Infection Control Platform: Optimizing MDRO Infectious Disease Surveillance, Outbreak Prevention and Control in One Mobile Platform

Abstract Description

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Authors (including presenting author) :

Law MHA (1), Wong EHE (1), Tong YHA (1), Cheung NT (1)(2),Luk SK (3), Leung TWI (2), Wu CC (2), Siu WCR (2), Tang CWP (2), Yeung WCS (2), Chan CLJ (2), Ho PC (1), Mok HMJ (1), Fung HV (1)

Affiliation :

(1) Health Informatics Department, Information Technology and Health Informatics Division, Head Office, Hospital Authority, HKSAR (2) Information Technology Department, Information Technology and Health Informatics Division, Head Office, Hospital Authority, HKSAR (3) Department of Pathology, Prince Margret Hospital & Yan Chai Hospital, HKSAR

Introduction :

The spread of multidrug-resistant organism (MDRO)infections is associated with higher healthcare cost, prolonged hospitalization and mortality. In the Hospital Authority (HA), the MDRO disease surveillance and reporting are mainly performed via paper records that creates additional manual processing and transcription hence affects efficiency in early notification and prevention on patient-to-patient transmissions. IT solutions are pursued to ensure prompt and effective communications of MDRO conditions in various hospital settings in order to optimize disease surveillance, outbreak prevention and control.

Objectives :

1. To develop an Infection Control Platform MDRO Surveillance System that can be operated in both mobile device and desktop for supporting the MDRO patient identification and outbreak management 2. To integrate the Infection Control Platform MDRO Surveillance System to facilitate infection control teams' operation across all HA hospitals

Methodology :

A pilot project of MDRO Surveillance System for Carbapenemase Producing Enterobacteriaceae (CPE) was conducted in 10 HA hospitals nominated from 7 Clusters during August 2018 to October 2018. The functionalities of the Surveillance System include but not limit to the followings: 1. With close collaboration with Laboratory team and Laboratory Standard team, positive MDRO identifications on screening and clinical tests performed by both the HA and the Department of Health (DH) are incorporated to generate a positive patient list. 2. Essential patient-specific clinical information such as current location, MDRO tagging status, diagnosis, antibiotics uses and patient movement etc are retrieved at the time of information need. 3. Documentation for the case information, risk factors identification and site visits can be accommodated in one record. 4. All the recorded information as well as the patient-specific information can be downloaded to one management report. 5. Essential information and case reporting of the positive patients could be shared within the same Cluster

Result & Outcome :

After three months’ pilot, an average of 77% usage was noted from the 10 hospitals. Among them, 4 hospitals achieved 100% utilization indicating the System has been successfully integrated to their MDRO CPE management workflow. The post-pilot user survey revealed that the System provided not only the timely identification of positive cases but also the effective notifications of colonized patients comparing to the conventional laboratory reporting. Comments on workload impact were also received during the pilot period. Data transcription from paper to the System was required because of the unavailability of mobile devices during site visit. As a result, further roll out of the System was tied in with the another program that could ensure the device availability to the infection control teams. The System was launched in Jan 2019 across all hospitals. Conclusion: MDRO Surveillance System was developed to support infection control on resistant pathogens in HA hospitals. With the support from the pilot hospitals and users, the trial run proved the IT system could integrate with clinical practice in various Clusters. Positive feedbacks were received from the infection control teams on improving the efficiency in disease monitoring and outbreak management.