January 6, 2017

How Intermountain helps rural providers fight antibiotic overuse

Daily Briefing

Intermountain Healthcare is using telehealth to connect its rural hospitals with infectious disease specialists to help stem excessive use of antibiotics, Joseph Conn writes for Modern Healthcare.

Nationwide, only 39 percent of hospitals have a fully developed antibiotic stewardship program, according to a report published last year in Clinical Infectious Diseases. And small hospitals are more likely to lack antibiotic stewardship resources: Edward Stenehjem—an infectious disease expert at the Intermountain's flagship facility, Intermountain Medical Center –said 72 percent of U.S. hospitals with fewer than 201 beds do not have access to an infectious disease specialist or an antibiotic stewardship program.

According to Stenehjem, Intermountain was having trouble connecting some of its providers to the right specialists. Many of the system's hospitals are small and lack access to an infectious disease specialist, and only one of its 21 hospitals has a formal antibiotic stewardship program.

To address this need, Intermountain created a telehealth consulting program that allows four of its rural hospitals in Utah—Alta View Hospital, Logan Regional Hospital, Park City Medical Center, and Riverton Hospital—to consult with infectious disease specialists within the system.

Under the initiative, physicians seeking a consult can call a hotline, which emails a request to a specialist. The specialist aims to respond via a phone call within 20 minutes of the email notification, and if the problem can't be resolved over the phone, he or she will arrange a video consult. Both providers use the same EHR systems, which means the specialist's recommendation can be added to the patient's record in real-time.

Intermountain doesn't yet have enough data to assess the financial or clinical benefits of the program, Stenehjem said. But the system plans to incorporate all of its hospitals into the program by April. "This program helps show the value of connecting our facilities with infectious diseases support, and helps us meet our goals around antibiotic stewardship," he said.

Intermountain is also mulling the possibility of expanding the initiative to hospitals outside the system—although Stenehjem acknowledged that doing so would pose additional challenges, such as billing and EHR integration concerns (Conn, Modern Healthcare, 1/3).

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