Creation and Validation of an Automated Registry for Outpatient Parenteral Antibiotics

Abstract

Existing outpatient parenteral antibiotic therapy (OPAT) registries are resource-intensive and OPAT programs struggle to produce objective data to show the value of their work. We describe the building and validation of an automated OPAT registry within our electronic medical record (EMR) and provide objective data on the value of the program. Variables and outcomes include age, sex, race, ethnicity, primary insurance payor, antibiotic names, infection syndromes treated, discharge disposition, thirty-day all cause readmission rate, thirty-day all cause death rate, complications, and an estimate of the hospital days saved. 146 OPAT episodes were manually chart-reviewed to validate the registry. Data were displayed in a dashboard within the EMR. Over the 4-year time frame our registry collected 3956 unique patients who completed 4710 episodes (approximately 1200 episodes per year). A total of 400 complications during OPAT were identified. All variables had an accuracy >90% on validation. The OPAT program resulted in a reduction in hospital length of stay by 88,820 days, or roughly 22,000 days/year. We intend our registry to serve as a blueprint for similar OPAT programs with limited administrative resources. Wider application of our system would allow for easier aggregation and comparisons of OPAT practice and address the lack inter-institutional standardization of OPAT data and outcomes.

We Shape Our Tools and Then Our Tools Shape Us: OPAT and the EHR

“…In a pair of recent articles in Open Forum Infectious Diseases , clinicians from 2 large OPAT programs share their EHR OPAT retooling strategies [ 14 , 15 ]. At the University of Rochester Medical Center (URMC), New York, a multidisciplinary team of an ID physician, an ID pharmacist, and information technology analysts created and implemented a multimodal OPAT EHR intervention bundle.…”