Sepsis, deterioration and hypotension alerts: what the evidence shows

Sepsis and deterioration alerts use data in the electronic health record to flag hospital patients at rising risk for clinician review. Among systems not reviewed here, a cluster randomized trial of the CONCERN early warning system in two health systems found a 35.6% lower instantaneous risk of death in intervention encounters (adjusted hazard ratio 0.64). Kaiser Permanente Northern California's Advance Alert Monitor, which sends alerts to a remote nurse team, was associated with lower mortality (9.8% versus 14.4%) in a staggered rollout over 19 hospitals.

A 2026 meta-analysis of external validations pooled an area under the curve of 0.79 for the Epic Deterioration Index and 0.65 for the Epic Sepsis Model. FDA guidance on clinical decision support, revised Jan. 29, 2026, cites software that detects sepsis and alerts a clinician as an example of a device software function. Alert burden is an open question: in a 2017 study of drug alerts and reminders in primary care, clinicians became less likely to accept alerts as they received more of them.