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Automated Infection Control Surveillance Technologies: Overview and Perspectives

Automated Infection Control Surveillance Technologies: Overview and Perspectives. Presenter: Lisa Payne Simon, MPH Massachusetts Coalition for the Prevention of Medical Errors September 11, 2008. Outline of today’s presentation. Problem statement

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Automated Infection Control Surveillance Technologies: Overview and Perspectives

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  1. Automated Infection Control Surveillance Technologies:Overview and Perspectives Presenter:Lisa Payne Simon, MPH Massachusetts Coalition for the Prevention of Medical Errors September 11, 2008

  2. Outline of today’s presentation • Problem statement • Automated infection control surveillance technology • Overview (Technology Review from Sg2) • Purchase decision: Factors to consider (APIC tools) • Illustration: the CA Healthcare-Associated Infection Prevention Initiative (CHAIPI) • Voices from the field: • Debbie Mulligan, RN, MSN, CIC – Infection Prevention Manager, Mission Hospital Regional Medical Center, Mission Viejo, CA • Julie Jefferson, RN, MPH, CIC – Director, Epidemiology & Infection Control, Rhode Island Hospital, Providence, RI • Patricia Burns RN, CIC – Infection Control Coordinator, Saint Elizabeth Medical Center, Edgewood, KY

  3. Impact of Hospital-Acquired Infections in CA and the Nation HAIs cause suffering, cost money – and are often avoidable • National impact: 2M cases annually; 5% mortality rate = 99,000 patient deaths/yr; half of all hospital complications; 8-9 extra days/case • Impact in California: 150,000 cases • annually resulting in $2.2 billion • additional dollars reimbursed each year

  4. Technology Overview • Key facts - Electronic surveillance: • Uses hospital data to detect outbreaks in infections. Data are analyzed internally or by vendors; returned in retrospective reports or real-time alerts • Replaces manual chart review • Enables ICPs to focus on prevention • Alerts caregivers to potential infections and guides treatment selection • Environmental drivers (regulatory, reimbursement) • Clinical impact • Reduces mortality (5% attributable mortality rate reduction) • Improves HAI identification and measurement accuracy; improves proactive intervention • Reduces length or stay by 8-10 days per case on average

  5. Technology Overview (cont.) • Financial impact • Reduces cost of care (fewer infections, reduced LOS) – estimated $3-$5 return for every $1 invested in surveillance technology • Effective Oct. 2008, CMS will eliminate higher payments for HAIs • Operational impact • Reduces ICP time reviewing charts; expands productivity and time for prevention activities • Expands depth and scope of reporting; improves QI • Supports collaboration across staff using defined goals, reporting • Information resource: Technology Review from Sg2

  6. Vendor Landscape - Market leaders • Continuum of products: Software for on-site monitoring vs. data mining/reporting/consulting services • Software: AICE Millenium, EpiQuest • Data Mining Services: • Cardinal Health/MedMined • Premier (Safety Surveillor) • Theradoc • The Advisory Board Company/Vecna

  7. Purchase Decision: APIC Tools offer Guidance • Association for Professionals in Infection Control and Epidemiology (APIC) is a resource for unbiased decision-making tools and support • Visit www.apic.org/SurvTechResources • Extensive literature references • Starter Questions • Product Comparison Tool • Glossary of informatics terms • Web community (user group)

  8. Purchasing an electronic surveillance solution – Factors to consider • What is the goal of adopting electronic surveillance for your hospital? • What solution is a clinical and operational fit for your organization and supports the goal? • What solution will the hospital IT department support and quickly implement? • What is the total cost of ownership for the solution? • Start-up expenses (capital budget-one time) • Ongoing expenses (operational budget-monthly) • Long-term support expenses (i.e.; HIS/Lab system changes and modifications)

  9. Purchasing an electronic surveillance solution – Factors to consider • Does the solution have a track record of results and positive return on investment? • Does the electronic surveillance solution enhance other internal quality improvement projects? • Can the electronic surveillance company provide multiple hospital references at different levels (i.e.; ICP, Director of Quality/Nursing, IT and executive)?

  10. Guidelines for assessing technologies for your hospital: Does the technology… • Eliminate non-value added work so you can spend more time on the tasks that really make a difference • Quantify improved patient outcomes and financial return on investment (ROI) • Give you a hospital-wide, objective view of your infections • Get up and running quickly • Provide a solid support team behind the technology • Engage executive leadership team in the process

  11. CA Experience: the CHAIPI PilotTesting Technology • Launched by Blue Shield of California Foundation • Cardinal Health/MedMined selected as vendor • Goal: use technology to reduce preventable HAIs • Grants awarded to 11 hospitals for technology • Timeline June 2005 through June 2007 • Compelling clinical & economic results • 605 infections prevented • 4,641 hospital days avoided • $9 million saved

  12. CHAIPI Expansion 2008 - 2009 • 55 hospitals and growing • Collaborative grants - Best practices + peer learning • Technology grants - MedMined surveillance - Preferred pricing - one vendor • Independent evaluation - Program outcomes - Infection Preventionist role • Inclusion of “for profit” hospitals • Multiple innovative partners

  13. Engaging a Wide Range of Organizations IHI • CIHSP • Operations • Help recruit hospitals • IHI • Curriculum content • Web platform for metrics • Quality improvement and evaluation expertise • BSCF • Driver • Funder • Coordinator • Evaluator CIHSP APIC • Cardinal Health/MedMined • Technology cohort: recruitment, training, service support, curriculum • Clinical/financial analysis of technology impact • APIC • Role development expertise for Infection Preventionists • Provide best practice guidelines for specific HAIs Cardinal Health/ MedMined

  14. Defining CHAIPI Program Success • Catalyze HAI reduction efforts statewide • Serve as a national model for testing technology to improve quality and lower costs • Save lives and money • Contribute new knowledge to the field

  15. Voices from the Field Cardinal Health/MedMined user • Debbie Mulligan, RN, MSN, CIC – Infection Prevention Manager, Mission Hospital Regional Medical Center, Mission Viejo, CA Premier (Safety Surveillor) user • Patricia Burns RN, CIC – Infection Control Coordinator, Saint Elizabeth Medical Center, Edgewood, KY Theradoc user • Julie A. Jefferson, RN, MPH, CIC – Director, Epidemiology & Infection Control, Rhode Island Hospital, Providence, RI

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