Eastern Health plans to use software to curb resistance to antimicrobial drugs

·4 min read
Dr. Peter Daley, an infectious diseases physician and Memorial University medical microbiologist, says outpatient antimicrobial drug use is declining in Newfoundland and Labrador but needs to decrease even more. (Darrell Roberts/CBC - image credit)
Dr. Peter Daley, an infectious diseases physician and Memorial University medical microbiologist, says outpatient antimicrobial drug use is declining in Newfoundland and Labrador but needs to decrease even more. (Darrell Roberts/CBC - image credit)
Darrell Roberts/CBC
Darrell Roberts/CBC

Eastern Health is paying for software that it hopes will curb antibiotic resistance in Newfoundland and Labrador while making drug prescription more accurate and more efficient.

Dr. Peter Daley, an infectious diseases physician and medical microbiologist at Memorial University, said Newfoundland and Labrador has the highest rate of outpatient antimicrobial drug use in Canada — and while it declined from 2017 to 2021, it still isn't ideal.

"We'd like to see it come down considerably further," he said Wednesday at an event at the Sheraton Hotel announcing the plan. "When we think about maybe half of prescriptions should never be given, then we have a long way to go to improve yet."

Antimicrobial drugs are used to treat a variety of infections but can cause liver and kidney damage or make patients sicker if the wrong medication is prescribed. Additionally, patients around the world are developing resistance to drugs, like antibiotics, as a result of unnecessary use.

"The germs that cause infectious disease are becoming progressively more resistant to the drugs that we use to treat them," Daley said.

'Don't ask for it'

Daley said despite good medical training, Eastern Health is still "routinely" seeing physicians prescribe antimicrobial drugs inappropriately.

"It comes to a lack of special understanding or special training. It comes to, in some cases, laziness or inability or unwillingness to continuously evaluate day by day the antibiotic therapy." he said.

Daley said patients also ask — or demand — that their physician prescribe an antibiotic drug, often because they misunderstand the purpose of the medication.

"The message is, 'Don't ask for it. You don't need it.'"

The software will exist as a desktop application for Eastern Health physicians and will use patient data — including symptoms, current medications and test results — to determine if an antimicrobial drug is appropriate.

"Our system is very manual, it's very limited. This will allow us to have a much wider impact," Daley said.

Daley said the software will be implemented slowly but he expects to see "significant difference" in one year.

Darrell Roberts/CBC
Darrell Roberts/CBC

Dr. Kalvin Yu, vice-president of medical and scientific affairs for Becton, Dickinson and Company, which is providing the software, said the application is a "safety net" that will notify a physician or pharmacist making the clinical decision if a patient needs a certain antimicrobial drug — or should stop taking one.

"Decreasing the workload and sort of the investigation that the clinicians have to do is helping the patients getting the best drug sooner rather than later," Yu said.

Yu said Eastern Health is the first Canadian jurisdiction to use the technology, but more than 400 hospitals in the United States are already using it. He said the technology has been available for about two decades.

Program will use patient data

Yu said BD uses patient laboratory data as part of the software. He said the software mostly uses data related to infectious diseases, but the company will also get data related to white blood cell count, blood thinner results and more.

He said that data could be used to expand the antimicrobial stewardship program to include other medications like narcotics.

"The possibilities are endless," he said.

Health Minister John Haggie was not at the event. Gillian Sweeney, assistant deputy minister of population health and wellness, did not take questions from reporters but during her remarks said, "Solutions like this one are very welcome."

CBC News has asked for an interview with Haggie.

Sherry Vivian/CBC
Sherry Vivian/CBC

BD Canada president Ivy Parks said protection of patient data is of "utmost importance."

"Our cybersecurity department has done a lot of work with Eastern Health to ensure the privacy of the data that's being transferred," she said.

Eastern Health paying $170K per year for contract

Eastern Health is paying about $170,000 per year, but will get the first six months for free as part of a risk-sharing agreement with BD, said Ron Johnson, Eastern Health's vice-president of innovation and rural health. He said the software should reduce costs in the long run because it will help avoid the misuse of drugs.

"If we match the right bug with the right bug we will impact, obviously, drug usage.… We'll lower the length of stays, we'll improve health outcomes, which all makes the system more efficient," he said.

Johnson said Eastern Health began looking for a company to provide the software in 2020 as a way to curb antimicrobial resistance and BD won the contract in a two-stage request-for-proposals process.

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