Gathering Intelligence: Antimicrobials

First of an occasional series  

The fight against antimicrobial resistance is ongoing, on many fronts, and in some ways, scientists are working like spies, gathering intelligence, figuring out the landscape of each person’s ability to thwart infection, what new threats are out there, and how to confront them.

You name it: anti-infective medications, antibiotics, antibacterial, anti-fungal, antivirals, antiprotozoals.

These drugs, used against infectious diseases over the decades, are increasingly finding resistance. At least 23,000 people die each year as a result of infections with bacteria resistant to antibiotics, and many more perish from related complications, says the Centers for Disease Control and Prevention.

VigiLanz of Minneapolis, is one of those digital intelligence companies on the forefront of this fight, with an antimicrobial stewardship platform that is not only trying to combat these infections as they appear – but also working to thwart those that are still evolving but haven’t even been named yet.

“Organisms out there are becoming more resistant in response to pharmaceuticals, and the response to that has to come in real time,” says Stacy Pur, the company’s VP of Clinical Intelligence. “You need a module that can be flexible enough to not only identify those cases that are known and published in the literature, but even those not yet published, having a novel type of resistance.”

VigiLanz says it is helping hospitals and health systems save patient lives and improve the efficiency of care. It is doing so by leveraging data collected from a hospital’s electronic medical record, physician order entries, and laboratory and pathology systems to monitor patients for drug interactions and ineffective or inappropriate antibiotics – right now, the company says.

Predictive Analytics

The key is what VigiLanz calls a “flexible electronic platform,” pharmacy stewardship programs,  infection prevention tools and applying the predictive analytics measures. That goes to the heart of patient safety, quality improvement, and cost containment issues, Pur says.

Pur says the company’s data programs have delved into numerous drug scenarios and resistance patterns associated with those medications, with “ongoing surveillance.”

Finding those new patterns are extremely important, “because once resistance is established, it is difficult to eradicate,” Pur says. “When you are able to identify the first case when it shows up, it’s much easier to prevent that from becoming embedded in the patient population.”

The antimicrobial threat is real and growing. “While antibiotics and similar drugs, called antimicrobial agents, have been responsible for reducing deaths and illnesses from infectious diseases, they have been used so much over the past 40 years, the infectious organisms the antibiotics are designed to kill have adapted to them, making them less effective,” the CDC notes.

At least 2 million people each year become infected with bacteria that are resistant to antibiotics, causing severe illnesses such as sepsis, the CDC says. The organism known as methicillin-resistant Staphylococcus aureus (MRSA) is responsible for more deaths annually than “emphysema, HIV/AIDS, Parkinson’s disease, and homicide, combined,” according to the Infectious Diseases Society of America.

Vigilance and a Relentless Fight

National health officials are working feverishly to combat the antimicrobial threat, using data as a key component, with companies such as VigiLanz helping to lead the way. Healthcare systems and physicians are coordinated electronically with VigiLanz in a system that identifies antimicrobial threats. VigiLanz has been working for more than a decade with its “platform that specifically addresses antimicrobial use with the goal to prevent resistance,” Pur says.

“VigiLanz has a proprietary system that is highly complex and allows us to build rules that generate very targeted alerts, aligning the clinician more closely with what they need,” Pur says. “It is both a predictive model that helps the healthcare worker intervene sooner, and supports the clinician in outpatient settings as well.”

When potential issues are identified, alerts are triggered to enable clinical pharmacists and other members of the care team to take appropriate action. “They are sending us real time data coming out of the electronic medical record,” Pur says.

The alert system “has a broad spectrum of data” and is geared toward the organization using it and “really varies of what the acute needs are,” she adds.

There are plenty of alerts out there, but too often they are not targeted or focused and “that’s where healthcare needs to go,” she says. The VigiLanz system provides standardization, “smart alerting what people need to know.” For instance, the VigiLanz system may identify patients who not only need more treatment but those that have had too much. At least 160 hospitals and health systems are using the VigiLanz system.

Meaningful Use Certification

Recently, VigiLanz announced it is one of the first to achieve Meaningful Use Stage 3 certification for use by facilities enrolled in the CDC’s National Healthcare Safety Network (NHSN), dubbed the nation’s most widely used healthcare-associated infection tracking system, for Antimicrobial Use and Antimicrobial Resistance (AUR) reporting.

The data allows clinicians to better benchmark their antibiotic usage and organism resistance nationally to target areas of improvement, according to the CDC. The registry has been used to help the CDC get a better handle on the impacts of antimicrobial resistance in hospitals and healthcare facilities.

Although the VigiLanz model has been around since 2001, VigiLanz leans on its name and what it stands for – vigilance – and the company constantly updates its programs to deal with new and evolving issues. “We make it compatible with the new issues that are emerging each day,” Pur says.

Interestingly, as hospitals and health systems juggle more data, sometimes it’s actually more difficult for them to get the information they really need.

“Even with significant investments in the electronic medical record (EHR) systems, today’s clinicians are still in need of easier access to the insights that can help them improve care delivery,” said VigiLanz CEO Dr. David Goldsteen at a recent conference.

“Data and analytics – when leveraged in real-time – can help bridge this gap, enabling improved decision-making and predictions that link directly to clinical, operational and financial outcomes,” he said.

— Joe Cantlupe

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