VA Medical Centers Protect Patients and Save Millions with Antimicrobial Stewardship Programs Powered by TheraDoc

According to The Center for Disease Control and Prevention (CDC), Antibiotic resistance is one of the biggest public health challenges of our time. Antimicrobial resistance each year causes more than 2 million infections, and at least 23,000 people die. When antibiotics are over prescribed or prescribed inappropriately (commonly called drug/bug mismatch), they become less effective in treating certain infections. Patients die unnecessarily, and billions of dollars are lost to ineffective care and lost productivity.

The CDC estimates 30-50 percent of antibiotics prescribed in hospitals are either inappropriate or unnecessary. In response, three VA medical centers (VACMs) are fighting back with TheraDoc, DSS’s industry leading software decision support tool that provides real-time electronic clinical surveillance for antimicrobial stewardship and infectious disease.

The three VAMCs are in VISN 5, the National Capital Health Care Network. According to an article in U.S. Medicine, the three VAMCs decided to integrate their antimicrobial stewardship programs to maximize impact and efficiencies. They started working with DSS in late 2015, with implementations completed by March of 2016.

The results are in, and they are impressive:

Patients – the number of pharmacy interventions – i.e., when a potentially harmful antibiotic prescription was flagged and addressed – soared. From the U.S. Medicine article:

“The increased ability to conduct reviews led to a more than three-fold rise in the number of pharmacy interventions driven by antimicrobial concerns. Interventions increased from 2,946 in 2016 to 10,016 in 2017.”

Cost Savings – the TheraDoc powered antimicrobial stewardship programs saved the three VAMCs $2.3 million:

That rise in interventions also significantly increased savings. Across the three VAMCs, “the shared ASP interventions led to $532,520 of estimated cost savings in 2016 and an estimated $1,790,906 of cost savings in 2017,” the authors said.”

Examples of the kind of interventions flagged by TheraDoc include:

  • Discontinuing poorly matched or unnecessary medications

  • Conversion of intravenous medications to oral

  • Eliminating redundant antimicrobials

  • Shortening duration to recommended timelines

  • Switching patients to more narrow antimicrobials

  • Restricting use of certain medications with express approval from an infectious disease specialist

These results demonstrate the positive impact of  using software tools that take raw hospital data and turn it into real-time picture of patient care. Critical lab monitoring tied to the proper medication selection needs to be proactively provided to the clinician. This allows for immediate medical intervention as patients’ conditions change, decreasing patient risk and creating significant financial savings for the VAMC.

What’s needed now is to increase TheraDoc adoption across more VISNs. The solution is currently at 42 VA facilities, but that’s a small fraction of the overall total. The VA can be in the vanguard of the fight against antimicrobial resistance and set an example for American healthcare. Think of the possibilities when these efficiencies and results are spread across the entire country, serving millions of veterans!