A Regional Informatics Platform for Coordinated Antibiotic-Resistant Infection Tracking, Alerting, and Prevention
Open accessAbstract
BACKGROUND: We developed and assessed the impact of a patient registry and electronic admission notification system relating to regional antimicrobial resistance (AMR) on regional AMR infection rates over time. We conducted an observational cohort study of all patients identified as infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) and/or vancomycin-resistant enterococci (VRE) on at least 1 occasion by any of 5 healthcare systems between 2003 and 2010. The 5 healthcare systems included 17 hospitals and associated clinics in the Indianapolis, Indiana, region. METHODS: We developed and standardized a registry of MRSA and VRE patients and created Web forms that infection preventionists (IPs) used to maintain the lists. We sent e-mail alerts to IPs whenever a patient previously infected or colonized with MRSA or VRE registered for admission to a study hospital from June 2007 through June 2010. RESULTS: Over a 3-year period, we delivered 12 748 e-mail alerts on 6270 unique patients to 24 IPs covering 17 hospitals. One in 5 (22%-23%) of all admission alerts was based on data from a healthcare system that was different from the admitting hospital; a few hospitals accounted for most of this crossover among facilities and systems. CONCLUSIONS: Regional patient registries identify an important patient cohort with relevant prior antibiotic-resistant infection data from different healthcare institutions. Regional registries can identify trends and interinstitutional movement not otherwise apparent from single institution data. Importantly, electronic alerts can notify of the need to isolate early and to institute other measures to prevent transmission.
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The INPC electronically notified infection preventionists in hospitals about a patient's prior infection with a multi-drug resistant organism, enabling rapid identification and isolation of patients who may carry "super-bugs."
“Moreover, the INPC electronically notified infection preventionists in hospitals about a patient’s prior infection with a multi-drug resistant organism [28], enabling rapid identification and isolation of patients who may carry “super-bugs.””
From Evolution of clinical Health Information Exchanges to population health resources: a case study of the Indiana network for patient care (2025) · cites this paper as [28]
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Cites
An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU
Pronovost, P., Needham, D., Berenholtz, S., Sinopoli, D., Chu, H., Cosgrove, S., Sexton, B., Hyzy, R., Welsh, R., Roth, G., et al. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa061115 · Cited by 4,387 · see citing works
Klevens, R. M. (2007) · JAMA · doi:10.1001/jama.298.15.1763 · Cited by 3,726 · see citing works
National Center for Health Statistics (NCHS)
Feinleib, M. (2005) · Encyclopedia of Biostatistics · doi:10.1002/0470011815.b2a16042 · Cited by 3,134 · see citing works
The “Meaningful Use” Regulation for Electronic Health Records
Blumenthal, D., & Tavenner, M. (2010) · New England Journal of Medicine · doi:10.1056/nejmp1006114 · Cited by 2,059 · see citing works
David, M. Z., & Daum, R. S. (2010) · Clinical Microbiology Reviews · doi:10.1128/cmr.00081-09 · Cited by 1,972 · see citing works
Hospital-Acquired Infections Due to Gram-Negative Bacteria
Peleg, A. Y., & Hooper, D. C. (2010) · New England Journal of Medicine · doi:10.1056/nejmra0904124 · Cited by 1,491 · see citing works
Vancomycin-Resistant Enterococci
Cetinkaya, Y. S., Falk, P. S., & Mayhall, C. G. (2000) · Clinical Microbiology Reviews · doi:10.1128/cmr.13.4.686-707.2000 · Cited by 1,187 · see citing works
Overriding of Drug Safety Alerts in Computerized Physician Order Entry
van der Sijs, H., Aarts, J., Vulto, A., & Berg, M. (2006) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1809 · Cited by 1,117 · see citing works
Graphviz— Open Source Graph Drawing Tools
Ellson, J., Gansner, E. R., Koutsofios, L., North, S. C., & Woodhull, G. (2002) · Lecture notes in computer science · doi:10.1007/3-540-45848-4_57 · Cited by 784 · see citing works
Stimulating the Adoption of Health Information Technology
Blumenthal, D. (2009) · New England Journal of Medicine · doi:10.1056/nejmp0901592 · Cited by 728 · see citing works
Health Care–Associated Invasive MRSA Infections, 2005-2008
Kallen, A. J. (2010) · JAMA · doi:10.1001/jama.2010.1115 · Cited by 439 · see citing works
Universal Surveillance for Methicillin-Resistant Staphylococcus aureus in 3 Affiliated Hospitals
Robicsek, A. A., Beaumont, J. L., Paule, S. M., Hacek, D. M., Thomson, R. B., Kaul, K. L., King, P., & Peterson, L. R. (2008) · Annals of Internal Medicine · doi:10.7326/0003-4819-148-6-200803180-00003 · Cited by 417 · see citing works
Popovich, K. J., Weinstein, R. A., & Hota, B. N. (2008) · Clinical Infectious Diseases · doi:10.1086/528716 · Cited by 375 · see citing works
Electronic Medical Records for Genetic Research: Results of the eMERGE Consortium
Kho, A. N., Pacheco, J. A., Peissig, P. L., Rasmussen, L., Newton, K. M., Weston, N., Crane, P. K., Pathak, J., Chute, C. G., Bielinski, S. J., et al. (2011) · Science Translational Medicine · doi:10.1126/scitranslmed.3001807 · Cited by 336 · see citing works
Self-citationThe Indiana Network For Patient Care: A Working Local Health Information Infrastructure
McDonald, C. J., Overhage, J. M., Barnes, M., Schadow, G., Blevins, L., Dexter, P. R., Mamlin, B., & the INPC Management Committee (2005) · Health Affairs · doi:10.1377/hlthaff.24.5.1214 · Cited by 330 · see citing works
Self-citationControl of Vancomycin-Resistant Enterococcus in Health Care Facilities in a Region
Ostrowsky, B. E., Trick, W. E., Sohn, A. H., Quirk, S. B., Holt, S. C., Carson, L. A., Hill, B. C., Arduino, M. J., Kuehnert, M. J., & Jarvis, W. R. (2001) · New England Journal of Medicine · doi:10.1056/nejm200105103441903 · Cited by 306 · see citing works
Technical Description of RODS: A Real-time Public Health Surveillance System
Tsui, F. R., Espino, J. U., Dato, V., Gesteland, P. H., Hutman, J., & D, M. M. W. M. (2003) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m1345 · Cited by 262 · see citing works
A randomized, controlled trial of clinical information shared from another institution
Overhage, J. M., Dexter, P. R., Perkins, S. M., Cordell, W. H., McGoff, J., McGrath, R. B., & McDonald, C. J. (2002) · Annals of Emergency Medicine · doi:10.1067/mem.2002.120794 · Cited by 160 · see citing works
Self-citationKallen, A. J., Hidrón, A., Patel, J. B., & Srinivasan, A. (2010) · Infection Control and Hospital Epidemiology · doi:10.1086/652152 · Cited by 155 · see citing works
U.S. Regional Health Information Organizations: Progress And Challenges
Adler‐Milstein, J., Bates, D. W., & Jha, A. K. (2009) · Health Affairs · doi:10.1377/hlthaff.28.2.483 · Cited by 135 · see citing works
Analysis of a probabilistic record linkage technique without human review.
Grannis, S. J., Overhage, J. M., Hui, S. L., & McDonald, C. J. (2003) · PubMed · Cited by 112 · see citing works
Self-citationHsiao, C., Hing, E., Socey, T. C., & Cai, B. (2010) · Cited by 81 · see citing works
Quantifying Interhospital Patient Sharing as a Mechanism for Infectious Disease Spread
Huang, S. S., Avery, T. R., Song, Y., Elkins, K. R., Nguyen, C. C., Nutter, S. K., Nafday, A., Condon, C. J., Chang, M. T., Chrest, D., et al. (2010) · Infection Control and Hospital Epidemiology · doi:10.1086/656747 · Cited by 78 · see citing works
Conterno, L. D. O., Shymanski, J., Ramotar, K., Toye, B., Zvonar, R. K., & Roth, V. R. (2007) · Journal of Hospital Infection · doi:10.1016/j.jhin.2006.12.014 · Cited by 77 · see citing works
Lee, B. Y., McGlone, S. M., Wong, K. F., Yilmaz, S. L., Avery, T. R., Song, Y., Christie, R. A., Eubank, S., Brown, S. T., Epstein, J. M., et al. (2011) · Infection Control and Hospital Epidemiology · doi:10.1086/660014 · Cited by 76 · see citing works
Current Epidemiology of Multidrug-Resistant Gram-Negative Bacilli in the United States
Kallen, A. J., & Srinivasan, A. (2010) · Infection Control and Hospital Epidemiology · doi:10.1086/655996 · Cited by 70 · see citing works
Screening for MRSA: A Flawed Hospital Infection Control Intervention
Wenzel, R. P., Bearman, G. M., & Edmond, M. B. (2008) · Infection Control and Hospital Epidemiology · doi:10.1086/593120 · Cited by 69 · see citing works
Lee, B. Y., Bartsch, S. M., Wong, K. F., Yilmaz, S. L., Avery, T. R., Singh, A., Song, Y., Kim, D. S., Brown, S. T., Potter, M. A., et al. (2012) · Health Affairs · doi:10.1377/hlthaff.2011.0992 · Cited by 62 · see citing works
Hubben, G. A. A., Bootsma, M., Luteijn, M., Glynn, D., Bishai, D. M., Bonten, M. J. M., & Postma, M. J. (2011) · PLoS ONE · doi:10.1371/journal.pone.0014783 · Cited by 55 · see citing works
Kho, A., Lemmon, L., Commiskey, M., Wilson, S. J., & McDonald, C. J. (2007) · Journal of the American Medical Informatics Association · doi:10.1197/jamia.m2577 · Cited by 47 · see citing works
Self-citationKho, A., Dexter, P. R., Warvel, J. S., Belsito, A. W., Commiskey, M., Wilson, S. J., Hui, S. L., & McDonald, C. J. (2007) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2007.02.005 · Cited by 44 · see citing works
Self-citationBarnes, S., Harris, A. D., Golden, B., Wasil, E., & Furuno, J. P. (2011) · Infection Control and Hospital Epidemiology · doi:10.1086/662375 · Cited by 41 · see citing works
Ward, M. M., Diekema, D. J., Yankey, J. W., Vaughn, T. E., BootsMiller, B. J., Pendergast, J., & Doebbeling, B. N. (2005) · Infection Control and Hospital Epidemiology · doi:10.1086/502483 · Cited by 31 · see citing works
Self-citationImplementation of Systems Redesign: Approaches to Spread and Sustain Adoption
Woodward-Hagg, H., Workman-Germann, J., Flanagan, M., Suskovich, D., Schachitti, S., Corum, C. L., & Doebbeling, B. N. (2008) · Cited by 24 · see citing works
Self-citationIndianapolis I3: the third generation Integrated Advanced Information Management Systems.
McGowan, J. J., Overhage, J. M., Barnes, M., & McDonald, C. J. (2004) · PubMed Central · Cited by 17 · see citing works
Self-citationImplementing the MRSA Bundle in ICUs: One Citywide Collaborative's Key Lessons Learned
Welsh, C. A., Flanagan, M., Kiess, C., & Doebbeling, B. N. (2011) · Infection Control and Hospital Epidemiology · doi:10.1086/661101 · Cited by 9 · see citing works
Self-citationSirio, C., Keyser, D. J., Norman, H., Weber, R. J., & Muto, C. A. (2005) · Cited by 8 · see citing works
Connecting the dots: creation of an electronic regional infection control network.
Kho, A., Dexter, P. R., Lemmon, L., Carey, D., Woodward-Hagg, H., Hare, S., & Doebbeling, B. N. (2007) · PubMed · Cited by 8 · see citing works
Self-citationAn operational citywide electronic infection control network: results from the first year.
Kho, A., Lemmon, L., Dexter, P. R., Doebbeling, B. N., & Doebbeling, B. N. (2008) · PubMed · Cited by 8 · see citing works
Self-citationHenriksen, K., Jb, B., Es, M., & Di, L. (2005) · Cited by 2 · see citing works
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Antimicrobial Stewardship: How the Microbiology Laboratory Can Right the Ship
Morency-Potvin, P., Schwartz, D. N., & Weinstein, R. A. (2017) · Clinical Microbiology Reviews · doi:10.1128/cmr.00066-16 · Cited by 230 · see citing works
Design and implementation of a privacy preserving electronic health record linkage tool in Chicago
Kho, A., Cashy, J., Jackson, K., Pah, A. R., Goel, S., Boehnke, J., Humphries, J. E., Kominers, S. D., Hota, B. N., Sims, S. A., et al. (2015) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocv038 · Cited by 144 · see citing works
Self-citationMays, J. A., Jackson, K. L., Derby, T. A., Behrens, J. J., Goel, S., Molitch, M. E., Kho, A. N., & Wallia, A. (2016) · Diabetes Care · doi:10.2337/dc16-0668 · Cited by 95 · see citing works
Self-citationClinical Microbiology Informatics
Rhoads, D. D., Sintchenko, V., Rauch, C. A., & Pantanowitz, L. (2014) · Clinical Microbiology Reviews · doi:10.1128/cmr.00049-14 · Cited by 74 · see citing works
Health Information Exchange Use (1990-2015): A Systematic Review
Devine, E. B., Totten, A. M., Gorman, P., Eden, K., Kassakian, S. Z., Woods, S. S., Daeges, M., Pappas, M., McDonagh, M. S., & Hersh, W. (2017) · eGEMs (Generating Evidence & Methods to improve patient outcomes) · doi:10.5334/egems.249 · Cited by 49 · see citing works
The Indiana Health Information Exchange
Overhage, J. M. (2016) · Health Information Exchange · doi:10.1016/b978-0-12-803135-3.00027-x · Cited by 47 · see citing works
Self-citationIdentifying Critically Ill Patients at Risk for Inappropriate Antibiotic Therapy
Micek, S. T., Heard, K. M., Gowan, M., & Kollef, M. H. (2014) · Critical Care Medicine · doi:10.1097/ccm.0000000000000337 · Cited by 21 · see citing works
Lee, B. Y., Bartsch, S. M., Hayden, M. K., Welling, J. S., DePasse, J. V., Kemble, S. K., Leonard, J., Weinstein, R. A., Mueller, L. E., Doshi, K., et al. (2019) · Clinical Infectious Diseases · doi:10.1093/cid/ciz300 · Cited by 20 · see citing works
Effect of contact precautions for MRSA on patient satisfaction scores
Livorsi, D. J., Kundu, M. G., Batteiger, B. E., & Kressel, A. B. (2015) · Journal of Hospital Infection · doi:10.1016/j.jhin.2015.02.007 · Cited by 16 · see citing works
The Indiana Health Information Exchange
Overhage, J. M., & Kansky, J. P. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-90802-3.00022-8 · Cited by 13 · see citing works
Self-citationLee, B. Y., Bartsch, S. M., Hayden, M. K., Welling, J. S., Mueller, L. E., Brown, S. T., Doshi, K., Leonard, J., Kemble, S. K., Weinstein, R. A., et al. (2020) · Clinical Infectious Diseases · doi:10.1093/cid/ciaa072 · Cited by 11 · see citing works
Clinical decision support system in medical knowledge literature review
Yang, J., Kang, U., & Lee, Y. (2015) · Information Technology and Management · doi:10.1007/s10799-015-0216-6 · Cited by 10 · see citing works
Jackson, K., Mbagwu, M., Pacheco, J. A., Baldridge, A. S., Viox, D. J., Linneman, J. G., Shukla, S. K., Peissig, P. L., Borthwick, K. M., Carrell, D., et al. (2016) · BMC Infectious Diseases · doi:10.1186/s12879-016-2020-2 · Cited by 9 · see citing works
Self-citationRosenman, M. B., Szucs, K. A., Finnell, S. M. E., Khokhar, S., Egg, J., Lemmon, L., Shepherd, D. C., Friedlin, J., Li, X., & Kho, A. (2014) · Infection Control and Hospital Epidemiology · doi:10.1086/677833 · Cited by 8 · see citing works
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Rudin, R. S., Motala, A., Goldzweig, C. L., & Shekelle, P. (2014) · Annals of Internal Medicine · doi:10.7326/m14-0877 · Cited by 6 · see citing works
Public Health: Interoperability Applications to Support Population Health
Dixon, B. E. (2022) · Health informatics · doi:10.1007/978-3-030-91237-6_23 · Cited by 3 · see citing works
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Kim, H. (2018) · Advances in Biotechnology & Microbiology · doi:10.19080/aibm.2018.11.555820 · Cited by 3 · see citing works
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Lee, J. Y. K. (2016) · Cited by 1 · see citing works
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Abhyankar, S., Vreeman, D. J., Westra, B. L., & Delaney, C. W. (2017) · International Journal of Nursing Knowledge · doi:10.1111/2047-3095.12183 · Cited by 1 · see citing works
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Schiff, G. D., Eguale, T., & Felkey, B. G. (2016) · CRC Press eBooks · doi:10.1201/b19633-22
Uğur, A. R., & Övet, H. (2022) · Osmaniye Korkut Ata Üniversitesi Fen Bilimleri Enstitüsü Dergisi · doi:10.47495/okufbed.1037719
- Authors
- Kho, A. N., Doebbeling, B. N., Cashy, J. P., Rosenman, M. B., Dexter, P. R., Shepherd, D. C., Lemmon, L., Teal, E., Khokar, S., & Overhage, J. M.
- Affiliations
- Northwestern University (US)
- Regenstrief Institute (US)
- Corresponding author
- Kho, Abel N.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-04-10
- Volume
- 57
- Issue
- 2
- Pages
- 254-262
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- PMC
- PMC6276894
- OpenAlex
- W2170484485
- Cited by
- 23
- References
- 41
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 2 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 3 · 2016: 5 · 2015: 3 · 2014: 5
- FWCI
- 3.16
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Clinical Infectious Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Purdue University Indianapolis (Indiana University) (submittedVersion)
- Funders
- U.S. National Library of Medicine (T15LM007117)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Keywords
- antimicrobial resistance, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, patient registry, electronic alerts, infection control, patient isolation
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Epidemiologic Methods, Female, Hospitalization, Humans, Indiana, Male, Medical Informatics Applications, Middle Aged, Registries, Cohort Studies, Prevalence, Methicillin Resistance, Gram-Positive Bacterial Infections, Enterococcus, Disease Notification, Vancomycin Resistance, Methicillin-Resistant Staphylococcus aureus, Young Adult
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