By Suzi Birz, Principal, HiQ Analytics
What if you could identify a poor hygiene practice before an
infection spread throughout your hospital? What if you could determine that a
particular restaurant was contributing to a salmonella outbreak within 24 hours
of patients presenting in the emergency department? These questions and more are
being addressed at hospitals around the country thanks to electronic
surveillance provided by MedMined, Inc.
Formed in 2000, MedMined, Inc., based in Birmingham, Alabama,
provides data mining analysis and related technical, clinical and financial
consulting services to the health care community. The patented technologies
monitor an entire hospital—both inpatient and outpatient—for emerging infection
outbreaks. MedMined services are employed in more than 120 hospitals in 23
states.
“MedMined provides hospital infection control programs with a
continuum of services, which serve to reduce preventable infections, improve
patient safety and decrease costs,” said Patrick Hymel, M.D., chief medical
officer for MedMined.
Hymel added that the responsibility of protecting a patient
from infection lies in the hands of the infection control practitioner (ICP)—a
role greatly assisted by MedMined technology.
“We give tools to reduce the amount of paperwork and medical
record review, which provides the ICP the opportunity to show up in the right
place at the right time, with the right information, in order to impact patient
care and improve outcomes,” Hymel added.
MedMined’s surveillance begins with an online data warehouse
and a Virtual Surveillance Interface. Hospital data, including lab data and
admission, discharge and transfer data, is sent to MedMined, where it is loaded
into a data warehouse and “normalized.” Then, with the use of algorithms created
by the company, the data is analyzed to detect patterns. The patterns are placed
on graphs with drill-down capability to see the specific patients and locations
involved. These reports include changes in activity representing emerging
problems or improvements. The reports are accessed by the hospital infection
control practitioner along with a list of actionable items also generated by the
service.
The Virtual Surveillance Interface allows hospital staff to
“ask questions” of the data and generate additional reports. The ICPs then work
with the staff on the unit to apply the actionable items, make process changes
and complete the documentation.
The MedMined Nosocomial Infection Marker™ (NIM)
The MedMined service features the Nosocomial Infection Marker
(NIM), which, for the first time, provides an accurate, electronic measurement
of the incidence of hospital-acquired infections.
The NIM uses sophisticated algorithms to analyze existing
patient clinical data to identify distinct hospital-acquired infections and
compute rates.
“The NIM allows ICPs and hospital executives to understand the
true impact of hospital-acquired infections on a hospital’s profitability,
thereby increasing the value of infection control and prevention efforts in the
eyes of executives,” Hymel explained.
This automated surrogate marker for nosocomial infections
provides a comprehensive, objective and efficient method for hospitals to track
infections of all types and in all locations, as well as to meet the demand of
mandatory reporting requirements.
Success Stories
One hospital that has benefited from MedMined’s technology is
Evanston Northwestern Healthcare (ENH), in Evanston, Illinois. According to
Lance Peterson, M.D., director of clinical microbiology and infectious disease
research at ENH, and a professor of pathology and medicine at Northwestern
University’s Feinberg School of Medicine, the hospital has found that the
electronic surveillance continues to improve and still remains easy to use. The
visuals, rapid graphing and alerts combine to make the reporting useful to both
the practitioner new to infection control and the one with 30 years experience.
“Using the visuals in this process makes it easier to follow
JCAHO’s advice of involving everyone,” Peterson explained.
Donna Hacek, a technical specialist in the department of
microbiology and molecular epidemiology at ENH, agreed that the MedMined service
allows ICPs to find infections faster than the traditional paper review model.
Peterson and Hacek shared two specific instances of success.
In one instance, because the surveillance is done on outpatient data as well as
inpatient data, the alert system picked up an outbreak of Salmonella javiana
in a local restaurant. In another instance, the hospital was able to detect
scattered instances of urinary tract infection, affording ENH the opportunity to
determine best practices for catheter care and implement hospital-wide
procedures in all three hospitals in the network.
Peterson asserted that many of the infections that are found
in a hospital are nosocomial. Therefore, patient impact varies in severity and
care is not reimbursable. These factors make the rapid discovery of infections
important to patient care and fiscal responsibility—a combination that makes the
service a continued “easy sell” to administration.
Take-Away Messages
MedMined believes in the importance of infection control.
Hymel explained that by asking clients about their challenges and monitoring
regulatory requirements, MedMined can continue to reinforce and empower the
specialty to help ICPs succeed.
“The services are tools for the ICP, but the success belongs
to the ICPs that use their clinical expertise to act on the information,” Hymel
said.
Hacek acknowledged that people might be intimidated by the
work involved with electronic surveillance or the possibility of the system
replacing an actual ICP. Still, she believes the benefits outweigh these
concerns.
“Don’t fear it,” Hacek said. “MedMined eliminates paperwork
and gives the ICP more time to interact with the caregivers and take care of
problem areas. It’s not more work—it allows you to do your job.”
Peterson echoed Hacek’s point.
“Remember the impact of nosocomial infections on the patients
and the bottom line,” he said. “Always look at the overall picture.”
Resources:
MedMined
Evanston Northwestern Healthcare
© 2005. AMN Healthcare, Inc. All Rights Reserved.