for display on a GUI a second visual indicator of a graphical object in response to the first indication. For example, the first indication may cause for display on the GUI a second visual indicator. 
     At block  730 , the method  700  includes receiving a second indication that an actionable sepsis-specific criteria has been met. For example, receiving a second indication that an actionable sepsis-specific criteria has been met based on a clinical diagnostic for the maternal patient representing a presence of organisms associated with maternal-fetal sepsis in the maternal patient. In some aspects, as described, the actionable sepsis-specific criteria may be determined to be satisfied by a remote system, server, service, or manually input into the system (e.g., a clinician may determine the actionable sepsis-specific criteria is satisfied). Additionally or alternatively, the actionable sepsis-specific criteria may be determined using the methods described in method  200  of  FIG. 2 . 
     At block  740 , the method  700  includes causing to change on the GUI the second visual indicator of the graphical object to a first visual indicator of the graphical object. For example, causing to change on the GUI the second visual indicator of the graphical object to a first visual indicator of the graphical object in response to receiving the second indication. In some aspects the method  700  may include causing for display on the GUI data representative of the clinical diagnostic and the maternal patient information simultaneously with the graphical object in near real time. Additionally or alternatively, changing on the GUI the second visual indicator to the first visual indicator of the graphical object may include at least one of a transformation, augmentation, and variegating the graphical object. 
       FIG. 8  is a flow diagram showing an example of determining a risk of maternal-fetal sepsis and causing for display a visual indicator, in accordance with aspects of the present disclosure. Method  800  may be performed by any computing device, such as computing device described with respect to  FIGS. 1A and 1B . 
     At block  810 , the method  800  may include receiving from a source, patient information corresponding to a patient. For example, receiving from a source patient information corresponding to a patient. In some aspects, the patient information may include vitals received in near real time from a current pregnancy of the patient. Alternatively or additionally, the vitals received may comprise at least one of oral temperature, heart rate, respiratory rate, blood pressure, SpO2, and cervix effacement. 
     At block  820 , the method  800  may include generate a risk assessment array for the patient representing the patient&#39;s risk of maternal-fetal sepsis based on the patient information. For example, generating a risk assessment array for the patient representing the patient&#39;s risk of maternal-fetal sepsis based on the patient information. 
     At block  830 , the method  800  may include determine the patient has satisfied the risk assessment array. 
     At block  840 , the method  800  may include cause for display on a GUI a second visual indicator of a graphical object in response to determining the patient has satisfied the risk assessment array. Additionally or alternatively, the method  800  may include receiving a clinical diagnostic for the patient representing the presence of organisms associated with maternal-fetal sepsis in the patient, determining an actionable sepsis-specific criteria has been satisfied based on the clinical diagnostic, and causing to change on the GUI the second visual indicator of the graphical object to a first visual indicator of the graphical object in response to determining the actionable sepsis-specific criteria has been satisfied. 
     Many different arrangements of the various components depicted, as well as components not shown, are possible without departing from the spirit and scope of the present invention. It will be understood that certain features and sub-combinations are of utility and may be employed without reference to other features and sub-combinations and are contemplated within the scope of the claims. Not all steps listed in the various figures need to be carried out in the specific order described. Accordingly, the scope of the invention is intended to be limited only by the following claims.