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

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

12 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 CHAIPI Expansion

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

14 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 Defining CHAIPI Program Success

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