In the complex world of healthcare IT today, many of the hot topics encompass concerns around meaningful use, accountable care, and population health. While these issues are at the core of healthcare IT, one area that tends to get overlooked in the industry is infection control.
According to a report from the Centers for Disease Control and Prevention (CDC), at any given time, about one in every 20 patients acquires an infection related to their hospital care, with 90,000 people dying in the U.S. each year from healthcare-associated infections (HAIs). Patients who get HAIs are likely to have their hospital stays extended, with some studies finding that such infections can make a stay up to 2.5 times longer. As a result, HAIs not only affect patient lives, but also add to the nation’s growing healthcare costs—in fact, the same CDC report found that HAIs add $5 billion per year in additional healthcare costs in the U.S.
And according to a recent study from healthcare research organization Regenstrief Institute, while advances in electronic health record (EHR) systems and health information exchange (HIE) are shifting efforts in public health toward greater use of information systems to automate disease surveillance, these technologies' capabilities are underutilized by those on the front lines of preventing and reporting infections.
Specifically, infection preventionists (IPs), who are often responsible for reporting information on patients diagnosed with HAIs like methicillin-resistant staphylococcus aureus, or MRSA, as well as sexually transmitted diseases such as chlamydia, aren’t even involved in the processes by which hospitals are acquiring, implementing, and developing their EHR strategies. The study’s results found that fewer than 20 percent of IPs questioned were involved in the design, selection or implementation of the EHR system.
So why are IPs not being involved in these important decisions, and why is infection control such an overlooked part of healthcare? From the people I’ve talked to, infection control just seems to fly under the radar of hospital systems’ senior level executives. For example, Brian Dixon, Ph.D., a Regenstrief Institute investigator, told me that the primary focus of hospital systems remains on frontline clinicians and their needs. Infection control also relies on existing methods for indentifying infections, so IPs have not stepped up as much as they should have and forced the issue. It falls on both sides, Dixon said.
Still, there have been recent efforts made to help tackle this growing healthcare problem. Carle Hospital and Physician Group, based in Urbana, Ill., recently implemented ICNet, an automated infection surveillance system that monitors an array of clinical data streams and provides real-time alerts that allow infection prevention teams to identify affected patients more quickly and avert potential disease transmission. Implemented last October, the system has been of particular value already in alerting staff to multiple-drug-resistant organisms (MDROs) such as MRSA. The rise of MDROs in hospitals and other care settings is one reason that the federal government has stepped up reporting of infection data and prohibited reimbursements to treat HAIs.
Healthcare professionals can also do their part in preventing the spread of infectious diseases. Shannon Medical Center, a 400-bed hospital in San Angelo, Texas, has implemented automated radio-frequency identification (RFID)-based hand-hygiene monitoring system. As a result of a pilot initiative in one of the hospital’s units, Shannon nearly tripled the amount of hand dispenses in that unit over the course of six months. The hospital also decreased HAIs by 62 percent.
Moreover, when President Barack Obama released his budget for fiscal year 2014 programs April 9, included was a request for $40 million for an Advanced Molecular Detection and Response to Infectious Disease Outbreaks initiative to modernize the CDC’s technology and methods to better detect and track infectious diseases.
To that end, the Association for Professionals in Infection Control and Epidemiology (APIC) was established to create a safer world through the prevention of infection and embrace this bold direction through patient safety, implementation science, competencies and certification, advocacy, and data standardization. APIC was founded in 1972 by a pioneering group of infection control nurses, and has since become a multidisciplinary organization which serves more than 14,000 members in 48 countries. Most APIC members are nurses, physicians, public health professionals, epidemiologists, or medical technologists.
APIC leaders believe this is the right time to commit to an uncompromising vision and organize the association’s mission and goals around a plan to advance toward healthcare without infection. The organization’s APIC Strategic Plan 2020 aims to demonstrate and support effective infection prevention and control as a key component of patient safety by 2020 through: collaboration with organizations, agencies, and consumer groups at increased level; adoption of key processes of care by facilities; development and dissemination of evidence-based checklists and bundles of care in collaboration with physicians, other clinicians, and researchers; adoption of frameworks by other professional organizations; use of tools and resources by members; and by recognition of IPs as patient safety leaders within their organizations and by regulatory bodies.
It is the last APIC objective that inspires hope that healthcare without infection could one day be possible. IPs, although often overlooked, can be a vital part of the decision-making process. Having a facility’s CIO or CMIO engage with the hospital epidemiologist or frontline IP and try to understand what his or her needs are when it comes to the EHR can be extremely valuable. Hospital systems are investing millions of dollars into EHR software; wouldn’t they want to leverage it to the best of the organization’s ability? We hear about patient engagement all the time, right? Well what about IP engagement?
So while the past and present might overlook infection control, there is certainly hope for the future. With organizations continuing to push the issue, patient care organizations will soon realize that engaging with IPs will be in the best interest of everyone involved, as the industry continues to search for ways to reduce costs and save lives.