Why HAI health IT should fall under meaningful use

By Sumant Ramachandra, M.D., Ph.D.
09:20 AM

By reversing an epidemic of preventable deaths throughout our nation’s hospitals, Washington could wipe $33 billion in annual spending from the debt almost overnight — and this is probably a low estimate.

This epidemic is not breast cancer or diabetes but infections contracted during hospital stays that kill nearly 100,000 Americans every year. Healthcare acquired infections, or HAIs, kill more people annually than car crashes, but they do not make front-page news. Given their widespread and costly impact on the healthcare system, however, perhaps they should.

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Hospitals need help. One in every 20 hospitalized patients has an HAI, according to the Department of Health and Human Services, which calls this a preventable healthcare expenditure that runs up a tab in the tens of billions of dollars. Cash strapped hospitals are also hit with a cost; the Centers for Disease Control and Prevention estimated that it took $15 million just to treat 188 patients in one hospital.

While there is the war on drugs, cancer and HIV/AIDS, we do not need a war on HAIs. The fight to rid the system of this wasteful spending on a preventable illness that can result in death begins with technology that is available today. Most of our healthcare spending in this country involves treatment costs. What we are talking about here is a special kind of health information technology (HIT) that can help prevent illness, save lives and stem the hemorrhage of unnecessary healthcare expenditures.

What’s more, the resources needed to fix this major healthcare problem are already built into our federal budget. We just need the green light now to make a few bureaucratic changes, which will allow these monies to go to hospitals to purchase the technology needed to solve this problem in the next few years.

Here is the reality: the government allocates money in the federal budget for hospitals to modernize their technologies. Because of recent legislation, hospitals can earn incentive payments to jump-start their HIT purchases, provided certain “Meaningful Use” criteria are met. And the incentives are hefty, with payments for individual hospitals beginning with a $2 million base. The government already is beginning to send Meaningful Use checks to qualifying facilities, yet electronic clinical surveillance systems that detect HAIs are not covered under Meaningful Use. In other words, government policy is not yet fully aligned with pressing healthcare needs.

[Commentary: Meaningful use numbers encouraging, but cautionary signs linger.]

Hospitals, equipped with the right technology and software can monitor and track the occurrence of HAIs. Through the increased use of electronic clinical surveillance systems, hospital caregivers can identify HAIs in real time and ensure that patients are getting the right antibiotic. This also helps to combat the rise of drug resistant bacteria like MRSA, which also contribute to unnecessary deaths and healthcare outlays.

Use of electronic clinical surveillance will help hospitals diagnose infections earlier, generating cost savings and saving lives. We’ve already seen the proof. The federal government and states have begun to recognize the financial and patient safety implications and the need for improved measures to reduce HAIs. Franciscan Health Systems in Washington State saved approximately $563,000 after using electronic clinical surveillance systems for six months. Pennsylvania instituted a mandatory program for HAIs in 2007 and saw infection rates drop dramatically across the state’s hospitals. Earlier this year, North Carolina passed similar legislation recommending the use of electronic surveillance systems—proving that this is a growing trend in the healthcare industry.

The scarcity of federal money for electronic surveillance systems remains the primary challenge to ending HAIs. Hospitals are making capital budgeting decisions with an eye toward electronic systems that are certified for Meaningful Use. However, they are reluctant to buy HAI-related technology because the government has not included HAIs in Meaningful Use, and technology cannot be certified until that happens. The simple solution is to include HAIs in the Meaningful Use criteria so hospitals can begin to buy the certified electronic surveillance technology they need and qualify for the Meaningful Use incentive payments.

[Related: Meaningful use -- how patient should patients be?]

The presence of drug-resistant bacteria proliferates in our nation’s hospitals despite everyone’s best efforts. But we already have a weapon at hand to combat this scourge: Today’s electronic surveillance technology can help us eradicate and prevent infections, as well as save lives and billions of dollars, right away, every year, and in the future.

Helping hospitals adopt electronic surveillance technology is the right thing to do, from the fiscal, clinical and patient safety perspectives. Americans and our healthcare system deserve no less.


Dr. Sumant Ramachandra brings nearly 20 years of healthcare experience and strong leadership abilities to his role as senior vice president, research and development, and chief scientific officer, Hospira, Inc. In this role, Dr. Ramachandra is charged with helping transform the company through the development and introduction of innovative products that address hospitals’ and healthcare providers’ most pressing needs: reduced costs, improved productivity and increased patient/caregiver safety. Prior to joining Hospira in July 2008, Dr. Ramachandra spent much of his career leading scientific advancements for some of the industry's largest pharmaceutical companies, including Merck, Pharmacia, Pfizer and Schering-Plough.