Design and Implementation of a Visual Analytics Electronic Antibiogram within an Electronic Health Record System at a Tertiary Pediatric Hospital
Design and Implementation of a Visual Analytics Electronic Antibiogram within an Electronic Health Record System at a Tertiary Pediatric Hospital
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DOI：
10.1055/s-0037-1615787
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发表时间：
2018-01-01
影响因子：
2.9
通讯作者：
Gerber, Jeffrey S.
中科院分区：
文献类型：
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作者：
Simpao, Allan F.;Ahumada, Luis M.;Gerber, Jeffrey S.
背景医院使用抗菌药物管理图来指导最佳的经验性抗生素治疗，减少不适当的抗生素使用，并确定需要抗菌药物管理计划干预的领域。创建医院病历是一个耗时的手动过程，通常每年都要执行一次。目的我们旨在将可视化分析软件应用于电子健康记录（EHR）数据，以构建自动化的电子病历（“电子病历”），符合国家指南，并包含患者特征的过滤器，从而提供详细的，临床相关的，方法我们使用可视化分析软件开发了一个安全的、与EHR相关的、特定于病情和患者的电子病历，该电子病历在每月更新的综合报告中提供生物体和抗生素的敏感性地图。根据标本来源、医院单位和感染类型，将抗菌药物敏感性数据分为9种临床情况。我们在费城儿童医院（一家三级儿科医院）的EHR系统中实施了电子病历，并分析了2016年3月至2017年3月的电子病历访问会话。结果电子病历在EHR中实施，有超过6，000例住院患者，4，500例门诊患者和3，900例急诊科分离株。电子病历提供了12个月的滚动病原体和易感性数据，每月更新。电子病历访问会话从平均每月261届会议，在前3个月的研究，每月345届会议在最后3 months.Conclusion电子病历，建立和更新使用电子健康记录数据，并坚持国家的指导方针是一个可行的替代每年，静态，手动编译的电子病历。未来的研究将检查电子病历对抗生素处方模式的影响。
Background Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually.Objective We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram ("e-antibiogram") that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data.Methods We used visual analytics software to develop a secure, EHR-linked, condition- and patient-specific e-antibiogram that supplies susceptibility maps for organisms and antibiotics in a comprehensive report that is updated on a monthly basis. Antimicrobial susceptibility data were grouped into nine clinical scenarios according to the specimen source, hospital unit, and infection type. We implemented the e-antibiogram within the EHR system at Children's Hospital of Philadelphia, a tertiary pediatric hospital and analyzed e-antibiogram access sessions from March 2016 to March 2017.Results The e-antibiogram was implemented in the EHR with over 6,000 inpatient, 4,500 outpatient, and 3,900 emergency department isolates. The e-antibiogram provides access to rolling 12-month pathogen and susceptibility data that is updated on a monthly basis. E-antibiogram access sessions increased from an average of 261 sessions per month during the first 3 months of the study to 345 sessions per month during the final 3 months.Conclusion An e-antibiogram that was built and is updated using EHR data and adheres to national guidelines is a feasible replacement for an annual, static, manually compiled antibiogram. Future research will examine the impact of the e-antibiogram on antibiotic prescribing patterns.