Summary: Adoption of Healthcare IT in infection control is enhancing the preparedness of hospitals in cases of infectious disease outbreak and reduce transmission risk
According to a report published by Grand View Research, the global Healthcare IT market was estimated to be USD 64.54 billion in 2016. The application of IT in healthcare is expected to increase linearly and aid in management of various disease conditions.
The major applications of Healthcare IT include the following:
- Electronic Health Records
- Computerized Provider Order Entry Systems
- Electronic Prescribing Systems
- Lab Information Systems
- Clinical Information Systems
- Telemedicine and Telehealth
One of the other applications of Healthcare IT which is making a significant impact in the life sciences industry is prevention. The launch of many mobile apps which aid in the prevention of infectious diseases, has increased the scope and the reach of healthcare IT in the life science industry.
1) Ebola Care
During the Ebola virus outbreak between 2013 – 2016, healthcare apps were launched to assist in the detection of Ebola and they were also used in the diagnosis of the disease. One such app is the Ebola care app, which is developed by a NGO in order to increase the access to data from the field. This app is available on iOS and Android phones, and information is collected based on this app, and transmitted online to decision makers, which results in faster and real time decision making. This app also educates the workers, regarding the disease, precautions to be taken, and actively taking steps in Ebola prevention. This app can also reallocate resources, arrange ambulances for the patients and children.
Hepatitis C virus (HCV) is a disease which affects more than 50.0% of the American population, yet only 9.0% of the patients receive treatment and are cured of this disease. As of 2016, there were 2,947 cases of acute hepatitis C reported across 42 states and approximately 3.5 million people with chronic hepatitis C in the U.S.
HepCure is an app developed by the New York State Department of Health’s AIDS institute and the Community Health Care Association on NYS in collaboration with other community health centers. This app is a bidirectional app for patients and providers, which assists in the following aspects:
- Helps organize and track patients suffering from HCV
- Recommend treatment options to the patients based on the guidelines set by the American Association for the Study of Liver Diseases (AASLD) and the Infectious Diseases Society of America (IDSA)
- Aids in the tracking of HCV quality care indicators
- Provides information about the disease and the treatment plan to the patient
- Organizes tele-educational webinars with the patients and tracks weekly progress of the patient.
- Provides access to educational information to the patients and providers.
- Aids in medication adherence by sending medication reminders
- Provides access to fact sheets
- Records the symptoms of the patients
It has been reported by HHS.com, that as of 2015, the app is used in five health centers, out of which three are federally certified health centers in New York. As of 2016, the app has been downloaded over 300 times since its launch in November 2015.
3) Transwomen Connected
This app is currently being developed by the Portland State University with dfusion, a health tech company which focuses on behavior change research. This app is being developed for HIV prevention in transgender women. This app is anticipated to also act as a supportive peer platform, where patients can share their stories.
It is anticipated that for the public release of this app will be in 2019-2020. The final app is anticipated to contain effective HIV and sexual health messages which are specifically tailored for transgender women. This app is also anticipated to offer emotional support by arranging meetings between the patients, and making the sharing of information easier.
Role of Electronic Health Records (EHR) in:
1) Disease prevention
According to a report published by Grand View Research the global EHR market was estimated to be USD 20.55 billion in 2016. The application of EHR in the screening and prevention of the following diseases is anticipated to increase:
- Breast Cancer
- Colorectal Cancer
EHR was used to increase the screening test for colorectal cancer, tobacco, coronary disease, and limpid management, ischemic vascular, and high blood pressure in the primary health care facilities in Albany, Georgia. The national average for colorectal cancer screening is estimated to be 39.0% by Healthcare IT News, however the average for colorectal cancer screening in Albany, Georgia was estimated to be 60.0%. It is estimated that one in 20 people over the age of 50 develop colon cancer. If the people undergo screening, then the risk of colon cancer is reduced by 70.0%.
Moreover, national average for the screening for tobacco was found to be 85.0% while the average for Albany, Georgia primary health centers was 90.0%. The national screening average for coronary disease and limpid management, ischemic vascular, and high blood pressure was estimated to be 79.0%, 78.0%, and 62.0% respectively, while screening average for these diseases in Albany was found to be 90.0%, 90.0% and 73.0% respectively. According to James Hotz, clinical service director at Albany Primary Healthcare Center, the higher average screening values are attributed to the proper implementation of EHR.
Hospitalized patients visit diagnostic, treatment and other procedural areas thus raising the risk for nosocomial disease transmission and spore contamination of surfaces. In October 2017, researchers at the University of California San Francisco used data from electronic health record (EHR) to track potential transmission of Clostridium difficile (C. diff) thus presenting scope for improvement of hospital infection control standards. Under this methodology, in circumstances where patient has been diagnosed with C. diff occupy or visit a hospitals/care center space, that space was tagged as ‘contaminated’ for 24 hours, irrespective of cleaning practices. In addition, others patients that passed through a ‘potentially contaminated’ space were also considered as exposed to C. diff.
2) Infection control
The global infection control market was estimated to be USD 150.4 billion in 2016. According to the Center for Disease Control and Prevention there were 99,000 deaths out of a total of 1.7 million cases of hospital acquired infection. The cost of these hospital acquired infection were also estimated to be USD 30 billion. In order to reduce the number of deaths and cost of hospital acquired infection, awareness pays a key role. According to a study, the awareness and implementation of sanitation guidelines is more in organizations where the IT department is involved in the purchase process as compared to the organizations where the IT department is not involved in the purchase process.
This study also concludes that in organizations with highly developed IT departments, the risk of patients acquiring infection from improperly sanitized technology decreases to 29.0% as compared to the organizations where the IT department is not advance, where the risk of patients acquiring infection from improperly sanitized technology was found to be 43.0%. Thus, healthcare IT plans an important role in infection control, especially hospital acquired infection.
Although data analysis in infection control is in the preliminary stages, it is anticipated play a major role in infection control owing to advancements in informatics. For instance, Stanford Hospital, a tertiary care center, developed an electronic algorithm using their electronic medical record (EMR) to reduce surveillance time for catheter-associated urinary tract infection (CAUTI) in adults. It was concluded that the electronic algorithm is effective in improving the overall surveillance efficiency for CAUTI. It was also implicated that data suggest that CAUTI surveillance can be fully automated using the National Healthcare Safety Network definitions.
There is a need for stronger algorithms to facilitate detection of hospital-acquired infections in patients and enhance the ability to distinguish amongst community-based and hospital-acquired infections. Integration of health information exchange and well-designed electronic health records may result in prevention of infectious disease spread. These findings underscore that health information exchange organizations, as well as the Office of National Coordinators for Health Information Technology, need to provide more training to physicians and healthcare professionals and education with respect to the benefits associated with health information exchange in tracking of infectious disease transmission.
Role of Healthcare Analytics in Infection Control
The global healthcare analytics market was estimated to be worth USD 7.04 billion in 2016. The application healthcare analytics in infection control was observed when Indiana University (IU) Health, aimed at reducing the rate of central-line associated bloodstream infections (CLABSIs) using predictive analytics. According to CDC, in 2017, there were 30,100 CLABSIs in the U.S. acute care facilities and the cost incurred with these infection was estimated to be USD $3,700 to $36,000 per episode.
IU health launched this model in its main campus, where the number of beds are 600, with level I trauma center and a 300 bed tertiary care center. IU health is also one of the largest transplant centers in the U.S. According to Kristen Kelly, the director of infection prevention at IU health, real time predictive analytics to identify the patient most likely to acquire infection and prevent the development of infection. Additionally, the hospital executives also used predictive analytics to monitor patient’s vitals in real time and thus, alerting the doctors to intervene before it was too late.
According to an article in Hospitals & Health Networks, approximately 80.0% of the hospital executives believed that predictive analytics helped improve the quality of healthcare in hospitals.
Another such instance was accounted in Health IT OUTCOMES.com, where Piedmoth Healthcare uses data analytics in infection control. Piedmont Healthcare is a non-profit organization which comprises of 8 hospitals with a total of 1674 beds in Atlanta Metro in the U.S. It was reported that the number of patients treated in this hospital in 2016 was 2 million patients. Additionally, the footprint of these hospitals is anticipated to increase, with the additional setting up of 3 more hospitals, which are anticipated to be operational by 2018.
Piedmont Healthcare hospital, according to Health IT OUTCOMES.com, records 555 billion data points of its patients across 22,000 fields. Thus, Piedmont invested in data analytics in order to reduce the time for decision making, it also ensured that the data needed to make decision, is with the decision maker in real time. Additionally, they used this data, in order to predict the spread of hospital related infections, and track these infections in real time. By tracking the progress of this infection in real-time, the care providers, can provide the correct treatment before it is too late.
To summarize, healthcare IT in infection control perform various functions that include hand hygiene compliance monitoring, contact tracing, asset management, medical scope management, environmental monitoring and surgical sterile processing. Hand hygiene compliance monitoring involves reporting of missed as well as successful hand hygiene events, reminding of dispenser installations, staff reminders to encourage hand hygiene compliance. In an event of an infectious disease outbreak, contact tracing services locate potential carriers through predictive analysis, thus aiding in infection control. In addition, an asset management system eliminates sources of human error and recognizes risk factors and send alerts to the concerned department. In this process, the products/assets are segregated and tagged according to available data on their capabilities of withstanding high degree disinfectants and high-pressure washing. Thus, data analytics is anticipated to reduce the occurrences of hospital acquired information.
Need for Enhanced Infection Prevention Protocols
The reuse of a single-use medical device in order to reduce cost, is anticipated to reduce the cost of medical devices exponentially. It has also been reported by the CDC that approximately 20.0%-30.0% of all the medical devices in the U.S. are reused. However, the reuse of medical devices, is anticipated to increase the risk and cases of hospital acquired infections. In order to reduce the cost incurred due to hospital acquired infection the U.S. FDA released a new set of guidelines for reusing medical devices. According to this document, class III medical devices for reuse have to submit the premarketing documents for approval again for six months, class II medical devices are to be tested for 12 months, and class I devices for 18 months before being reused.
Thus, the U.S. FDA along with other international regulatory agencies has set up a protocol to use healthcare IT to reduce the number of hospital acquired infections and control the spread of infectious diseases.