Leveraging the Syndromic Surveillance capabilities of MEDITECH to prevent Sepsis
My Personal Inspiration to Prevent HAI
When I was eleven years old my Father was hospitalized for complications that were non-life threatening, yet due to a series of unfortunate events peppered with carelessness and lack of enforcing protocols he never did make it back home. He acquired pneumonia from being placed on a ventilator and eventually developed sepsis, which unfortunately is an all too common occurrence. Hospital associated pneumonia (HAP) occurs in 5-15 out of every 1000 admissions; adding a ventilator increases the odds of infection by 6 to 20% (VAP) and Ventilator Associated Pneumonia is the leading nosocomial infection in the ICU.
In American hospitals alone, its estimated that HAIs account for 1.7 million infections and 99,000 associated deaths each year. Patients who acquire infections from surgery spend, on average, an additional 6.5 days in the hospital, are five times more likely to be readmitted after discharge and twice as likely to die. Moreover, surgical patients who develop infections are 60 percent more likely to require admission to a hospital’s intensive care unit. Surgical infections are believed to account for up to ten billion dollars annually in healthcare expenditures. (Source: CDC)
Sepsis, for example, accounts for one in every two to three patient deaths and is the leading cause of hospital re-admissions. This is mostly due to misdiagnosis or wrongful prophylaxis initiation. Prolonging or misdiagnosing infections can also lead to serious chronic problems later in life.
Patients aren’t the only ones at risk, as hospitals and ACO’s can be penalized for reporting preventable deaths and abnormally high readmission rates. There are also thousands of medical malpractice lawsuits filed daily causing many hospitals to pay out to friends, family and ambulance chasers alike of the patients they put in their care.
MEDITECH Syndromic Surveillance
MEDITECH has created a tool to alert clinicians to these infections well before they spiral out of control. It’s called Syndromic Surveillance and it comes in two flavors: Predictive and Analytic.
Predictive Surveillance, being the more robust of the two is available in the 6.1 platform and comes complete with its own Rules Engine. Rules can be built to comb the entire patient population and flag patients that meet the criteria defined within the rule. Documentation, Conditions, Lab Values, and delta changes (nerd for one value that changes to another) can all be accounted for and compared against each other. These flagged patients can be automatically added to watch boards monitored by infection control staff. Suggested prophylaxis based off hospital conditional protocols can be brought to the attention of care providers and once initialized, those patients can remain on the board to be monitored or automatically removed based on their improving condition.
Analytic Surveillance does not utilize a rules engine but can be a pretty powerful tool if the boards are built correctly. These boards are usually applied to a specific location and although all patients in that location will be on the board, the sort criteria will bring the “at risk” patients to the top so that action can be taken.
Reduce HAI Today By Building Surveillance Dashboards
Download our MEDITECH Syndromic Surveillance guide for a deeper dive into the setup involved in flagging patients at risk for HAI in the MEDITECH 6.1 platform.
If you want to start saving lives and avoid unwanted re-admissions today, let Galen do your nerdy work! We will build the boards and complex rule algorithms to aide care providers and infection control staff in monitoring these infections and take appropriate action. Galen will also build out hospital protocol order sets using evidence based medicine and prior knowledge of susceptibility patterns to make sure the patients current and preexisting conditions are a factor in the appropriate therapy ordered. These sets can be tailored to the guidelines set forth by your hospital’s Antibiotic Stewardship Program.
Bloomberg Business Week has named MEDITECH a leader in the ESS (Electronic System Surveillance) market. If you’re interested in getting started with Syndromic Surveillance, here’s just some of what Galen can build for you:
- Sepsis/SIRS/Septic Shock
- Ventilator Associated Pneumonia (VAP)
- Catheter Associated Urinary Tract Infection (CAUTI)
- Congestive Heart Failure
- Surgical Site Infection (SSI)
- Post-Operative Care
- Venous Thromboembolism (VTE)
- Deep Vein Thrombosis (DVT)
- Central Line Infections