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TELE-EXPERTISE SYSTEM BASED ON THE USE OF THE ELECTRONIC PATIENT RECORD TO SUPPORT REAL-TIME ANTIMICROBIAL USE

Published online by Cambridge University Press:  01 March 2018

David Morquin ,
Roxana Ologeanu-Taddei ,
Yatrika Koumar  and
Jacques Reynes
David Morquin
Affiliation:
Department of Infectious Diseases, UMI 233 INSERM U1175, CHU de Montpellierd-morquin@chu-montpellier.fr
Roxana Ologeanu-Taddei
Affiliation:
University of Montpellier
Yatrika Koumar
Affiliation:
Department of Infectious Diseases, UMI 233 INSERM U1175, CHU de Montpellier
Jacques Reynes
Affiliation:
Department of Infectious Diseases, UMI 233 INSERM U1175, CHU de Montpellier
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Abstract

Objectives: The aims of this study are (i) to present the design of a tele-expertise system, based on the telephone and electronic patient record (EPR), which supports the counseling of the infectious diseases specialist (IDS) for appropriate antimicrobial use, in a French University hospital; and (ii) to assess the diffusion of the system, the users’ adherence, and their perceived utility.

Methods: A prospective observational study was conducted to measure (i) the number and patterns of telephone calls for tele-expertise council, the number of initial and secondary assessments from the IDS and multidisciplinary meetings; (ii) the clinicians’ adherence rate to therapeutic proposals by the IDS and the number of clinical situations for which the IDS decided to move to bedside; and (iii) the perceived utility of the system by the medical managers of the most demanding departments.

Results: The review of patients’ records for 1 year period indicates that 87 percent of the therapeutic recommendations were fully followed. The adherence was high, despite the IDS moving to the bedside only in 6 percent of cases. Medical managers of the most demanding departments considered the system to be useful. Moreover, 6,994 tele-expertise notifications have been recorded into the EPR for 48 months.

Conclusions: The tele-expertise system is an original way to design information technology supported antimicrobial stewardship intervention based on the remote access to relevant information by the IDS and on the traceability of the medical counseling for the clinicians.

Keywords

Tele-expertiseElectronic patient recordDesign researchAntimicrobial stewardship
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 2 , 2018 , pp. 156 - 162
Copyright
Copyright © Cambridge University Press 2018 

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