ICNet Systems is one of a select few vendors working with the Centers for Disease Control and Prevention (CDC) to demonstrate its Antimicrobial Use & Resistance Module (AUR). So far, three ICNet client hospitals have successfully submitted data. As a result of this work, the CDC’s National Healthcare Safety Network (NHSN) recently opened a nationwide, voluntary program for hospitals to report antibiotic use data, detect patterns of drug resistance and facilitate antibiotic stewardship.
Over the past year, ICNet has worked with the NHSN to report data from Passavant Hospital in Jacksonville, Ill.; Midland Memorial Hospital in Midland, Texas; and Enloe Medical Center in Chico, Calif. Another client, Carle Foundation Hospital in Urbana, Ill., will be reporting data soon. As of December 2013, a total of 31 hospitals and health systems nationwide had reported at least a month’s worth of data electronically to NHSN.
With the growing resistance to antibiotics exacerbated by antibiotic overuse and misuse, more infections and pathogens have become resistant to multiple types or entire classes of antibiotics. Many experts in the infectious disease field now fear the prospect of a post-antibiotic era when care for vulnerable cancer, dialysis and surgery patients may be imperiled, and a child’s simple scratch could prove fatal.
The NHSN, which also collects data on the rates of healthcare-associated infections
(HAIs), stressed that a main goal of the AUR program was to promote the development of antimicrobial stewardship programs. These programs conserve antibiotics through more appropriate use and seek to interrupt transmission of resistant pathogens. Studies have shown that feedback from reliable reports of antimicrobial use and resistance help clinicians facilitate optimal antibiotic therapies, which not only prevent patient harm but also can save well over $1 million per year in antibiotic expense at a typical hospital, a recent study at the University of Maryland Medical Center found.
The NHSN module is unique in the sense that it is populated entirely from electronic reporting. ICNet was chosen to take part based on its experience in the field as the leading global vendor of automated infection control and antimicrobial stewardship software applications. ICNet is able to import data in a wide range of formats from any existing hospital system or EMR vendor, including lab, pharmacy, radiology and surgery systems. One of the core goals in the test phase of the NHSN project has been to define industry-standard data exchange and messaging specifications for all vendors to use to report antimicrobial data. All data used in the project were submitted from electronic medication administration records and/or bar-coded medication records.
“We are proud to participate in this program with the CDC; managing this precious resource of antibiotics is imperative nationally as well as globally,” says Adam Boris, ICNet’s North American CEO. “Multiple-drug resistant organisms, also known as ‘superbugs,’ have developed resistance to most available antibiotics, largely through the misuse of antibiotic therapies. Our ABX Alert™ solution for comprehensive pharmacy surveillance has already helped our clients begin to address this issue, but we need regional and national benchmarks on antibiotic use and resistance if clinicians are going to make real progress to better manage the drugs they have available.”
ABX Alert is a real-time clinical decision support application that interfaces with existing hospital information systems to ensure appropriate prescribing of antibiotics. ABX Alert detects and prevents adverse drug events for all classes of drugs, as well as provides accurate and detailed reports on a wide range of quality-of-care metrics, including auditing of doctors’ adherence to prescribing protocols and the efficacy of interventions on patient outcomes.
The CDC’s preliminary analysis of non-risk-adjusted data from the project revealed huge variations in antibiotic use. For example, on surgical ICUs, the rate of use of vancomycin – a powerful antibiotic often used when other drugs fail – ranged from 39.4 per 1,000 patient days to 223 per 1,000 patient days.
For all antibiotics used facility-wide, rates per 1,000 patient days range from about 100 to 830, the CDC found.
A final report on the test phase of the program is still being developed. The CDC will use its Vital Signs monthly report in March to detail results and issue a call to action for
national reporting of data by all hospitals and better stewardship of first- and second-line antibiotics.