Clinical study shows positive antimicrobial stewardship outcomes from using a clinical decision support system in a community hospital
PITTSBURGH (May 26, 2022) — A new study published in Open Forum Infectious Diseases suggests that a clinical decision support solution (CDSS) can dramatically decrease total antibiotic usage and improve inpatient workflow efficiency.
The research was conducted by physician and pharmacist-scientists at the University of Pittsburgh School of Medicine and UPMC, a leading academic medical center with an extended health system in Pennsylvania, New York, and Maryland, in partnership with Infectious Disease (ID) Connect. Building on an established tele-antimicrobial program, the CDSS implementation via ILÚM Insight® was associated with an immediate 11% reduction in antibiotic usage. Over the course of the study, this lowered antibiotic use by 1.03 days for each patient admission. ILÚM Insight presented real-time infectious disease alerts and enabled intervention opportunities with more efficient communication for physicians and pharmacists. Clinicians used both mobile and desktop applications to receive push notifications, view relevant patient information, and communicate asynchronously. Medical record reviews from the study showed that both remote ID experts and local pharmacists documented over twofold more ID intervention activities without increasing the total time they spent on stewardship and without decreasing their other non-stewardship efforts.
“These findings provide practical solutions to help the many hospitals that have minimal to no ID pharmacist coverage,” said lead researcher Tina Khadem, Pharm.D., University of Pittsburgh and UPMC. “The study also points us to ways that hospitals can more effectively combat increasing rates of antibiotic resistance and unnecessary antibiotic prescriptions.”
Other significant findings among patients treated after the ILÚM Insight implementation included:
- Having fewer patients on antibiotic therapy – with 48% of all patients receiving antibiotics after the ILÚM Insight implementation versus 52% prior to the implementation
- Shortening the average inpatient length of stay for patients receiving antimicrobials from 7.03 days to 6.83 days
- Reducing the time to optimal antibiotic therapy by a full day
- Seeing a 20% improvement in the use of oral antibiotics relative to intravenous antibiotic medications
- Improving quality by increasing documented patient interventions by 220% from the pre-implementation manual intervention documentation process
“ID Connect’s software helps doctors and pharmacists select the most appropriate antimicrobial therapy while managing toxicity, costs, and potential for drug resistance and infection transmission,” said Dave Zynn, president and chief executive officer of ID Connect. “By using machine learning and technology that combines a patient’s demographic factors, medication history, past hospitalizations, risk factors and other data to generate individualized treatment recommendations, we are able to give clinicians real-time convenient tools to face these challenges.”
The antimicrobial stewardship assessments included in the study were part of a four-phase program conducted over three years at a 146-bed hospital in New Castle, Pennsylvania. The first three phases of the study focused on antimicrobial stewardship education and tele-stewardship ID consultation forums. The final phase of the study was focused on the ILÚM Insight CDSS implementation from February 2020 to December 2021.
Spun out of leading academic medical center UPMC, ID Connect is a world leader in telemedicine-enabled care of infectious diseases, antimicrobial stewardship, and infection control and prevention. Our technology, precision medicine and data science are paired with world-class ID physicians to effectively manage infectious diseases across the U.S. At ID Connect, we strive to make people healthy, improve outcomes, and keep our communities free of infectious diseases.
A $24 billion health care provider and insurer, Pittsburgh-based UPMC is inventing new models of patient-centered, cost-effective, accountable care. The largest nongovernmental employer in Pennsylvania, UPMC integrates 92,000 employees, 40 hospitals, 800 doctors’ offices and outpatient sites, and a 4.1 million-member Insurance Services Division, the largest medical insurer in western Pennsylvania. In the most recent fiscal year, UPMC contributed $1.7 billion in benefits to its communities, including more care to the region’s most vulnerable citizens than any other health care institution, and paid more than $900 million in federal, state and local taxes. Working in close collaboration with the University of Pittsburgh Schools of the Health Sciences, UPMC shares its clinical, managerial and technological skills worldwide through its innovation and commercialization arm, UPMC Enterprises, and through UPMC International. U.S. News consistently ranks UPMC Presbyterian Shadyside among the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. For more information, go to UPMC.com.
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