Half of patients infected with the new MRSA strain died within 30 days compared to just 11 percent of patients infected with other MRSA strains, according to the study presented at the 47th annual meeting of the Infectious Diseases Society of America (IDSA) in Philadelphia earlier this month. 

The CDC was quick to refute the evidence due to the size of the study, and Paul G. Auwaerter, a clinical director at Johns Hopkins who was on the IDSA panel when the study was released, agreed. Carol Moore, PharmD., the study’s primary author, did acknolodge that another factor could be the age of patients, who are 64 years old, as compared with 52 years old for other MRSA-infected patients.

Given the virulence and lethal nature of MRSA, infectious disease specialists, government leaders and healthcare executives are calling for programs to better prevent, monitor and manage MRSA. For example, several states, including California, Illinois, New Jersey and Pennsylvania, have enacted legislation that requires hospitals to screen patients for MRSA. The CDC has also launched a massive national campaign to prevent MRSA skin infections (http://www.cdc.gov/ncidod/dhqp/ar_mrsa.html. And, Albert Einstein Health Network in Philadelphia has decreased MRSA infections rates 62 percent by stuffing used hospital gowns into disposable gloves.

Additionally, HHS will also make $50 million in grants funded by the American Recovery and Reinvestment Act (ARRA) to states fighting against hospital-acquired infections (HAIs). Forty million will be available through competitive grants to states for hospital infection prevention and reporting, while $10 million will come in the form of state grants to improve inspections for outpatient surgery centers (http://www.hhs.gov/news/press/2009pres/05/20090506a.html). 

Overall, HAIs are rising, making them among the top ten leading causes of death in the U.S. and adding up to $20 billion dollars to healthcare costs annually, according to the 2008 National Healthcare Quality Report (http://www.ahrq.gov/qual/nhqr08/nhqr08.pdf).  The CDC says HAIs cost as much as $45 billion annually.

While hospitals and health systems must tap multiple strategies to prevent, monitor and manage new and emerging strains of MRSA and other HAIs, they must also influence care at the bedside in real-time through technology that functions as a patient-specific early warning system. 

Technologies such as MEDAI’s Pinpoint Review pull data from sources as diverse a pharmacy, lab and electronic health records, capture the events of a patient’s hospital stay in a single, concise record, and run the data through a predictive modeling engine.  Once clinicians receive real-time predictions about a patient either on their mobile device or desktop, they can make faster, more accurate decisions about care plans, discharge planning, and order sets.  They can also identify patients whose risk level has changed and, even more important, develop strategies for prevention through a review of risk drivers.  

Hospitals can not afford to manage HAIs with a grab bag of tools and techniques. Instead, they must invest in technologies that deliver real-time information to enhance patient care at the bedside.

Costs continue to rise and quality measurements remain flat. The US currently spends more than twice as much on each person for healthcare as most other industrialized countries, but it has fallen to last place among those countries in preventing deaths through the use of timely and effective medical care. According to the WHO, the US proudly ranks as the 37th best health system in the world – just ahead of Slovenia.

Below the surface, it gets much, much worse. We are bombarded with stories on CNN and The New York Times about healthcare reform, electronic medical records, and “universal” healthcare, but industry fragmentation and poor coordination of services portends a further decay of our healthcare system.

According to a 2008 study by the Commonwealth Fund, 47 percent of adults reported serious failures of care coordination including: specialists not receiving basic medical information from primary care physicians, test results not being available at the time of an appointment; and, not being contacted or needing to repeatedly call to obtain test results.

Despite the individual technological advances that have been adopted throughout the industry, the system itself remains terribly siloed, and thus ineffective. Currently, seventy-five cents of every health care dollar we spend is on treatment of chronic disease, most of which is preventable if evidence-based medicine is practiced.

Predictive modeling offers a solution that directly addresses these issues. By aggregating data from multiple stakeholders and combining it with advance data mining and forecasting abilities, we can now successfully identify the specific individuals who will account for a majority of future health-care costs. With early detection comes early intervention.

Proactive identification of patients not following evidence-based treatment protocols, and the provision of that information to providers and patients leads to more effective and efficient care, particularly around chronic diseases. Leveraging a technology like predictive modeling across the care continuum will simultaneously address fragmentation, provide stakeholders with what they need to know when they need to know it, and facilitate physician engagement — all leading to improved quality and decrease spending.