02Jan

Studies released this year by JAMA Internal Medicine reveal the power of electronic health records (EHRs) in tracking down sources of common hospital-acquired infections. By tracing the movements of nearly 90,000 patients over a three-year period, the University of California’s San Francisco Health Informatics team was able to pinpoint the sources of a single common bacterium – Clostridium, or “C. Diff.” UCSF’s findings illuminate new possibilities for EHRs, namely the potential for uncovering meaningful patterns in large-scale hospital datasets.

EHRs: A Modern Treasure Trove

According to Robert Wachter, MD and chair of the UCSF’s department of medicine, “The electronic health record is a treasure trove of clinical data and insights”—yet we’re only on the brink of unearthing its potential. Nevertheless, study findings reveal the possibilities to come, including a transformation in patient care once “clinicians and technology experts join hands.”

In the UCSF study, researchers did just that, combining the power of technology with the records produced by myriad patients and their caregivers. The UCSF team examined time and location stamps – entered into the hospital’s EHR system each time a patient moves from wing to wing or room to room, undergoes a procedure, or visits with a clinician – to map the location changes of hundreds of thousands of patients. Even amidst the complexity of so many interactions and exchanges, the researchers were eventually able to trace the C. diff infection site to a single CT scanner to the UC Medical Center’s Emergency Department.

Tracking Each Surface, Year after Year

During hospitalization, the study’s abstract explains, patients encounter countless surfaces – and despite our best efforts, it can be impossible to know which ones are contaminated. Yet until now, researchers hadn’t thought to capture an analysis of each potential contact point in a single institution. EHR data makes it easy to identify a patient’s location at any given time—and these pioneering researchers took advantage, evaluating whether a single room, for example, could be associated with an increased risk of contamination.

The UCSF team, led by assistant professor Sara Murray, M.D, M.A.S., was able to create a map that revealed where each infected patient had travelled in the hospital—over the course of three years. Locations were analyzed in tandem with the patients who visited them – and the research revealed that infected patients tended to visit the same locations. In the case of the UC Medical Center, patients who visited a single CT scanner saw a much higher rate of infection over the three-year period than those who avoided it. Cleaning procedures immediately changed, and today, the CT scanner no longer raises concerns.

Data-Driven Innovation

As technology continues to advance, we’re bound to see countless breakthroughs with regards to EHR data. In the case of the University of California, an inspired approach not only helped to minimize infection rates across the institution – it also showed us what’s possible when clinical data and technology merge.