Posting in Energy
About 30,000 people will die in American hospitals this year from catheter infections, the CDC estimates. Can technology reduce this toll? Yes, it can
It's filled with germs, terrible germs. Germs like MRSA that have faced down every antibiotic ever invented.
Some big careers have been made in the fight against hospital infections. Peter Pronovost won a MacArthur "genius grant" for showing how checklists can eliminate most of them. Donald Berwick became the head of Medicare after his 100,000 Lives campaign showed how infections could be reduced.
(The slide at right, credited to Pronovost, describes how to prevent infections. The whole slide show can be seen at the Department of Health and Human Services.)
Yet still, infections happen. Despite the fact catheter infections are now called "never events" for which insurers and government won't pay, they happen. About 30,000 people will die in American hospitals this year from catheter infections, the CDC estimates.
Can technology reduce this toll? Yes, it can:
- Washable computer gear, which I wrote about last week, can eliminate one source of infection. If the gear is washed regularly.
- Electronic Health Records, being installed in 85% of hospitals thanks to the HITECH stimulus, can bring best practices, including monitoring of catheters, to the patient's bedside.
- LEDs inside ventilators can kill bugs in the air. Strong lights can be placed inside ventilators, far from patients, reducing the chance of airborne infection.
The best technology might be regular reporting of problems to top hospital managers, according to a survey from the Association for Professionals in Infection Control and Epidemiology (APIC) sponsored by a catheter company.
Half their members, surveyed at the group's annual meeting this week, said infections are still a problem at their facilities, and blame a lack of commitment from hospital leadership.
Members of the group say they're spending all their time looking for and reporting on infections, meaning they have little time for training people and preventing them. Automate the reporting and their time is freed up. Get those reports to hospital leaders, make them accountable for results, and they will pay attention.
Hospital infections are becoming increasingly dangerous as more bugs become immune to more drugs. But technology now making its way into hospitals will make these infections easier to detect, and free experts to train workers on checklists and other procedures making them a thing of the past.
Jul 21, 2010
Dana, You are correct with regard to setting up a tech grid, or monitoring system, that set off bells and whistles, which would be well within reasonable costs. We agree on implementation of new ideas, but waking up the hospital management to simple concepts seems to be the problem, as this is a human decision, or space issue, outside our ability to help them. My experience with hospital systems in general, is that they are in the Dark Ages with regard to technological administrative systems, logistics, compilation of patient history,including current drugs, x- rays,blood work, etc. and the only complete system that I have encountered is the Veterans Administration system that brings all documentation and history into one physicians tablet, or PC. A serious problem for technologists who are seeking to assist hospitals is the persistent administrative politics, much akin to climate change, where new and inventive technologies are not allowed to operate, without additions or deletions related to political will. Without encumbrances such as politics, IBM would realize great technological changes as envisaged in Smarter Planet or Smarter People. And thinking smart in this age of mounting problems will only assist Cities, States, Hospitals, and corporations, an opportunity to save money, become more efficient, and start getting smart ! Thank you for your fine column that opens doors to new ideas, oceanconveyor
Oceanconveyor. You're right. Technology can help, but simple adherence to things like checklists would actually do the job. What the latest technology can do is create alarms against violations of protocols and alert top management so people can be held accountable when, say, you're left in a room with 25 other people. Being able to measure those costs is the first step in finding ways to bring them down. And I recognize these costs are both human and financial.
Having been exposed to MRSA, and treated in a top quality Hospital, I do not think technology is the answer to every problem that arises in our society. While being treated for MRSA, I was put in a room with approximately 25 other patients waiting for a bed; some of these patients had just endured heart bypass operations, and the hospital staff had me mingled with them.Imagine children of parents not aware of this salient fact, then seeing their parents die from infections " unknown " ! Technology will not solve this problem, but a simpler solution might be isolating me or MRSA patients from patients, who are vulnerable to any infection due to surgery. Although threatened by the chief resident that I could die, I checked myself out of the Hospital, as I felt that I was a real threat to their lives. Common sense, and not technology, is sometimes the cheapest and most efficient answer to problems, not more laws, not more technology, just enforcement of isolating MRSA patients !