Development of a Novel, Multi-facility Electronic Interface for the Exchange of MRSA Surveillance Data

Background: The Ohio State Health Network (OSHN) is a membership organization that provides networking opportunities between the Ohio State University Medical Center (OSUMC) and 7 referral hospitals in Ohio. Using this existing network, a research project to collect comprehensive information on methicillin-resistant Staphylococcus aureus (MRSA) infections was established to increase the understanding of inter-facility transmission of MRSA isolates within this network of geographically distinct hospitals and lead to improved infection control.
Objective: Develop a secure electronic interface to exchange surveillance and research data from network facilities into research data mart accessible to investigative staff.

Methods: OSUMC Information Warehouse (IW) developed a database through an existing secure intranet connection shared by all facilities within the network. Infection Preventionists (IP) at each site enter identifiable patient health information (PHI) directly on each eligible MRSA case through a secure log on. A unique identifier code is automatically generated and assigned for that patient.  This code is affixed to the respective MRSA isolate which is mailed to OSUMC microbiology laboratory for genotyping and storage.  Additional clinical and epidemiologic data are collected on each case by the respective IPs and directly entered through the secure intranet portal. To avoid duplications, a search function is used prior to each data entry.  All data are stored behind the protected firewall at the OSUMC IW, who serves as an honest broker of the patient data containing PHI. The key to the code is retained by the OSUMC IW and by the IP at each facility.  These data are considered infection control/quality data at each hospital and the PHI is retained for local quality analysis, including outbreak investigation. Research staff can view and analyze all data through a separate search engine that allows identification of cases only using the unique identifier code, thus protecting patient identity.  Keying off of the respective genotypes, geocoding and social networking software are utilized for studying transmission patterns.

Results: All eight hospitals successfully implemented the electronic interface.  Currently 1227 isolates have been entered into this novel system.  Among these isolates, complete epidemiologic data have been collected on 445, genotyping completed on 337, geocoding and GIS mapping completed on 937.  Social network analysis is to begin upon completion of other data collection and entry.

Conclusions: We report the development and use of a novel, multi-facility electronic data interface which has increased the timeliness and efficiency for the exchange of MRSA surveillance data for analysis.  This method has great promise for enhancing our understanding of transmission of antimicrobial resistant pathogens between facilities and across communities.