Information technology aspects of large-scale implementation of automated surveillance of healthcare-associated infections

Michael Behnke; John Karlsson Valik; Sophie Gubbels; Daniel Teixeira; Brian Kristensen; Mohamed Abbas; Stephanie M van Rooden; Petra Gastmeier; Maaike S M van Mourik; PRAISE network

doi:10.1016/j.cmi.2021.02.027

Information technology aspects of large-scale implementation of automated surveillance of healthcare-associated infections

Clin Microbiol Infect. 2021 Jul:27 Suppl 1:S29-S39. doi: 10.1016/j.cmi.2021.02.027.

Authors

Michael Behnke¹, John Karlsson Valik², Sophie Gubbels³, Daniel Teixeira⁴, Brian Kristensen⁵, Mohamed Abbas⁴, Stephanie M van Rooden⁶, Petra Gastmeier⁷, Maaike S M van Mourik⁸; PRAISE network

Collaborators

PRAISE network:
Maaike S M van Mourik⁹, Stephanie M van Rooden¹⁰, Mohamed Abbas¹¹, Olov Aspevall¹², Pascal Astagneau¹³, Marc J M Bonten¹⁴, Elena Carrara¹⁵, Aina Gomila-Grange¹⁶, Sabine C de Greeff¹⁷, Sophie Gubbels³, Wendy Harrison¹⁸, Hilary Humphreys¹⁹, Anders Johansson²⁰, Mayke B G Koek²¹, Brian Kristensen⁵, Alain Lepape²², Jean-Christophe Lucet²³, Siddharth Mookerjee²⁴, Pontus Naucler², Zaira R Palacios-Baena²⁵, Elisabeth Presterl²⁶, Miquel Pujol²⁷, Jacqui Reilly²⁸, Christopher Roberts¹⁸, Evelina Tacconelli²⁹, Daniel Teixeira³⁰, Thomas Tängdén³¹, John Karlsson Valik², Michael Behnke³², Petra Gastmeier³³

Affiliations

¹ National Reference Center for Surveillance of Nosocomial Infections, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany. Electronic address: [email protected].
² Department of Medicine Solna, Division of Infectious Diseases, Karolinska Institutet and Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden.
³ Data Integration and Analysis Secretariat, Statens Serum Institut, Copenhagen, Denmark.
⁴ Infection Control Programme, Geneva University Hospitals, Geneva, Switzerland.
⁵ Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark.
⁶ Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Centre for Infectious Disease Epidemiology and Surveillance National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
⁷ National Reference Center for Surveillance of Nosocomial Infections, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany.
⁸ Department of Medical Microbiology and Infection Control, University Medical Center Utrecht, Utrecht, the Netherlands.
⁹ Department of Medical Microbiology, University Medical Center Utrecht, the Netherlands.
¹⁰ Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
¹¹ Centre for Infectious Disease Epidemiology and Surveillance National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands; Infection Control Programme, Geneva University Hospitals, Geneva, Switzerland.
¹² Unit for Surveillance and Coordination, Public Health Agency of Sweden, Solna, Sweden.
¹³ Centre for Prevention of Healthcare-Associated Infections, Assistance Publique - Hôpitaux de Paris & Faculty of Medicine, Sorbonne University, Paris, France.
¹⁴ Department of Medical Microbiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
¹⁵ Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
¹⁶ Infectious Diseases Unit, Bellvitge Biomedical Research Institute (IDIBELL), Bellvitge University Hospital and Infectious Diseases Unit, Consorci Corporació Sanitària Parc Taulí, Barcelona, Spain.
¹⁷ Centre for Infectious Disease Epidemiology and Surveillance National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
¹⁸ Healthcare Associated Infections, Antimicrobial Resistance and Prescribing Programme (HARP), Public Health Wales, Bangor, Wales, UK.
¹⁹ Department of Clinical Microbiology, The Royal College of Surgeons in Ireland, Department of Microbiology, Beaumont Hospital, Dublin, Ireland.
²⁰ Clinic for Infectious Diseases, Umea University, Umea, Sweden.
²¹ Department of Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and Environment (RIVM), Bilthoven, the Netherlands.
²² Clinical Research Unit, Department of Intensive Care, Centre Hospitalier Universitaire Lyon Sud, Pierre-Bénite, France.
²³ Infection Control Unit, Hôpital Bichat-Claude Bernard Assistance Publique - Hôpitaux de Paris, Paris, France.
²⁴ Infection Prevention and Control Department, Imperial College Healthcare NHS Trust, London, England, UK.
²⁵ Unit of Infectious Diseases, Clinical Microbiology and Preventive Medicine, Hospital Universitario Virgen Macarena, Institute of Biomedicine of Seville (IBIS), Seville, Spain.
²⁶ Department of Infection Control and Hospital Epidemiology, Medical University of Vienna, Vienna, Austria.
²⁷ Bellvitge University Hospital, Barcelona, Spain.
²⁸ Safeguarding Health Through Infection Prevention Research Group, Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, Scotland, UK.
²⁹ Infectious Diseases, Research Clinical Unit, DZIF Center, University Hospital Tübingen, Tübingen, Germany.
³⁰ Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy; Infection Control Programme, Geneva University Hospitals, Geneva, Switzerland.
³¹ Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
³² National Reference Center for Surveillance of Nosocomial Infections, Charité University Medicine Berlin, Berlin, Germany.
³³ National Reference Center for Surveillance of Nosocomial Infections, Charité University Hospital Berlin, Berlin, Germany.

PMID: 34217465
DOI: 10.1016/j.cmi.2021.02.027

Abstract

Introduction: Healthcare-associated infections (HAI) are a major public health concern. Monitoring of HAI rates, with feedback, is a core component of infection prevention and control programmes. Digitalization of healthcare data has created novel opportunities for automating the HAI surveillance process to varying degrees. However, methods are not standardized and vary widely between different healthcare facilities. Most current automated surveillance (AS) systems have been confined to local settings, and practical guidance on how to implement large-scale AS is needed.

Methods: This document was written by a task force formed in March 2019 within the PRAISE network (Providing a Roadmap for Automated Infection Surveillance in Europe), gathering experts in HAI surveillance from ten European countries.

Results: The document provides an overview of the key e-health aspects of implementing an AS system of HAI in a clinical environment to support both the infection prevention and control team and information technology (IT) departments. The focus is on understanding the basic principles of storage and structure of healthcare data, as well as the general organization of IT infrastructure in surveillance networks and participating healthcare facilities. The fundamentals of data standardization, interoperability and algorithms in relation to HAI surveillance are covered. Finally, technical aspects and practical examples of accessing, storing and sharing healthcare data within a HAI surveillance network, as well as maintenance and quality control of such a system, are discussed.

Conclusions: With the guidance given in this document, along with the PRAISE roadmap and governance documents, readers will find comprehensive support to implement large-scale AS in a surveillance network.

Keywords: Automated; Bloodstream infection; Data; Digital infection control; Electronic HAI surveillance; Electronic health record; Healthcare-associated infection; Quality; Surgical site infection; Surveillance.

MeSH terms

Automation
Cross Infection / epidemiology*
Europe / epidemiology
Humans
Infection Control / instrumentation*
Infection Control / methods*
Information Technology / standards*