Health IT Use Lags in Infection Prevention Efforts

Larry Hand

February 22, 2013

As US hospitals increasingly use health information technologies to improve the quality and efficiency of healthcare delivery, many hospital infection preventionists (IPs) lag in awareness and engagement in those activities, according to an article published online February 18 in the American Journal of Infection Control.

The lack of awareness and engagement could amount to "missed opportunities" to improve infectious disease reporting efficiency and promote disease prevention, according to Brian E. Dixon, MPA, PhD, from the School of Informatics and Computing, Indiana University–Purdue University Indianapolis, and colleagues.

Dr. Dixon and colleagues conducted a survey of hospital-based IPs across select US states in late 2010. The researchers chose states (Indiana, Washington, and Idaho) that were presumed to have active public health department involvement in recent development of health information exchanges (HIEs) and tried to balance them with states (Florida, Nebraska, and New Mexico) with mature HIEs whose public health departments might be engaged with them.

Of 63 IPs invited to take the survey, 44 (69%) responded; 5 responses were excluded because they were not complete. The 39 remaining responses represented independent hospitals (43.6%), hospitals within integrated delivery networks (33.3%), and integrated networks (20.5%).

Although 28 respondents (72%) were aware that their institutions were using electronic health record (EHR) systems, only 20% of infection control departments had participated in the development of EHR systems. Only 10% of respondents were engaged in HIE activities, and almost half (49%) indicated they didn't know if their organizations was involved in a HIE network.

"Although HIE infrastructures were available in all of the target regions, only 1 respondent indicated leveraging an HIE to report notifiable disease information to public health," the researchers write.

Printing and Faxing

Of the 39 IPs, 35 (92.1%) report to local health departments, 23 (60.5%) report to state health agencies, and 20 (52.3%) report to both. Most IPs (27, 71.1%) primarily used printing and faxing to transmit reports; only 4 IPs (10.5%) use public health agencies' Web-based systems for reporting. Others IPs varied between electronic and print faxing.

Asked what "one thing" public health agencies could do to improve disease reporting, respondents indicated that they needed better access to information such as community health trends, better communication with agencies, paperless reporting capability, and less redundancy. (Local and state agencies may require different information, necessitating double reporting.)

From EHR systems, IPs indicated most often that they needed better decision support. Rather than going through EHR information "in a manner similar to performing paper chart reviews," they need the systems to "flag" questionable reports and "identify potential nosocomial infections." They also said they needed more access to patient histories to determine whether infections were first-time or recurrent, as well as better interoperability among systems.

The researchers urge IPs to become more engaged in EHR and HIE development and operation, possibly through service on hospital EHR committees or task forces. "[A] lack of awareness may lead to underutilization of health information technologies by IPs, potentially hindering efforts to improve notifiable disease surveillance processes and shift toward disease prevention."

The authors have disclosed no relevant financial relationships.

Am J Infect Control. Published online February 18, 2012. Abstract