Design and Implementation of a Visual Analytics Electronic Antibiogram within an Electronic Health Record System at a Tertiary Pediatric Hospital

Allan F. Simpao, Luis M. Ahumada, Beatriz Larru Martinez, Ana M. Cardenas, Talene A. Metjian, Kaede V. Sullivan, Jorge A. Gálvez, Bimal R. Desai, Mohamed A. Rehman, Jeffrey S. Gerber

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)37-45
Number of pages9
JournalApplied clinical informatics
Volume9
Issue number1
DOIs
StatePublished - Jan 1 2018

Keywords

  • analytics
  • antibiogram
  • clinical decision support systems
  • data visualization
  • electronic health records
  • pediatrics
  • quality improvement

ASJC Scopus subject areas

  • Health Informatics
  • Computer Science Applications
  • Health Information Management

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