Healthcare-acquired infections, or "HAIs", have not been given a lot of airtime in the continuing debate on healthcare. This is really surprising given that 1.7 million hospital-based infections (and 99,000 associated deaths) occur each year in the U.S. and as much as $33 billion in healthcare costs annually. It seems that everyone knows someone impacted by these deadly infections.
So, while not a particularly popular topic, it is important to realize that addressing the spread and infection rate of HAIs across the country would make a big impact in improving care, reducing cost, and implementing new advances in medical technology.
Typically, HAIs are contracted by patients at a hospital, rehabilitation facility or nursing home who are already undergoing treatment for other ailments. And, while antibiotics have historically been used to treat HAIs and even with the recently hailed FDA approvals of next generation drugs, they are still becoming less effective against the plethora of increasingly drug-resistant infections. There are other limitations to these medications as well; for one, they do nothing in terms of prevention -- they are only able to treat patients once an infection has been identified.
What's needed is an alternative solution -- one that leverages the latest technology to identify, confirm, and diagnose HAIs more quickly. Such a technology exists, and deserves careful consideration. If widely adopted, it could ease the infection-identification process and has the potential to significantly reduce HAI infection rates, and, subsequently, healthcare costs.
The technology is known as electronic clinical surveillance, and it arms hospitals in their fight against identifying and treating HAIs. These systems help hospitals to maintain facility-wide infection surveillance and reporting, adverse drug event surveillance, patient-based infection management and monitoring for non-drug adverse events.
These clinical surveillance systems allow for rapid diagnosis, which leads to faster quarantine times and, thus, fewer infections. This also has a spillover effect: because of fewer infections, overall antibiotic use declines, thus saving on hospital drug cost and yielding more effective antibiotics. A "virtuous circle" is formed as optimized antibiotic use leads to better drug matches for patients, which in turn reduces infections' resistance and leads to fewer sick patients.
The technology is beginning to be adopted in certain areas and hospitals around the country. In 2007, for example, the Pennsylvania legislature passed a bill that required hospitals to report all HAIs to the National Healthcare Safety Network (NHSN). It also encouraged hospitals to implement qualified electronic surveillance systems, and to great effect.
While hospitals initially reported an uptick in infections -- due to sharper identification methods as a result of the new technology -- the hospitals' rate of HAIs declined in the long-run. According to a report published by Aimee Palumbo, CSTE fellow at the Pennsylvania Department of Health, a 14 percent decline in the rate of catheter-associated urinary tract infections was reported in 2009, just two years after the legislation passed. Additionally, the CDC reported that the Pittsburgh Veterans Affairs Healthcare System documented a 60-percent decline in MRSA infections.
Hospitals that installed the electronic systems can focus their energies more on data collection and less on verification -- a timely and costly process -- because the clinical surveillance system had already verified the data. Electronic collection removes a step from the process, resulting in saved time and reduced costs. In 2006, Johns Hopkins University Hospital reported that since installing an electronic surveillance platform, hospital staff reported an 80 percent reduction in time spent on blood stream infection surveillance, and a 50 percent reduction in HAI confirmation -- all while maintaining 98 percent accuracy.
Hopefully Pennsylvania and Johns Hopkins are just the beginning. The electronic clinical surveillance system is a technology that improves care, reduces costs, and applies the latest technology in an effort to do both.