Building up an infection control strategy based on the e-health concept

Introduction

Healthcare-associated infection (HAI) control is one of the most important challenges in quality and safety. Defined as the intensive use of the information and communication technologies, e-health can be a major part of this matter. Aiming for implementation of an infection control strategy based on the e-health concept in a 280-bed, paper-free, general hospital, the Infection Control Committee (ICC), along with the Quality and Antibiotics Committees and the IT team, has been working on the implementation of new tools for widespread use.

Methods

The authors used the electronic medical record, a special program for infection surveillance and data-mining, and some additional resources, such as messages and alerts sent by email or by SMS, as a global approach for improving infection control. On the electronic medical record (Soarian^®; Siemens Medical Solutions), interventions are made at different levels. On patient admission, through the fulfillment by the physician of a questionnaire on detection of increased risk for infection/colonization, several protocols regarding isolation and screening testing are automatically activated and the ICC is informed via email, thus minimizing the spread of epidemiologically important microorganisms. During hospitalization, new templates for prescribing microbiological tests are in progress to improve the availability of clinical information to the laboratory and to the Vigiguard^® (Biomérieux) program. New context-sensitive templates for antimicrobial prescription are being implemented to improve the quality of such therapeutics. Alerts to the pharmacy are sent when there is some inaccuracy in terms of the chosen antimicrobial or the duration of therapy, thus reducing the emergence of new drug resistances and minimizing costs. New fields were created to individualize infection control issues in the patient's history, and to generate an automatic note on epidemiologically important issues at the transfer or discharge of the patient, thus complying with the recommendations for information transfer. Finally, surveillance of several infections/colonizations will be obtained in real time from Vigiguard^®, a tool with a data-mining engine.

Conclusions

The authors hope that the application of the e-health concept to the infection control policy in a paper-free hospital will improve quality of and reduce the risk of HAI.