The "Epic" Challenge of Optimizing Antimicrobial Stewardship: The Role of Electronic Medical Records and Technology
Open Access
- 10 May 2013
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 57 (7), 1005-1013
- https://doi.org/10.1093/cid/cit318
Abstract
Antimicrobial stewardship programs (ASPs) are established means for institutions to improve patient outcomes while reducing the emergence of resistant bacteria. With the increased adoption and evolution of electronic medical records (EMRs), there is a need to assimilate the tools of ASPs into EMRs, using decision support and feedback. Third-party software vendors provide the mainstay for integration of individual institutional EMR and ASP efforts. Epic is the leading implementer of EMR technology in the United States. A collaboration of physicians and pharmacists are working closely with Epic to provide a more comprehensive platform of ASP tools that may be institutionally individualized. We review the historical relationship between ASPs and the EMR, cite examples of Epic stewardship tools from 3 academic medical centers’ ASPs, discuss limitations of these Epic tools, and conclude with the current process in evolution to integrate ASP tools and decision support capacities directly into Epic's EMR.Keywords
This publication has 19 references indexed in Scilit:
- Is the "Low-Hanging Fruit" Worth Picking for Antimicrobial Stewardship Programs?Clinical Infectious Diseases, 2012
- Demonstration of the Weighted-Incidence Syndromic Combination Antibiogram: An Empiric Prescribing Decision AidInfection Control & Hospital Epidemiology, 2012
- Impact of antimicrobial stewardship in critical care: a systematic reviewJournal of Antimicrobial Chemotherapy, 2011
- Globalisation and antibiotic resistanceBMJ, 2010
- Piperacillin-Tazobactam for Pseudomonas aeruginosa Infection: Clinical Implications of an Extended-Infusion Dosing StrategyClinical Infectious Diseases, 2007
- Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America Guidelines for Developing an Institutional Program to Enhance Antimicrobial StewardshipClinical Infectious Diseases, 2007
- Antimicrobial Stewardship Programs in Health Care SystemsClinical Microbiology Reviews, 2005
- Outcomes of an intervention to improve hospital antibiotic prescribing: interrupted time series with segmented regression analysisJournal of Antimicrobial Chemotherapy, 2003
- Favorable Impact of a Multidisciplinary Antibiotic Management Program Conducted During 7 YearsInfection Control & Hospital Epidemiology, 2003
- Changes in antimicrobial agent usage resulting from interactions among clinical pharmacy, the infectious disease division, and the microbiology laboratoryDiagnostic Microbiology and Infectious Disease, 1993