According to the Centers for Disease Control and Prevention (CDC), antibiotic-resistant infections are associated with 23,000 deaths and 2 million illnesses in the United States each year. Estimates of annual impact of antibiotic-resistant infections on the U.S. economy vary, but have ranged as high as $20 billion in excess direct health care costs, and as much as $35 billion in lost productivity from hospitalizations and sick days.1
A growing body of evidence has demonstrated that hospital based programs dedicated to improving antibiotic use, or antimicrobial stewardship programs, can optimize treatment of infections and may help reduce adverse events related to inappropriate antibiotic use. They've been shown to significantly reduce hospital rates of antibiotic resistance.2 These programs often achieve these benefits while also saving hospitals money.3
To improve antibiotic use in hospitals, CDC recommended in 2014 that all acute care hospitals implement antibiotic stewardship programs.4
ICNet, a company Baxter acquired earlier this year, develops clinical surveillance software with modules focused on infection prevention, surgical outcomes and pharmacy.
"With ICNet's software platforms, we offer an even stronger set of technologies that provide pharmacists and physicians with tools that help promote safety and antimicrobial stewardship, as well as enhance efficiency and quality of care, so that they can increase their focus on other essential clinical practices," says Philip Rackliffe, Global Franchise Head, Baxter's Integrated Pharmacy Solutions franchise.
ICNet's software modules integrate data from the hospital's clinical information systems and organize it into actionable information. Customized alerts and reports automate and expedite what once were manual tasks. The modular structure of the software allows clinicians to target specific goals for infection prevention, antimicrobial stewardship and surgical surveillance.
"ICNet's tool is becoming integral for providing daily reports for our pharmacy antibiotic stewardship program," Phil Holman, lead pharmacist for Enloe Medical Centre in Chico, Calif., says. "Participating in the CDC data reporting network has also provided us with reliable benchmarking and utilization data."
ICNet's infection prevention module continually runs automated algorithms to detect signs of possible infection in lab reports, patient admissions data and pharmacy, among other data sources. Infection prevention and control practitioners receive pre-set alerts when a positive finding arises, allowing them to follow up on patients with drug-resistant organisms promptly.
The module allows flexibility for the individual to watch for certain conditions and set up specially tailored alerts. It also provides facility-level alerts and reports, including trending data, and analyses for the hospital group as a whole. When high-risk alerts are not acted on within a prescribed period of time at the facility level, the central offices of a healthcare group can follow up, providing an additional layer of oversight. ICNet software can be configured for local and emerging national public health threats such as tuberculosis contact tracing, Ebola, AIDS and flu pandemics.
"Over the past eight months, our pharmacy department has been utilizing ICNet to enhance our antimicrobial stewardship efforts," says Christine Barabas, a pharmacist from South County Hospital in Wakefield, Rhode Island. "On a daily basis, pharmacists are able to review relevant information such as positive cultures with no antimicrobial therapy via real time reporting, and are often the first to notify clinicians of important results. This allows therapy to be modified and optimized in a more timely fashion."
She adds that using ICNet surveillance software in their small institution has saved time by cutting down on manual chart reviews, and she speculates that at larger institutions, this tool could save even more time as well as lower overall costs associated with the inappropriate use of antimicrobials.
ICNet's technology is being used abroad by healthcare providers across the world, to help monitor healthcare-associated infections (HCAIs).
Mediclinic Southern Africa, a private hospital group, has installed ICNet software at all 52 of Mediclinic's hospitals and added a system administrator for a single installation covering 150 users over the geographical area of South Africa and Namibia, in order to manage HCAIs.
"The installation of ICNet software has helped to enhance the hospitals' reputations for excellence in patient care and a proactive infection prevention strategy," says Briëtte Du Toit, Infection Prevention and Control Specialist at Mediclinic.
She notes that ICNet software has been an integral part of their clinical practice by specifically helping to identify ventilator-associated pneumonia, surgical site infections, catheter-associated urinary tract infections and central line-associated blood stream infections, so that clinicians can address the emerging issues throughout the Mediclinic sites.
In addition, the use of the software has the potential to help hospitals gain efficiencies and save time. This can allow pharmacists and healthcare professionals extra time to connect further with the patients they serve and address other important clinical issues.
"Implementing ICNet surveillance software at Life Healthcare is part of our clinical outcome improvement agenda," says Dr. Sharon Vasuthevan, group nursing executive at Life Healthcare, a private hospital operator in South Africa. "But it is also part of our strategy to use more technology in supporting healthcare professionals, which frees them up to be part of crucial clinical conversations."
1The White House, 18/9/14 Press Office
2DiazGranados CA. Prospective audit for antimicrobial stewardship in intensive care: impact on resistance and clinical outcomes. American journal of infection control. Aug 2012;40(6):526-529.
Elligsen M, Walker SA, Pinto R, et al. Audit and feedback to reduce broad-spectrum antibiotic use among intensive care unit patients: a controlled interrupted time series analysis. Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. Apr 2012;33(4):354-361.
3Griffith M, Postelnick M, Scheetz M. Antimicrobial stewardship programs: methods of operation and suggested outcomes. Expert review of anti-infective therapy. Jan 2012;10(1):63-73.
Roberts RR, Hota B, Ahmad I, et al. Hospital and societal costs of antimicrobial-resistant infections in a Chicago teaching hospital: implications for antibiotic stewardship. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. Oct 15 2009;49(8):1175-1184.
Sick AC, Lehmann CU, Tamma PD, Lee CK, Agwu AL. Sustained savings from a longitudinal cost analysis of an internet-based preapproval antimicrobial stewardship program. Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America.Jun 2013;34(6):573-580.
Standiford HC, Chan S, Tripoli M, Weekes E, Forrest GN. Antimicrobial stewardship at a large tertiary care academic medical center: cost analysis before, during, and after a 7-year program. Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. Apr 2012;33(4):338-345.
4Fridkin SK, Baggs J, Fagan R, et al. Vital Signs: Improving Antibiotic Use Among Hospitalized Patients. MMWR. Morbidity and mortality weekly report. 2014;63.