Devices & Technology

Electronic Surveillance Provides Hospital Infection Control


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Alabama Hospitals Benefit from MedMined  

The Alabama Hospital Quality Initiative (AHQI), a group of 37 hospitals dedicated to monitoring and eliminating hospital-acquired or nosocomial infections, is one more success story to come out of MedMined’s Data Mining Surveillance service and Nosocomial Infection Marker.

A recent study of data from six pilot medical centers in Alabama from 2002 to 2004 revealed that AHQI, in collaboration with MedMined, helped the hospitals reduce their rate of infections by more than 19 percent over that time period. This decrease resulted in a reduction in both lengths of stay and readmissions due to infections.

 

By Suzi Birz, Principal, HiQ Analytics  

What if you could identify a poor hygiene practice before an infection spread throughout your hospital? What if you could determine that a particular restaurant was contributing to a salmonella outbreak within 24 hours of patients presenting in the emergency department? These questions and more are being addressed at hospitals around the country thanks to electronic surveillance provided by MedMined, Inc.  

Formed in 2000, MedMined, Inc., based in Birmingham, Alabama, provides data mining analysis and related technical, clinical and financial consulting services to the health care community. The patented technologies monitor an entire hospital—both inpatient and outpatient—for emerging infection outbreaks. MedMined services are employed in more than 120 hospitals in 23 states.  

“MedMined provides hospital infection control programs with a continuum of services, which serve to reduce preventable infections, improve patient safety and decrease costs,” said Patrick Hymel, M.D., chief medical officer for MedMined.  

Hymel added that the responsibility of protecting a patient from infection lies in the hands of the infection control practitioner (ICP)—a role greatly assisted by MedMined technology.  

“We give tools to reduce the amount of paperwork and medical record review, which provides the ICP the opportunity to show up in the right place at the right time, with the right information, in order to impact patient care and improve outcomes,” Hymel added.  

MedMined’s surveillance begins with an online data warehouse and a Virtual Surveillance Interface. Hospital data, including lab data and admission, discharge and transfer data, is sent to MedMined, where it is loaded into a data warehouse and “normalized.” Then, with the use of algorithms created by the company, the data is analyzed to detect patterns. The patterns are placed on graphs with drill-down capability to see the specific patients and locations involved. These reports include changes in activity representing emerging problems or improvements. The reports are accessed by the hospital infection control practitioner along with a list of actionable items also generated by the service.  

The Virtual Surveillance Interface allows hospital staff to “ask questions” of the data and generate additional reports. The ICPs then work with the staff on the unit to apply the actionable items, make process changes and complete the documentation.  

The MedMined Nosocomial Infection Marker™ (NIM)  

The MedMined service features the Nosocomial Infection Marker (NIM), which, for the first time, provides an accurate, electronic measurement of the incidence of hospital-acquired infections.  

The NIM uses sophisticated algorithms to analyze existing patient clinical data to identify distinct hospital-acquired infections and compute rates.  

“The NIM allows ICPs and hospital executives to understand the true impact of hospital-acquired infections on a hospital’s profitability, thereby increasing the value of infection control and prevention efforts in the eyes of executives,” Hymel explained.  

This automated surrogate marker for nosocomial infections provides a comprehensive, objective and efficient method for hospitals to track infections of all types and in all locations, as well as to meet the demand of mandatory reporting requirements.  

Success Stories  

One hospital that has benefited from MedMined’s technology is Evanston Northwestern Healthcare (ENH), in Evanston, Illinois. According to Lance Peterson, M.D., director of clinical microbiology and infectious disease research at ENH, and a professor of pathology and medicine at Northwestern University’s Feinberg School of Medicine, the hospital has found that the electronic surveillance continues to improve and still remains easy to use. The visuals, rapid graphing and alerts combine to make the reporting useful to both the practitioner new to infection control and the one with 30 years experience.  

p>“Using the visuals in this process makes it easier to follow JCAHO’s advice of involving everyone,” Peterson explained.  

Donna Hacek, a technical specialist in the department of microbiology and molecular epidemiology at ENH, agreed that the MedMined service allows ICPs to find infections faster than the traditional paper review model.  

Peterson and Hacek shared two specific instances of success. In one instance, because the surveillance is done on outpatient data as well as inpatient data, the alert system picked up an outbreak of Salmonella javiana in a local restaurant. In another instance, the hospital was able to detect scattered instances of urinary tract infection, affording ENH the opportunity to determine best practices for catheter care and implement hospital-wide procedures in all three hospitals in the network.  

Peterson asserted that many of the infections that are found in a hospital are nosocomial. Therefore, patient impact varies in severity and care is not reimbursable. These factors make the rapid discovery of infections important to patient care and fiscal responsibility—a combination that makes the service a continued “easy sell” to administration.  

Take-Away Messages  

MedMined believes in the importance of infection control. Hymel explained that by asking clients about their challenges and monitoring regulatory requirements, MedMined can continue to reinforce and empower the specialty to help ICPs succeed.  

“The services are tools for the ICP, but the success belongs to the ICPs that use their clinical expertise to act on the information,” Hymel said.  

Hacek acknowledged that people might be intimidated by the work involved with electronic surveillance or the possibility of the system replacing an actual ICP. Still, she believes the benefits outweigh these concerns.  

“Don’t fear it,” Hacek said. “MedMined eliminates paperwork and gives the ICP more time to interact with the caregivers and take care of problem areas. It’s not more work—it allows you to do your job.”  

Peterson echoed Hacek’s point.  

“Remember the impact of nosocomial infections on the patients and the bottom line,” he said. “Always look at the overall picture.”  

Resources:  

MedMined 

Evanston Northwestern Healthcare  

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