A regional informatics platform for coordinated antibiotic-resistant infection tracking, alerting, and prevention

Abel N. Kho; Bradley N. Doebbeling; John P. Cashy; Marc B. Rosenman; Paul R. Dexter; David C. Shepherd; Larry Lemmon; Evgenia Teal; Shahid Khokar; J. Marc Overhage

doi:10.1093/cid/cit229

A regional informatics platform for coordinated antibiotic-resistant infection tracking, alerting, and prevention

Abel N. Kho, Bradley N. Doebbeling, John P. Cashy, Marc B. Rosenman, Paul R. Dexter, David C. Shepherd, Larry Lemmon, Evgenia Teal, Shahid Khokar, J. Marc Overhage

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Background. We developed and assessed the impact of a patient registry and electronic admission notification system relating to regional antimicrobial resistance (AMR) on regional AMR infection rates over time. We conducted an observational cohort study of all patients identified as infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) on at least 1 occasion by any of 5 healthcare systems between 2003 and 2010. The 5 healthcare systems included 17 hospitals and associated clinics in the Indianapolis, Indiana, region.Methods. We developed and standardized a registry of MRSA and VRE patients and created Web forms that infection preventionists (IPs) used to maintain the lists. We sent e-mail alerts to IPs whenever a patient previously infected or colonized with MRSA or VRE registered for admission to a study hospital from June 2007 through June 2010.Results. Over a 3-year period, we delivered 12 748 e-mail alerts on 6270 unique patients to 24 IPs covering 17 hospitals. One in 5 (22%-23%) of all admission alerts was based on data from a healthcare system that was different from the admitting hospital; a few hospitals accounted for most of this crossover among facilities and systems.Conclusions. Regional patient registries identify an important patient cohort with relevant prior antibiotic-resistant infection data from different healthcare institutions. Regional registries can identify trends and interinstitutional movement not otherwise apparent from single institution data. Importantly, electronic alerts can notify of the need to isolate early and to institute other measures to prevent transmission.

Original language	English (US)
Pages (from-to)	254-262
Number of pages	9
Journal	Clinical Infectious Diseases
Volume	57
Issue number	2
DOIs	https://doi.org/10.1093/cid/cit229
State	Published - Jul 15 2013
Externally published	Yes

Keywords

MRSA
VRE
clinical decision support
health information exchange
infection control

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

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10.1093/cid/cit229

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@article{3ea3f29814f04cbd889a23eb354db8b1,

title = "A regional informatics platform for coordinated antibiotic-resistant infection tracking, alerting, and prevention",

abstract = "Background. We developed and assessed the impact of a patient registry and electronic admission notification system relating to regional antimicrobial resistance (AMR) on regional AMR infection rates over time. We conducted an observational cohort study of all patients identified as infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) on at least 1 occasion by any of 5 healthcare systems between 2003 and 2010. The 5 healthcare systems included 17 hospitals and associated clinics in the Indianapolis, Indiana, region.Methods. We developed and standardized a registry of MRSA and VRE patients and created Web forms that infection preventionists (IPs) used to maintain the lists. We sent e-mail alerts to IPs whenever a patient previously infected or colonized with MRSA or VRE registered for admission to a study hospital from June 2007 through June 2010.Results. Over a 3-year period, we delivered 12 748 e-mail alerts on 6270 unique patients to 24 IPs covering 17 hospitals. One in 5 (22%-23%) of all admission alerts was based on data from a healthcare system that was different from the admitting hospital; a few hospitals accounted for most of this crossover among facilities and systems.Conclusions. Regional patient registries identify an important patient cohort with relevant prior antibiotic-resistant infection data from different healthcare institutions. Regional registries can identify trends and interinstitutional movement not otherwise apparent from single institution data. Importantly, electronic alerts can notify of the need to isolate early and to institute other measures to prevent transmission.",

keywords = "MRSA, VRE, clinical decision support, health information exchange, infection control",

author = "Kho, {Abel N.} and Doebbeling, {Bradley N.} and Cashy, {John P.} and Rosenman, {Marc B.} and Dexter, {Paul R.} and Shepherd, {David C.} and Larry Lemmon and Evgenia Teal and Shahid Khokar and Overhage, {J. Marc}",

note = "Funding Information: Financial support. This work was funded in part under contracts 290-04-0015 and HSA290200600013-3 Task Order 5 (A. N. K., B. N. D., M. B. R., D. C. S., and J. M. O.) from the Agency for Healthcare Research and Quality (AHRQ), US Department of Health and Human Services. J. M. O. was initially funded through the NLM T15 LM007117. Potential conflicts of interest. All authors: No reported conflicts.",

year = "2013",

month = jul,

day = "15",

doi = "10.1093/cid/cit229",

language = "English (US)",

volume = "57",

pages = "254--262",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "2",

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TY - JOUR

T1 - A regional informatics platform for coordinated antibiotic-resistant infection tracking, alerting, and prevention

AU - Kho, Abel N.

AU - Doebbeling, Bradley N.

AU - Cashy, John P.

AU - Rosenman, Marc B.

AU - Dexter, Paul R.

AU - Shepherd, David C.

AU - Lemmon, Larry

AU - Teal, Evgenia

AU - Khokar, Shahid

AU - Overhage, J. Marc

N1 - Funding Information: Financial support. This work was funded in part under contracts 290-04-0015 and HSA290200600013-3 Task Order 5 (A. N. K., B. N. D., M. B. R., D. C. S., and J. M. O.) from the Agency for Healthcare Research and Quality (AHRQ), US Department of Health and Human Services. J. M. O. was initially funded through the NLM T15 LM007117. Potential conflicts of interest. All authors: No reported conflicts.

PY - 2013/7/15

Y1 - 2013/7/15

N2 - Background. We developed and assessed the impact of a patient registry and electronic admission notification system relating to regional antimicrobial resistance (AMR) on regional AMR infection rates over time. We conducted an observational cohort study of all patients identified as infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) on at least 1 occasion by any of 5 healthcare systems between 2003 and 2010. The 5 healthcare systems included 17 hospitals and associated clinics in the Indianapolis, Indiana, region.Methods. We developed and standardized a registry of MRSA and VRE patients and created Web forms that infection preventionists (IPs) used to maintain the lists. We sent e-mail alerts to IPs whenever a patient previously infected or colonized with MRSA or VRE registered for admission to a study hospital from June 2007 through June 2010.Results. Over a 3-year period, we delivered 12 748 e-mail alerts on 6270 unique patients to 24 IPs covering 17 hospitals. One in 5 (22%-23%) of all admission alerts was based on data from a healthcare system that was different from the admitting hospital; a few hospitals accounted for most of this crossover among facilities and systems.Conclusions. Regional patient registries identify an important patient cohort with relevant prior antibiotic-resistant infection data from different healthcare institutions. Regional registries can identify trends and interinstitutional movement not otherwise apparent from single institution data. Importantly, electronic alerts can notify of the need to isolate early and to institute other measures to prevent transmission.

AB - Background. We developed and assessed the impact of a patient registry and electronic admission notification system relating to regional antimicrobial resistance (AMR) on regional AMR infection rates over time. We conducted an observational cohort study of all patients identified as infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) on at least 1 occasion by any of 5 healthcare systems between 2003 and 2010. The 5 healthcare systems included 17 hospitals and associated clinics in the Indianapolis, Indiana, region.Methods. We developed and standardized a registry of MRSA and VRE patients and created Web forms that infection preventionists (IPs) used to maintain the lists. We sent e-mail alerts to IPs whenever a patient previously infected or colonized with MRSA or VRE registered for admission to a study hospital from June 2007 through June 2010.Results. Over a 3-year period, we delivered 12 748 e-mail alerts on 6270 unique patients to 24 IPs covering 17 hospitals. One in 5 (22%-23%) of all admission alerts was based on data from a healthcare system that was different from the admitting hospital; a few hospitals accounted for most of this crossover among facilities and systems.Conclusions. Regional patient registries identify an important patient cohort with relevant prior antibiotic-resistant infection data from different healthcare institutions. Regional registries can identify trends and interinstitutional movement not otherwise apparent from single institution data. Importantly, electronic alerts can notify of the need to isolate early and to institute other measures to prevent transmission.

KW - MRSA

KW - VRE

KW - clinical decision support

KW - health information exchange

KW - infection control

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DO - 10.1093/cid/cit229

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A regional informatics platform for coordinated antibiotic-resistant infection tracking, alerting, and prevention

Abstract

Keywords

ASJC Scopus subject areas

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