UCSF researchers mine EHRs to track 435k patient movements, pinpoint source of C. diff

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A team of UC San Francisco health informatics researchers analyzed EHR data from a three-year period to identify one source of Clostridium difficile, a common hospital-acquired infection.

For the study, the research team used time and location stamps from EHRs to trace the movements of more than 85,000 patients seen at UCSF Medical Center at Parnassus between 2013 and 2016. They detected 435,000 location changes, which they used to construct a map of where patients with C. diff infections had traveled in the hospital.

The research revealed one location in particular — a CT scanner in the emergency department — as a significant source of infection. Four percent of patients who entered the scanner within 24 hours of a patient with C. diff contracted the infection within two months, while the overall rate of infection for those who used the scanner was 1.6 percent.

The research results, published in the Oct. 23 issue of JAMA Internal Medicine, led UCSF Medical Center at Parnassus to align cleaning practices for the CT scanner with those used in other radiology suites.

"Most studies looking at C. diff in hospitals typically only look at whether patients were on the same hospital floor," said Russ Cucina, MD, senior author on the study and chief health information officer at UCSF. "But they don't think about everywhere else in the hospital patients go. If we just look at transmission in their room, we're missing potential opportunities for disease transmission." 

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