Nabbing infections with technology

updated 3:50 p.m. ET Dec. 30, 2008

HERSHEY, Pa. - At Hershey Medical Center, a sophisticated computer program serves as a watchdog for infection outbreaks.

With a few mouse clicks on a Web browser, the hospital's infection-control staffers can quickly generate reports with charts and graphs illustrating how many patients within a particular unit are infected, and which lab specimen contained the germs.

"It's more for us to look at the hospital as a whole and look for trends," said Dr. Kathleen Julian, an infection disease physician. "Is there a cluster of problems in this unit?"

Pennsylvania health officials view the nascent technology as a critical tool for helping hospitals reduce health care costs by identifying potential systemic infection-control problems sooner than is possible by reviewing paper records by hand — an approach some health professionals call "shoe-leather epidemiology."

Using traditional investigation methods, infection-control professionals must spend hours poring over patient charts, but limit the scope of their inquiry to areas of the hospital where infection outbreaks are most likely to occur. With electronic monitoring, hospitals can cast a wider net, using software that employs algorithms to do the heavy lifting of sorting through every single laboratory, pharmacy and X-ray report that is entered into the hospital's computer network.

Gov. Ed Rendell's administration is expecting more hospitals to adopt the technology under a sweeping 2007 state law designed to reduce infections contracted by patients during their hospital stays.

"It frees up your infection-control people from trying to find infections ... so they can get out on the floor and put systems in place so they don't happen again," said Ann Torregrossa, policy director for the Governor's Office of Health Care Reform.

Leader of ‘electronic surveillance’
Pennsylvania is the only state in the nation to include "electronic surveillance" — like the Hershey hospital's system — in its infection reporting laws, according to the Association of Professionals in Infection Control and Epidemiology.

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Pennsylvania became one of the first states to mandate infection reporting by hospitals in 2003, and it was the first state to release public reports on infection rates in 2005.

Gov. Ed Rendell's administration championed the 2007 law as part of a broader health care reform agenda that includes reducing the cost of care. The administration has estimated that hospital-acquired infections add more than $3.5 billion annually to hospital bills in the state.

Monitoring infections has taken on greater urgency nationally with the emergence of antibiotic-resistant "superbugs" such as methicillin-resistant Staphylococcus aureas, or MRSA.

Also, in October, the federal government began withholding Medicare reimbursements to hospitals for preventable errors, including urinary tract and vascular infections stemming from the improper use of catheters, as well as certain surgical site infections.

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Pennsylvania's law requires hospitals, outpatient surgery centers and nursing homes to develop state-approved infection control plans and report all infections to the Centers for Disease Control and Prevention. It also calls for the eventual awarding of bonuses to hospitals that reduce infections by at least 10 percent.

Rendell's administration originally sought a statewide mandate for the computerized infection tracking systems so that health officials could make uniform comparisons. But the state's hospitals fought back, arguing that the requirement was a costly mandate that would unfairly penalize small hospitals that have lower infection rates.

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