Impact

Besides improving the quality of care and patient safety, the DebugIT project will also fundamentally contribute towards fewer interventions needed, fewer crises, shorter stays in hospital, lower costs of drugs, thus contributing to improved productivity, facilitating better patient care at the point of need. The overall feedback loops of the system and the integrated mining engine will allow for faster health information processing and quicker transfer of the new knowledge generated into clinical practice.

In addition, the new system will provide user-friendly decision support at the point of care, thus optimising medical interventions and preventing errors when treating infectious diseases and prescribing antibiotics.

Few studies have examined the costs of antibiotic resistance. One has noted that antibioticresistant infections double the duration of hospital stay, double mortality and probably double morbidity (and presumably the costs) as compared with drug-susceptible infections. A cost comparison of treating methicillin-resistant (MRSA) versus methicillin-susceptible (MSSA) S. aureus in New York City found almost a threefold increase in mortality (21% versus 8%) and an economic cost increase of 22% associated with MRSA. For all hospitalized individuals with MRSA in New York City, such costs would translate into millions of dollars.

Another study has estimated the economic costs at US $150 million to $30 billion a year, depending on the number of deaths. It noted that the antimicrobial resistance selected in one year will persist, and subsequent years will bear the burden of the resistance problem of previous years. The US Office of Technology Assessment advisory committee estimated a cost of several billion dollars when evaluating the effects of major resistant nosocomial agents. If community infections are considered, the costs are even greater, particularly for combination therapies of multiple drugs such as those used to treat MDR tuberculosis and for treatments that substitute the parenteral route for the oral route.

Track record of sharing

The results, goals and approach of the DebugIT project have been shared with a large audience of healthcare and health IT professionals. Christian Lovis of the University hospitals Geneva presented the DebugIT project to the eHealth community in Geneva. The project coordinator represented by Dr. Dirk Colaert presented the project at the 2nd EU-Korea Cooperation Forum on ICT Research in Brussels. Henning Müller (PhD) of project partner University Hospitals Geneva delivered a project presentation at this year’s 21st annual conference of the Swiss society for medical informatics (05-06 june 2008) in Sierre, Switzerland. This year’s medical informatics Europe conference was held in Gothenburg, Sweden with the objective to cover the most urgent topics occupying the eHealth (research) community today. The DebugIT conference paper passed the critical review of a total of 250 reviewers and was selected as one of 230 presentations deemed of high quality. It is published in the MIE 2008 conference proceedings by IOS Press.

The Geneva Health Forum brings together on an equal basis all actors involved in access to health – including international, national and local organizations; government agencies; the private sector; hospitals; universities; civil society; and most importantly those who need care. It provides an interactive and dynamic platform for critical reflexion on the complexity of global access to health. As part of the so-called “Open Communications”, which are presentations followed by debates,

Further sharing and dissemination work has concentrated on information workshops at Swedish hospitals and specific stakeholder workshops such as the EUROREC group. A detailed presentation of the conceptual approach of the DebugIT project, goals, objectives and expected impacts has been developed in a four-page flyer format. This flyer is designed and distributed to reach the most relevant audiences in the field of data mining, patient safety and antibiotics resistance.

Lessons learnt

Lesson 1 - Advanced ICT tools are suited to provide new knowledge about and help fight antimicrobial resistance.

Lesson 2 - Large research projects involving partners from academia and industry need a clear project management structure and careful guidance and support to be successful.

Lesson 3 - The awareness for the problem of antimicrobial resistance is increasing rapidly among healthcare decision-makers. This will help similar projects get access to funding.