TELE-EXPERTISE SYSTEM BASED ON THE USE OF THE ELECTRONIC PATIENT RECORD TO SUPPORT REAL-TIME ANTIMICROBIAL USE

David Morquin (), Roxana Ologeanu-Taddei, Yatrika Koumar and Jacques Reynes ()
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David Morquin: Département d'Anesthésie-Réanimation [Gui de Chauliac - CHU Montpellier] - CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier] - Hôpital Gui de Chauliac [CHU Montpellier] - CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
Roxana Ologeanu-Taddei: MRM - Montpellier Research in Management - UPVM - Université Paul-Valéry - Montpellier 3 - UPVD - Université de Perpignan Via Domitia - Groupe Sup de Co Montpellier (GSCM) - Montpellier Business School - UM - Université de Montpellier
Yatrika Koumar: CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
Jacques Reynes: CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]

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Abstract: Objectives: The aims of this study are (i) to present the design of a tele-expertise system, based on the telephone and electronic patient record (EPR), which supports the counseling of the infectious diseases specialist (IDS) for appropriate antimicrobial use, in a French University hospital; and (ii) to assess the diffusion of the system, the users' adherence, and their perceived utility. Methods: A prospective observational study was conducted to measure (i) the number and patterns of telephone calls for tele-expertise council, the number of initial and secondary assessments from the IDS and multidisciplinary meetings; (ii) the clinicians' adherence rate to therapeutic proposals by the IDS and the number of clinical situations for which the IDS decided to move to bedside; and (iii) the perceived utility of the system by the medical managers of the most demanding departments. Results: The review of patients' records for 1 year period indicates that 87 percent of the therapeutic recommendations were fully followed. The adherence was high, despite the IDS moving to the bedside only in 6 percent of cases. Medical managers of the most demanding departments considered the system to be useful. Moreover, 6,994 tele-expertise notifications have been recorded into the EPR for 48 months. Conclusions: The tele-expertise system is an original way to design information technology supported antimicrobial stewardship intervention based on the remote access to relevant information by the IDS and on the traceability of the medical counseling for the clinicians.

Keywords: Tele-expertise; Electronic patient record; Design research; Antimicrobial stewardship (search for similar items in EconPapers)
Date: 2018
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Published in International Journal of Technology Assessment in Health Care, 2018, 34 (02), pp.156-162. ⟨10.1017/S0266462318000089⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-02091790

DOI: 10.1017/S0266462318000089

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