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EHR Helped Hospital Track C. Diff

By MedPage Today  
   October 24, 2017

Spatial, temporal analytics may aid infection control in hospitals.

This article first appeared October 23, 2017 on Medpage Today.

By Alexandria Bachert, MPH

Using electronic health record (EHR) data on time and location allowed researchers to identify a source of a Clostridium difficile at the University of California San Francisco Medical Center.

Exposure to C. difficile infection (CDI) in the computed tomography scanner in the emergency department (CT-ED) was associated with a 4% incidence of CDI (OR 2.5 versus unexposed individuals in the same space; 95% CI 1.2-5.2), reported Russ Cucina, MD, senior study author and chief health information officer at UCSF, and colleagues.

Writing online in JAMA Internal Medicine, they noted that the association remained significant even after adjusting for covariates such as antibiotic use and length of hospital stay (OR 2.7; 95% CI 1.3-5.7), as well as in sensitivity analyses in which the incubation period was extended from 24 to 72 hours (OR 2.8; 95% CI 1.2-6.3).

"Most studies looking at C. diff in hospitals typically only look at whether patients were on the same hospital floor," stated Cucina. "If we just look at transmission in their room, we're missing potential opportunities for disease transmission."

Our novel analytic methods identify a previously undiscovered opportunity for real-world practice change, explained Cucina and colleagues.

Robert Wachter, MD, chair of the UCSF Department of Medicine, who was not involved in the study, agreed: "The electronic health record is a treasure trove of clinical data and insights, but we are just beginning to discover how to unlock its secrets. This study demonstrates the potential to transform patient care when innovative clinicians and technology experts join hands to tackle healthcare's hardest problems," he stated in a press release.

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