Abstract
Severe sepsis and septic shock is a major health concern. A key component in the treatment of severe sepsis and septic shock is optimization of the septic patient's abnormal physiology. However, following the evidence based guidelines present many unique challenges. The article presents the challenges and how a 5 hospital system in San Antonio, Texas uses a telemedicine approach to help comply with the sepsis bundles. A multidisciplinary sepsis team meets regularly to assess compliance and review data. The processes and tools continue to be changed accordingly, to improve adherence to best evidence practice for the severe septic and septic shock patient.