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August 15, 2020
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Web-based tool identifies facilities at risk for intaking patients with MDROs

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Researchers developed a web-based tool to identify facilities at risk for intaking patients colonized or infected with multidrug-resistant organisms, which may aid health departments in combating the infections, they said.

The researchers used CMS and Tennessee state hospital data to map patient-sharing networks among health care facilities in Tennessee. They described the tool in Emerging Infectious Diseases,

Allison Chan
Rany Octaria

“If we have an outbreak or ongoing transmission in a specific facility or even between multiple facilities, we can use this tool to find the facility of interest where that ongoing transmission is occurring and identify facilities downstream that are at the highest risk to receive patient transfers either directly or indirectly,” Allison Chan, MPH, an epidemiologist in the Tennessee Department of Health’s Healthcare Associated Infections and Antimicrobial Resistance Program, told Healio.

“A lot of facilities likely know which facilities they commonly transfer patients to directly,” Chan said. “However, they may not be as aware which facilities they frequently send patients to indirectly when patients are staying in the community or go back home.”

Using the two datasets, the authors developed networks for skilled nursing facilities and hospitals. The networks included indirect and direct transfers that accounted for up to 365 days in the community outside of admissions to the facility. The tool allows users to visualize a given facility and narrow the display by year, network dataset, minimum number of transfers and length of time in a given community. It also creates a visualization of the selected facility with its connected facilities used to receive or send patients, the number of interfacility transfers and facilities at risk for receiving transfers from the selected facility.

The researchers noted that one of the tool’s limitations was the use of two different networks for the datasets. Rany Octaria, MD, MPH, epidemiology PhD student at Vanderbilt University and the Tennessee Department of Health’s Healthcare Associated Infections and Antimicrobial Resistance Program, told Healio that learning to code during the tool’s development was another major challenge.

“The resources to learn this — because this is a new tool — were not all in one place,” Octaria said. “A lot of learning was done — which is why were so excited, if other health departments are interested in this tool, to work with them to see if we can create a place where people can upload their data and visualize it.”

Chan said that further expansion of the tool may be useful in the future.

“We’re always looking to improve the tool itself. At this time, it only allows for exports and the visualization of downstream facilities for these facilities,” Chan said. “We’re working to add those upstream facilities as well — facilities that actually send patients to a given facility.”