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Use of a Regional Health Information Exchange to Detect Crossover of Patients with MRSA between Urban Hospitals

^a Northwestern University, Chicago, IL
^b Regenstrief Institute, Inc., Indianapolis, IN
^c Infection Control Department, Wishard Memorial Hospital, Indianapolis, IN
^d Indiana University School of Medicine, Indianapolis, IN.

^_* Correspondence: Abel N. Kho, MD, MS, Assistant Professor, Northwestern University, Division of General Internal Medicine, Affiliated Scientist, Regenstrief Institute, Inc., 676 N. St Clair St, Suite 200, Chicago, IL 60611 (Email: abel.kho{at}nmff.org).

Received for publication: 08/03/07; accepted for publication: 10/23/07.

Background: A significant portion of patients already known to be colonized or infected with Methicillin-Resistant Staphylococcus aureus (MRSA) may not be identified at admission by neighboring hospitals.

Methods: We utilized data from a Regional Health Information Exchange to assess the frequency that patients known to have MRSA at one healthcare system are admitted to a neighboring healthcare system unaware of their MRSA status. We conducted a retrospective, registry trial from January 1999 through January 2006 involving three healthcare systems in central Indianapolis, representing six hospitals.

Results: Over one year, 286 unique patients generated 587 admissions accounting for 4,335 inpatient days where the receiving hospital was not aware of the prior history of MRSA. The patients accounted for an additional 10% of MRSA admissions received by study hospitals over one year and over 3,600 inpatient days without contact isolation.

Conclusions: Information exchange could improve timely identification of known MRSA patients within an urban setting.