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Clinical Trial by Harvard Pilgrim Health Care Institute, HCA Healthcare, UCI Health and CDC Identifies Strategy to Rapidly Detect and Respond to Hospital Outbreaks Using Algorithm-Driven Technology
A clinical trial conducted by Harvard Pilgrim Health Care Institute, HCA Healthcare, UCI Health, and CDC showcased a significant reduction in the size of hospital outbreaks by 64% using an automated outbreak detection tool. The trial involved 82 hospitals and aimed to detect and respond to potential outbreaks of various pathogens, proving successful as an early warning system in preventing the spread of contagious bacteria and other harmful infections.
Uno studio clinico condotto dall'Harvard Pilgrim Health Care Institute, HCA Healthcare, UCI Health e CDC ha dimostrato una notevole riduzione del 64% delle dimensioni dei focolai ospedalieri attraverso l'uso di uno strumento automatico di rilevamento dei focolai. La ricerca ha coinvolto 82 ospedali e mirava a rilevare e rispondere ai potenziali focolai di vari patogeni, rivelando il suo successo come sistema di allarme precoce nella prevenzione della diffusione di batteri contagiosi e altre infezioni dannose.
Un ensayo clínico llevado a cabo por el Harvard Pilgrim Health Care Institute, HCA Healthcare, UCI Health y los CDC demostró una reducción significativa del 64% en el tamaño de los brotes hospitalarios mediante el uso de una herramienta automática de detección de brotes. El ensayo involucró a 82 hospitales y tuvo como objetivo detectar y responder a posibles brotes de diversos patógenos, demostrando ser exitoso como un sistema de alerta temprana para prevenir la propagación de bacterias contagiosas y otras infecciones perjudiciales.
하버드 필그림 헬스 케어 인스티튜트, HCA 헬스케어, UCI 헬스, CDC가 진행한 임상 시험에서 자동 발병 탐지 도구를 사용하여 병원 내 발병 크기를 64% 감소시키는 결과를 보였습니다. 이 시험은 82개 병원을 포함하였으며 다양한 병원체의 잠재적 발병을 탐지하고 대응하는 것을 목표로 하였으며, 전염성 박테리아 및 기타 유해 감염의 확산을 방지하는 초기 경보 시스템으로서의 성공을 입증하였습니다.
Un essai clinique réalisé par l'Harvard Pilgrim Health Care Institute, HCA Healthcare, UCI Health et le CDC a démontré une réduction significative de 64% de la taille des épidémies hospitalières grâce à l'utilisation d'un outil automatisé de détection des épidémies. L'essai a impliqué 82 hôpitaux et visait à détecter et répondre aux flambées potentielles de divers pathogènes, se révélant comme un système d'alerte précoce efficace pour prévenir la propagation de bactéries contagieuses et d'autres infections nuisibles.
Eine klinische Studie durchgeführt vom Harvard Pilgrim Health Care Institute, HCA Healthcare, UCI Health und dem CDC zeigte eine signifikante Reduzierung der Größe von Krankenhausausbrüchen um 64% durch den Einsatz eines automatisierten Ausbruch-Erkennungstools. Die Studie umfasste 82 Krankenhäuser und zielte darauf ab, potenzielle Ausbrüche verschiedener Pathogene zu erkennen und darauf zu reagieren. Sie erwies sich als erfolgreich als Frühwarnsystem zur Verhinderung der Verbreitung von ansteckenden Bakterien und anderen schädlichen Infektionen.
Positive
An automated outbreak detection tool reduced the size of outbreaks by 64% in the trial period.
The tool served as an early warning system for potential hospital outbreaks.
The study involved 82 hospitals and was led by Harvard Pilgrim Health Care Institute, HCA Healthcare, UCI Health, and CDC.
Early detection through automation tools and quick action can prevent outbreaks from growing.
The algorithm-driven statistical outbreak detection tool provided real-time alerts to hospital infection prevention programs.
The trial demonstrated the effectiveness of automated technology in reducing the risk of hospital-acquired infections.
Negative
None.
An automated outbreak detection tool reduced the size of outbreaks by 64% in the trial period preceding the COVID-19 pandemic in a study of 82 hospitals
BOSTON & NASHVILLE, Tenn. & ORANGE, Calif. & ATLANTA--(BUSINESS WIRE)--
An automated tool that improves outbreak detection for hundreds of pathogens successfully served as an early warning system to find and respond to potential hospital outbreaks, as reported today in NEJM Evidence.
The large multi-state, real-world study was conducted in 82 hospitals and led by Harvard Pilgrim Health Care Institute, HCA Healthcare, University of California, Irvine (UCI) Health and the Centers for Disease Control and Prevention (CDC).
Contagious bacteria and other pathogens can spread in hospitals, increasing the risk of harmful infections in patients. While hospitals and health systems work to prevent infections and reduce the opportunity for outbreaks to occur, there is no standardized approach for detecting transmission. Early detection can lead to a rapid response that reduces the chance for outbreaks to occur.
"Despite significant progress in reducing healthcare-associated infection outbreaks, including of antimicrobial-resistant pathogens, they remain an industry challenge and can present as clusters that signal potential for transmission to patients,” said Joseph Perz, DrPH, MA, Senior Advisor for Public Health Programs in CDC’s Division of Healthcare Quality Promotion, and committee member for the CDC’s Council for Outbreak Response: Healthcare-Associated Infections. “The CLUSTER trial provides evidence that early detection powered by automation tools and quick action can prevent outbreaks from growing."
Most hospitals focus on a small number of antibiotic-resistant organisms and miss outbreaks from other pathogens. To address this, investigators developed an algorithm-driven statistical outbreak detection tool that used clinical laboratory data to provide real-time alerts to hospital infection prevention programs about potential transmission of over 100 bacterial and fungal species. This method relied on an automated review of organisms grown from patients’ clinical cultures and a statistical assessment of whether an increase was seen compared to prior experience. Detected increases triggered an automatic notification for hospital personnel to implement a response protocol to prevent additional cases.
“Outbreaks in hospitals are often missed or detected late, after preventable infections have occurred. This study provides a practical and standardized approach to identify early transmission and halt events that could become an outbreak in hospitals,” said lead investigator, Meghan A. Baker, MD, ScD, Harvard Medical School assistant professor of population medicine at the Harvard Pilgrim Health Care Institute.
The automated outbreak detection method was tested from 2019-2022 in a randomized clinical trial in 82 hospitals across 16 states in the HCA Healthcare system, a leader in real-world evidence-based research. Half of the hospitals implemented the automated early detection method, and the other half continued with usual care. Hospitals that were assigned to receive and respond to the automated alerts experienced a 64% reduction in the size of potential outbreaks until the trial was interrupted by the COVID-19 pandemic. During the pandemic, personnel were not able to respond as effectively to automated alerts, and across the combined pre-pandemic and pandemic trial period, there was no overall effect. Nevertheless, in analyses restricted to the pre-pandemic period, the outbreak detection tool was associated with a demonstrable and significant reduction in cases. While the actual risks of an outbreak are low, even one outbreak can be significant. The automated system notified hospitals about possible events approximately three times per year per hospital so early preventative responses could be taken to maximize patient safety.
“This ongoing collaboration continues to leverage our scale – both the number of our hospitals and our advanced data ecosystem – as we work to rapidly answer clinical questions that benefit patients everywhere,” said Kenneth Sands, MD, MPH, chief epidemiologist at HCA Healthcare. “We are using this detection tool in the hospitals where we tested it and are evaluating implementation more widely across our system.”
The underlying software is available for free to all hospital systems but must be integrated into their respective electronic health record system or other clinical workflow platforms.
The study was funded by CDC and conducted through a longstanding scientific consortium, including HCA Healthcare, Harvard Pilgrim Health Care Institute's Department of Population Medicine, the University of California, Irvine and the CDC’s Prevention Epicenters Program. It is part of a growing body of work by the partners to improve patient care and reduce risk of healthcare-associated infections.
About Harvard Pilgrim Health Care Institute’s Department of Population Medicine
The Harvard Pilgrim Health Care Institute's Department of Population Medicine is a unique collaboration between Harvard Pilgrim Health Care and Harvard Medical School. Created in 1992, it is the first appointing medical school department in the United States based in a health plan. The Institute focuses on improving health care delivery and population health through innovative research and education, in partnership with health plans, delivery systems, and public health agencies. Point32Health is the parent company of Harvard Pilgrim Health Care and Tufts Health Plan. Follow us on Twitter and LinkedIn.
About HCA Healthcare
Nashville-based HCA Healthcare is one of the nation’s leading providers of healthcare services comprising 186hospitals and approximately 2,400 ambulatory sites of care, including surgery centers, freestanding ERs, urgent care centers, and physician clinics, in 20 states and the United Kingdom. With its founding in 1968, HCA Healthcare created a new model for hospital care in the United States, using combined resources to strengthen hospitals, deliver patient-focused care and improve the practice of medicine. With a robust system for analyzing clinical data across large and diverse patient populations, HCA Healthcare is a leader in pragmatic research like the Swap Out, ABATE and REDUCE MRSA trials that can help identify new standards of care. HCA Healthcare is a learning health system that uses its more than 43 million annual patient encounters to advance science, improve patient care and save lives.
About UCI Health
UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system in Orange County. Patients can access UCI Health at primary and specialty care offices across Orange County and at its main campus, UCI Medical Center in Orange, Calif. The 459-bed, acute care hospital, listed among America’s Best Hospitals by U.S. News & World Report for 22 consecutive years, provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation services. UCI Medical Center is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. Follow us on Facebook, Instagram, LinkedIn and Twitter.
About the Centers for Disease Control and Prevention (CDC)
Whether diseases start at home or abroad, are curable or preventable, chronic or acute, or from human activity or deliberate attack, CDC’s world-leading experts protect lives and livelihoods, national security and the U.S. economy by providing timely, commonsense information, and rapidly identifying and responding to diseases, including outbreaks and illnesses. CDC drives science, public health research, and data innovation in communities across the country by investing in local initiatives to protect everyone’s health.
