Feasibility and acceptance of a cloud-based mobile app for antimicrobial stewardship and infection control in Colombian hospitals.

William J Ketcherside,Maria Virginia Villegas Botero,Jonathan Bf Olson,Lauren N Hunt,Christian Pallares Gutiérrez,Ayleen D Rivera,Vadim Sapiro,Paul Malpiedi,Jorge A Cano,Iñigo Prieto Pradera,Lina Marcela Coy,Benjamin J Park,Jimish M Mehta,Alex Saeed

doi:10.3396/ijic.v16i3.021.20

Abstract

Infection control and antimicrobial stewardship programs (ICASPs) are essential to reduce the emergence and spread of antimicrobial resistance. The primary objective of this study was to assess the feasibility of extending a commercial off-the-shelf (COTS) software for ICASPs in low- and middle-income countries (LMICs). This project involved three hospitals in Colombia, including Centro Médico Imbanaco, Clínica San Francisco, and DIME Clínica Neurocardiovascular. A COTS platform (ILÚM Health Solutions™ Kenilworth, NJ) was extended to function in a range of technology settings, and translatable to almost any language. ICASP features were added, including clinical practice guidelines, hand hygiene (HH) documentation, and isolation precaution (IP) documentation. The platform was delivered as a smartphone mobile application ("app") for both iOS and Android. The app was successfully implemented at all sites, however, full back-end data integration was not feasible at any site. In contrast to the United States, a suite of surveillance tools and physician-focused decision support without patient data proved to be valuable. Language translation processing occurred quickly and incurred minimal costs. HH and IP compliance tracking were the most used features among ICASP staff; treatment guidelines were most often used by physicians. Use of the app streamlined activities and reduced the time spent on ICASP tasks. Users consistently reported positive impressions including simplicity of design, ease of navigation, and improved efficiency. This ICASP app was feasible in limited-resource settings, highly acceptable to users, and represents an innovative approach to antimicrobial resistance prevention.

Highlights

App Description and Features The project team extended a commercial off the shelf (COTS) app designed for infectious diseases (ID) management in U.S acute care hospitals (ILÚM Health Solutions; Kenilworth, NJ)
Future directions This project revealed information about user needs and demonstrated gains in productivity through automating manual tasks. It laid the groundwork for further outcomes studies at these three sites, which will explore the clinical and economic impact of this tool. This novel Infection control and antimicrobial stewardship programs (ICASPs) mobile app was feasible at hospitals with varying levels of information technology capacity and was highly acceptable to users
Improved efficiency was observed with decreased time on tasks related to hand hygiene (HH) and isolation precaution (IP) compliance

Summary

Introduction

Antimicrobial resistance (AMR) is a global threat that results in increased healthcare costs and poorer patient outcomes.[1,2,3] In low- and middle-income countries (LMICs), antibiotic consumption, healthcareassociated infections, and AMR rates are rising.[4,5,6,7] Professional, non-governmental, and government organizations are concerned about AMR progression in LMICs and seek innovative solutions.[8,9,10]Infection control and antimicrobial stewardship programs (ICASPs) reduce the emergence and spread of AMR.[10,11] In general, health facilities in LMICs have many barriers to implementation and execution of ICASPs, including limited staff with specialized training, minimal laboratory and diagnostic tools, gaps in data on antimicrobial use and resistance, and lack of a robust health information technology infrastructure. 12-15 physician, and utilize hospital-specific guidelines for antimicrobial use. Antimicrobial resistance (AMR) is a global threat that results in increased healthcare costs and poorer patient outcomes.[1,2,3] In low- and middle-income countries (LMICs), antibiotic consumption, healthcareassociated infections, and AMR rates are rising.[4,5,6,7] Professional, non-governmental, and government organizations are concerned about AMR progression in LMICs and seek innovative solutions.[8,9,10]. Infection control and antimicrobial stewardship programs (ICASPs) reduce the emergence and spread of AMR.[10,11] In general, health facilities in LMICs have many barriers to implementation and execution of ICASPs, including limited staff with specialized training, minimal laboratory and diagnostic tools, gaps in data on antimicrobial use and resistance, and lack of a robust health information technology infrastructure.

Objectives

Methods

Results

Discussion

Conclusion