Healthcare in the United States – The Infection picture

There is no doubt that the inclusion of information technology into healthcare has been immensely beneficial and due to this, much of the concerns today are centered around appropriate use of new technologies in medical care, accessibility and coverage. However, while we are busy giving importance to these concerns, more pressing issues such as infection control become easily overlooked.

A recent report issued by the Centers for Disease Control and Prevention (CDC), at any period of time, one in twenty patients gets infected and this ultimately points to the fact that about 90,000 patients are dying every year in the United States from several healthcare associated infections (HAIs). Apparently if a patient suffers from a HAI, he is likely to stay for a longer period in the hospital than is required. Furthermore, there have been studies which show that such infections might result in patients staying up to 2.5 or 3 times longer than normal. This means that HAIs are not just a major concern for patients but also for the countries ever-rising healthcare costs. The report derived that HAIs results in an additional 5 billion dollars per year as healthcare costs in the United States.

A study from the Regenstrief Institute, an Indianapolis-based informatics and healthcare research network has concluded that the inclusion of technologies such as electronic medical record (EMR) systems and the health information exchange (HIE) system is not adequately used by people whose prime responsibility is to report and prevent infections acquired from hospitals. Assessment of the awareness of EMR and HIE activities was carried out through an online survey aimed at infection preventionists from states which had well-established HIE networks. Researchers involved in the study found that about half the population of infection preventionists taken for the study had no knowledge of whether their hospitals were involved in any form of health information exchange system. As per the data collected, only about ten percent of the infection preventionists could clearly state that they were aware of their hospitals being a part of HIE activities.

This is what Brian Dixon, Ph.D, Regenstrief Institute Investigator and the corresponding author of the aforementioned study had to say:

There is a push from the Centers for Medicare & Medicaid Services (CMS) to reduce hospital-acquired infections and increase the use of electronic health record systems. The Centers for Disease Control and Prevention (CDC) are encouraging local and state health departments to use health information technologies to improve infectious disease reporting and prevention activities. We found that while hospital-based infection preventionists—the people on the front line—may have access to health information technology, they lack specially designed computer tools needed to sift through the massive amounts of data in electronic medical records.”

In fact, infection preventionists who are in charge of communicating data about patients suffering from HIAs, some of which include infections via methicillin-resistant Staphylococcus aureus commonly referred to as MRSA and sexually transmitted diseases (STDs) such as chalymidia have been found to not even be a part of basic procedures by means of which most hospitals develop, implement and design much of their electronic health record policies. As per the above study, as few as about 20 percent of the IP population under study was found to be a part of implementing the EHR system.

To understand the reason behind this negligence towards infection control, the people from Healthcare informatics interviewed researchers from the Regenstrief Institute. Most of them seem to be of the opinion that infection control somehow mysteriously goes ignored by many of the senior executives in hospitals. According to Dixon, the main aim of many of the existing hospital systems lies on the requirements of frontline clinicians. Much of infection control depends on current methods of infection identification so many of the infection preventionists haven’t raised their concerns over the issue. He says that the issue falls on both sides.

However, there have been certain efforts taken to answer the existing healthcare problem. ICNet, an automated infection surveillance system was recently employed by Carle Hospital and Physician Group, Urbana, III. ICNet is responsible for generating alerts for when an infection results thereby enabling potential IPs to recognize the patients under concern and prevent further transmission of the disease. Till date, the system has successfully alerted physicians of infections caused by several multiple drug resistant organisms (MDROs) such as MSRA. In fact, it has been reported that the increase in the MDROs in hospitals around the country is one of the prime reasons that the Federal government has prohibited reimbursements for the treatment of HAIs.

Further, several healthcare agencies are also doing whatever they can to curb the spread of potentially life threatening infection diseases. For instance, a radio frequency identification based hygiene recording system has been employed by the Shannon Medical Center, a hospital in San Angelo, Texas. The result of the above was that the number of hand dispenses in that particular unit went up three times over the next six months; additionally, HAIs have been brought down by a significant 62 percent in the medical center due to the same.

The budget for the fiscal year 2014 released by President Barack Obama comprised of a request for about 40 million dollars towards the initiation of an Advanced Molecular Detection and Response to Infectious Disease Outbreaks system which might lead to the modernization of CDC’s systems resulting in improved ways of tracking and thereby preventing infectious diseases.

Yet another bold initiative towards infection control was the formation of the Association for Professionals in Infection Control and Epidemiology (APIC) in the year 1972. Today, the APIC serves almost 14,000 members in a total of 48 countries. The APIC Strategic Plan 2020 aims to eradicate infection through potential collaboration with leading organizations and centers around the globe, employment of evidence based checklists, association with clinical researchers, utilization of resources made available by its members, identification of key infection preventionists as pioneers in infection prevention and the like. Despite the fact that they are overlooked, more often it is believed that the role of IPs could actually become key towards the decision making process for infection prevention schemes.

Hence with the advent of initiatives like the above, there most certainly is hope for the future towards infection control. Let’s hope that healthcare organizations realize the importance of IPs in the aforementioned process sooner than expected. Like they say, it is never considered too early to save millions of lives.

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