In the United States, 72% of all hospitals have less than 200 beds and the majority of these hospitals do not have access to antibiotic stewardship programs or infectious diseases physicians. Infectious diseases input in the clinical care of patients has been shown to improve quality of care, improves clinical outcomes, and reduces costs to both the patient and the facility. In 2014, only 1 of Intermountain’s small hospitals (bed size < 200) had access to an infectious diseases physician and only 1 had a formalized antibiotic stewardship program.
While antibiotics are truly a miracle of modern medicine, they are frequently prescribed incorrectly by medical providers. Most of the common diagnoses seen in primary care and urgent care (bronchitis, colds, ear aches, and many sinus infections) are caused by viruses and antibiotics have no impact on viral infections. In addition, the antibiotics prescribed to patients admitted to the hospital can be improved upon in approximately 50% of cases.
Antibiotics can have nasty side effects. Antibiotics can lead to rashes, serious allergic reactions, gastrointestinal problems, and in some cases even predispose patients to other bacterial infections (C. difficile). Consequently, when antibiotics are used inappropriately, the patient runs a risk of complications and, many times, won’t get better any faster.
As mentioned above, the use of antibiotics leads to antibiotic resistance, which is one of the world’s most pressing threats to public health. Bacteria are evolving in ways that reduce the effectiveness of antibiotics, producing bacteria that can survive and continue to cause harm in the presence of antibiotics. Infections caused by these bacteria can be difficult and sometimes impossible to treat, and can be shared with others, perpetuating antibiotic resistance.
Because of the importance of providing timely infectious diseases care and the need to develop antibiotic stewardship programs in all of our hospitals, the Infectious Diseases TeleHealth program was developed. The Infectious Diseases TeleHealth program provides ID consultation to patients within Intermountain’s small hospitals and provides antibiotic stewardship program support to the local staff. The ID TeleHealth program is now live at Logan Regional Hospital, Riverton Hospital, Alta View Hospital, and Park City Hospital. All the other remaining Intermountain small hospitals will be brought on-line by April 2017.
This program helps show the value of connecting our facilities with infectious diseases support, and helps us meet our goals around antibiotic stewardship. This is an important first step and look forward to expanding our TeleHealth program to the rest of Intermountain’s hospitals, providing additional antibiotic stewardship support to the whole system.