The "epic" challenge of optimizing antimicrobial stewardship: The role of electronic medical records and technology

Clinical Infectious Diseases

Volumn 57, Issue 7, 2013, Pages 1005-1013

  Kullar, Ravina ^a,f   Goff, Debra A ^b   Schulz, Lucas T ^c   Fox, Barry C ^d   Rose, Warren E ^e  

^a OREGON STATE UNIVERSITY   (United States)

^b THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER   (United States)

^c University of Wisconsin Health   (United States)

^d UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE AND PUBLIC HEALTH   (United States)

^e UNIVERSITY OF WISCONSIN MADISON   (United States)

^f CUBIST PHARMACEUTICALS INC   (United States)

Author keywords

Antimicrobial stewardship; Electronic medical records; Epic; Technology

Indexed keywords

AMPHOTERICIN B LIPID COMPLEX; ANTIBIOTIC AGENT; ANTIINFECTIVE AGENT; CIPROFLOXACIN; DAPTOMYCIN; MEROPENEM; MICAFUNGIN; MOXIFLOXACIN; POTASSIUM CHLORIDE; SODIUM CHLORIDE; VORICONAZOLE;

ALARM MONITORING; ANTIMICROBIAL STEWARDSHIP PROGRAM; ARTICLE; CLINICAL DECISION MAKING; COMPUTER PROGRAM; COST CONTROL; DECISION SUPPORT SYSTEM; ELECTRONIC MEDICAL RECORD; ELECTRONIC PRESCRIBING; ENTERIC FEEDING; FEEDBACK SYSTEM; HEALTH CARE COST; HEALTH PROGRAM; HUMAN; INFORMATION TECHNOLOGY; MEDICAL DOCUMENTATION; METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS INFECTION; PARENTERAL NUTRITION; PATIENT MONITORING; PHARMACIST; PHYSICIAN; PRIORITY JOURNAL; SCORING SYSTEM; UNITED STATES; UNIVERSITY HOSPITAL;

ANTIMICROBIAL STEWARDSHIP; ELECTRONIC MEDICAL RECORDS; EPIC; TECHNOLOGY;

ANTI-BACTERIAL AGENTS; DECISION SUPPORT SYSTEMS, CLINICAL; DELIVERY OF HEALTH CARE; DRUG UTILIZATION; ELECTRONIC HEALTH RECORDS; HEALTH RESOURCES; HUMANS; MEDICAL INFORMATICS; SOFTWARE; USER-COMPUTER INTERFACE;

EID: 84884374820     PISSN: 10584838     EISSN: 15376591     Source Type: Journal    
DOI: 10.1093/cid/cit318     Document Type: Article

References (28)

1. So A, Furlong M, Heddini A. Globalisation and antibiotic resistance. BMJ 2010; 341:c5116.
2. Chan M. World Health Day 2011: Combat drug resistance: no action today means no cure tomorrow. Geneva, Switzerland: World Health Organization, 2011.
3. Dellit TH, Owens RC, McGowan JE Jr, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007; 44:159-77.
4. Schentag JJ, Ballow CH, Fritz AL, et al. Changes in antimicrobial agent usage resulting from interactions among clinical pharmacy, the infectious disease division, and the microbiology laboratory. Diagn Microbiol Infect Dis 1993; 16:255-64.
5. Carling P, Fung T, Killion A, Terrin N, Barza M. Favorable impact of a multidisciplinary antibiotic management program conducted during 7 years. Infect Control Hosp Epidemiol 2003; 24:699-706.
6. Goff DA, Bauer KA, Reed EE, Stevenson KB, Taylor JJ, West JE. Is the "low-hanging fruit" worth picking for antimicrobial stewardship programs? Clin Infect Dis 2012; 55:587-92.
7. Ansari F, Gray K, Nathwani D, et al. Outcomes of an intervention to improve hospital antibiotic prescribing: interrupted time series with segmented regression analysis. J Antimicrob Chemother 2003; 52: 842-8.
8. Lodise TP Jr, Lomaestro B, Drusano GL. Piperacillin-tazobactam for Pseudomonas aeruginosa infection: clinical implications of an extendedinfusion dosing strategy. Clin Infect Dis 2007; 44:357-63.
9. Kaki R, Elligsen M, Walker S, Simor A, Palmay L, Daneman N. Impact of antimicrobial stewardship in critical care: a systematic review. J Antimicrob Chemother 2011; 66:1223-30.
10. MacDougall C, Polk RE. Antimicrobial stewardship programs in health care systems. Clin Microbiol Rev 2005; 18:638-56.
11. Trivedi KK. The California Antimicrobial Stewardship Program Initiative, 2010. Available at: http://www.cdph.ca.gov/programs/hai/Pages/ AntimicrobialStewardshipProgramInitiative.aspx. Accessed 1 November 2012.
12. Centers for Medicare and Medicaid Services. EHR incentive programs. Available at: http://www.cms.gov/Regulations-and-Guidance/Legislation/ EHRIncentivePrograms. Accessed 20 February 2013.
13. Hebert C, Ridgway J, Vekhter B, et al. Demonstration of the weightedincidence syndromic combination antibiogram: an empiric prescribing decision aid. Infect Control Hosp Epidemiol 2012; 33:381-8.
14. Buckley C. Clinical market share 2012: meaningful use momentum continues. In: Zsembery C, ed. Orem, Utah: KLAS, 2012.
15. Pitcher P. Community hospital CIS market share 2012: small hospitals, big changes. Orem, UT: KLAS, 2012.
16. Fox B, Osterby K, Shenk G, et al. Additional institutional cost of antimicrobial stewardship with accidental loss of automated decision support. Abstract 718. In: Program and abstracts of the 50th Annual Meeting of the Infectious Diseases Society of America. Arlington, VA: IDSA, 2012.
17. Evans RS, Pestotnik SL, Classen DC, et al. A computer-assisted management program for antibiotics and other antiinfective agents. N Engl J Med 1998; 338:232-8.
18. Pestotnik SL, Classen DC, Evans RS, Burke JP. Implementing antibiotic practice guidelines through computer-assisted decision support: clinical and financial outcomes. Ann Intern Med 1996; 124:884-90.
19. McGregor JC, Weekes E, Forrest GN, et al. Impact of a computerized clinical decision support system on reducing inappropriate antimicrobial use: a randomized controlled trial. J Am Med Inform Assoc 2006; 13: 378-84.
20. Hermsen ED, VanSchooneveld TC, Sayles H, Rupp ME. Implementation of a clinical decision support system for antimicrobial stewardship. Infect Control Hosp Epidemiol 2012; 33:412-5.
21. Patel J, Esterly JS, Scheetz MH, Bolon MK, Postelnick MJ. Effective use of a clinical decision-support system to advance antimicrobial stewardship. Am J Health Syst Pharm 2012; 69:1543-4.
22. Marrie TJ, Lau CY, Wheeler SL, Wong CJ, Vandervoort MK, Feagan BG. A controlled trial of a critical pathway for treatment of community-acquired pneumonia. CAPITAL Study Investigators. Community-Acquired Pneumonia Intervention Trial Assessing Levofloxacin. JAMA 2000; 283:749-55.
23. Whippy A, Skeath M, Crawford B, et al. Kaiser Permanente's performance improvement system, part 3: multisite improvements in care for patients with sepsis. Jt Comm J Qual Patient Saf 2011; 37:483-93.
24. Cook PP, Rizzo S, Gooch M, et al. Sustained reduction in antimicrobial use and decrease in methicillin-resistant Staphylococcus aureus and Clostridium difficile infections following implementation of an electronic medical record at a tertiary-care teaching hospital. J Antimicrob Chemother 2011; 66:205-9.
25. Goff DA, Jankowski C, Tenover FC. Using rapid diagnostic tests to optimize antimicrobial selection in antimicrobial stewardship programs. Pharmacotherapy 2012; 32:677-87.
26. Bauer KA, West JE, Balada-Llasat JM, Pancholi P, Stevenson KB, Goff DA. An antimicrobial stewardship program's impact with rapid polymerase chain reaction methicillin-resistant Staphylococcus aureus/S. aureus blood culture test in patients with S. aureus bacteremia. Clin Infect Dis 2010; 51:1074-80.
27. Fox B, Osterby K, Lavitschke M, Schulz L. Use of best practice alerts in electronic medical records to promote anti-infective de-escalation. Abstract 718. In: Program and abstracts of the 50th Annual Meeting of the Infectious Diseases Society of America. Arlington, VA: IDSA, 2012.
28. Moukheiber Z. Epic Systems' tough billionaire. Forbes. 2012. Available at: http://www.forbes.com/sites/zinamoukheiber/2012/04/18/epicsystems-tough- billionaire/. Accessed 1 November 2012.