1 research outputs found
Can routinely collected electronic health data be used to develop novel healthcare associated infection surveillance tools?
Background: Healthcare associated infections (HCAI) pose a significant burden to health systems both
within the UK and internationally. Surveillance is an essential component to any infection control
programme, however traditional surveillance systems are time consuming and costly. Large amounts of
electronic routine data are collected within the English NHS, yet these are not currently exploited for
HCAI surveillance.
Aim: To investigate whether routinely collected electronic hospital data can be exploited for HCAI
surveillance within the NHS.
Methods: This thesis made use of local linked electronic health data from Imperial College Healthcare
NHS Trust, including information on patient admissions, discharges, diagnoses, procedures, laboratory
tests, diagnostic imaging requests and traditional infection surveillance data. To establish the evidence
base on surveillance and risks of HCAI, two literature reviews were carried out. Based on these, three
types of innovative surveillance tools were generated and assessed for their utility and applicability.
Results: The key findings were firstly the emerging importance of automated and syndromic surveillance
in infection surveillance, but the lack of investigation and application of these tools within the NHS.
Syndromic surveillance of surgical site infections was successful in coronary artery bypass graft patients;
however it was an inappropriate methodology for caesarean section patients. Automated case detection
of healthcare associated urinary tract infections, based on electronic microbiology data, demonstrated
similar rates of infection to those recorded during a point prevalence survey. Routine administrative
data demonstrated mixed utility in the creation of simplified risk scores or infection, with poorly
performing risk models of surgical site infections but reasonable model fit for HCA UTI.
Conclusion: Whilst in principle routine administrative data can be used to generate novel surveillance
tools for healthcare associated infections; in reality it is not yet practical within the IT infrastructure of
the NHS