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ESCAVO is a company that is best known for their sepsis management apps. We had the pleasure of talking with Daniel Nichita, MD, the President of ESCAVO, who told us more about the company, their apps, and future plans.

ESCAVO is a company that develops digital health content and mobile health applications, which range from point-of-care medical reference guides to clinical decision support tools. The ESCAVO team comprises physicians, experienced software developers, and graphic designers committed to the improvement of healthcare quality and delivery through mobile technology.

Here on SteadyHealth, we already reviewed three apps that ESCAVO designed for healthcare professionals, including Sepsis Clinical Guide, Sepsis Timer, and The Chief Complaint. We had the pleasure of talking with Daniel Nichita, MD, the President of ESCAVO, who provided us with a lot of useful and interesting information about their apps and their future plans.

Can you tell us the story behind your mobile apps? Where did the idea for your apps come from? What served as your inspiration?

Sepsis Clinical Guide: My mother died from sepsis in 2009 and during her ordeal, I was by her bedside and witnessed significant lapses in medical care. Although a significant effort was put into her care, recognition and treatment of her sepsis were significantly delayed which unfortunately contributed to her death. The hospital where she was treated had no sepsis protocols in place and staff did not seem to follow sepsis management guidelines available at the time, which emphasized the importance of prompt treatment, and especially prompt antibiotic administration. Being an MD, an editor for a medical education publisher, and having experience in tech, I decided to author and develop the Sepsis Clinical Guide app to put major sepsis guidelines in the hands of clinicians in a practical, concise, simple to digest format that can be used as a reference at the bedside. The app was developed with the help of Boxador, an LA-based technology incubator, and has also been translated into Spanish. 

Sepsis Timer: In 2015, US CMS instituted a new core measure called SEP-1 that tracks hospital performance on sepsis treatment and potentially penalizes hospitals that don't do well. This measure essentially implements treatment recommendations provided by the Surviving Sepsis Campaign guidelines, specifically their Sepsis Bundles, which call for certain initial treatment steps to occur within 3 and 6 hours. Sepsis Timer app was inspired by the need of hospital staff to carefully track sepsis treatment steps and times to comply with this CMS measure. The idea for the app was actually given to us by a sepsis coordinator at a US hospital who thought it would be very helpful to have a simple reminder and alerting tool that house staff can use on their mobile devices.

The Chief Complaint: The Chief Complaint app was authored by Dr. Chris Feier MD, PharmD, a practicing emergency room physician and assistant professor of emergency medicine the Keck School of Medicine of the University of Southern California. The app is based on a popular EM reference book he wrote by the same name which has been widely praised by readers on Amazon and elsewhere. The book started as an effort by Dr. Feier to create concise notes and treatment algorithms during his residency on flashcards to help him remember how to best treat patients for common conditions in the ER. He eventually further developed these cards and aggregated them into a nicely formatted book that became The Chief Complaint print version and later the app. Incidentally, Dr. Feier did a lot of the layout and front-end design programming of the app himself using the ESCAVO content management platform, so he also has a knack for tech and software development too.

How did you build the content that's contained in the apps? Does the information in your apps come from evidence-based resources, such as scientific literature, peer-reviewed articles and case studies?

The content of the Sepsis Clinical Guide app is based on evidence-based guidelines from leading organizations such as the Surviving Sepsis Campaign, Infectious Diseases Society of America and many others, as well as numerous studies and peer-reviewed papers. All content is carefully referenced, the app currently has nearly 160 citations.

The treatment steps and timing intervals used in Sepsis Timer are based on the Surviving Sepsis Campaign Sepsis Bundles and CMS SEP-1 guidelines. Some of the information in the help sections of the app is taken from our Sepsis Clinical Guide app which is based on numerous guidelines and studies.

The Chief Complaint app's content is based on the book by the same name by Dr. Chris Feier, as mentioned above. The app's content is exhaustively referenced with over 450 citations, more than any medical reference app that I'm aware of. In addition, the app emphasizes evidence-based medicine throughout with features such as Journal Club (discussions of key studies on certain topics) and links to relevant articles on popular evidence-based sites such as Essentials of Emergency Medicine, theNNT, and EM:RAP podcasts (these require separate subscriptions on those services). In my opinion, The Chief Complaint is one of the best apps for emergency medicine out there, every EM clinician should have a copy.    

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