Research has shown that up to one-third of hospital-acquired infections can be prevented with high-intensity electronic infection surveillance and control programs. These applications gauge whether there is an infection problem, the problem’s magnitude and the factors that contribute to infections. Electronic systems also allow hospitals and clinicians to measure the effectiveness of strategies used to decrease infection rates.
| Hospital-acquired infection surveillance | ||
| 2008 Most Wired* | 2008 Least Wired** | |
| Manual only | 1% | 29% |
| Partially electronic | 58% | 41% |
| Fully electronic | 41% | 7% |
| No system in place | 0% | 23% |
| *Most Wired: Aggregate data for the 100 highest scoring respondents. **Least Wired: Aggregate data for the 100 lowest scoring respondents. Source: H&HN’s Most Wired Survey and Benchmarking Study, 2008 |
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Electronic HAI surveillance systems provide real-time access to infection-related data and alerts of opportunities to better use antimicrobials. According to 2008 survey data, more than 40 percent of Most Wired hospitals and health systems report using electronic surveillance systems to reduce the time spent on data analysis and instead focus on clinical interventions and opportunities. Only 7 percent of least wired hospitals have fully electronic systems.
Sanford USD Medical Center, Sioux Falls, S.D., developed a real-time interface to send lab test results and antibiotic orders to an external software system. It allows Sanford’s infection control team to view lab results and compare them with physician antibiotic orders. The team then makes recommendations for discontinuing orders that are inappropriate for an infection and for ordering more pertinent medication.
“This immediate matching of lab results to medication orders saves the patient the cost of medications plus not having to receive medications that are not warranted,” says Dennis Hofer, Sanford Health’s executive director, information technology. “The previous, manual method of catching inappropriate orders based on test results was tedious and sometimes not timely enough to receive the value for either the patient or the Medical Center. With the data pulled together in one system and in a methodic view, infection control users can respond more quickly and easily.”
The Methodist Hospital, Houston, has used an electronic data mining system for about 3 years. According to Kathryn Hawkins, director of infection prevention and control, actual infection rate data has improved—for example, prevalence of vancomycin-resistant enterococci (VRE) has decreased. “Rapid compiling and analysis of culture data facilitates our ability to modify institutional processes that can reduce the risk of HAIs,” she says.
Developing interfaces to extract data from existing clinical, laboratory and pharmacy systems is difficult and time-consuming. Testing and validation is important for successful outcomes. Despite these obstacles, hospitals report few problems in the implementation and use of these systems. Quality Compass, a division of The Advisory Board Company, and Cardinal Health’s MedMined are the vendors most frequently mentioned by Most Wired hospitals. Both offer extensive clinical and operational support, including financial reporting to show the cost and length-of-stay impact of HAIs and inefficient use of antimicrobials. Data-mining technology detects opportunities to prevent infections and offers best-practice recommendations.
Electronic surveillance enables hospitals to shift resources from manual data collection and analysis to critical clinical education and prevention activities that directly affect patient care.
This article first appeared in the Summer issue of HHN's Most Wired Magazine.
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