Healthcare organizations are using telecommunication technology in many innovative ways to help reach goals. The latest involves a tool that allows some rural hospitals to curb excessive or improper use of antibiotics—a common problem across the healthcare industry.
Intermountain Healthcare, which has 21 hospitals, allows patients at four of its smaller hospitals to consult with infectious disease specialists through video and phone conferencing. The program also provides antibiotic stewardship program support to participating hospitals' staff members.
The system has nearly a dozen small hospitals across Utah and Idaho—many of which lack access to a physician specializing in infectious disease.
Only one has a formal antibiotic stewardship program, as the newly required Joint Commission programs are called, according to a blog post by Dr. Edward Stenehjem, an infectious disease expert at the system's flagship, Intermountain Medical Center, in Murray, a Salt Lake City suburb.
According to a report published this summer in the journal Clinical Infectious Diseases, just 39% of more than 4,100 hospitals surveyed had a fully developed antibiotic stewardship program.
The Intermountain program was conceived as a service for inpatients and their physicians – either hospitalists in the larger hospitals or primary care physicians in the smaller ones, but it’s “bled over” into ambulatory care, Stenehjem said.
Physicians requesting a consult with a specialist call an 800 number, which emails a consult request to the receiving specialist, who typically returns the phone call in 10 to 20 minutes.
If a phone call doesn't satisfy the requesting providers’ and patients’ needs, then a video consult is arranged.
Since both physicians are on the same electronic medical record system, the specialist’s documentation of his or her infectious disease consult note is entered into the patient’s record on the spot.
So far, there’s not enough data to prove the clinical or financial efficacy of the program. And the Intermountain folks are only considering offering the service to hospitals outside their system, Stenehjem said. That will present some challenges, such as billing and integrating telehealth and EHR systems.
In conducting a literature search for an article he’s working on stewardship., Stenehjem said he found only four articles about programs in small hospitals.
In September, Stenehjem, while presenting to the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria, said nearly three-quarters (72%) of U.S. hospitals with 200 or fewer beds do not have access to an infectious disease specialist or an antibiotic stewardship program.
And yet, in about half the clinical cases in which antibiotics are prescribed, those treatments can be improved upon, he added.
Intermountain's program is up and running at 69-bed Alta View Hospital, Sandy, Utah; 139-bed Logan (Utah) Regional Hospital; 26-bed Park City (Utah) Medical Center; and 88-bed Riverton (Utah) Hospital.
The remaining hospitals in the Intermountain network will be connected to the ID TeleHealth program by April 2017, Stenehjem said.
“This program helps show the value of connecting our facilities with infectious diseases support, and helps us meet our goals around antibiotic stewardship,” Stenehjem said.
