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Infectious Disease Telemedicine: 1, Germs: 0

Veterans Health Administration (VA) hospitals are refusing to be held back by a shortage of Infectious Disease (ID) specialists. A pilot program, described this month in Infection Control and Hospital Epidemiology, paired staff at two rural VA hospitals lacking ID specialists with ID experts at larger health systems for weekly meetings through a connected care platform. Infectious disease telemedicine looks promising: During the study, rural providers followed more than two-thirds of the specialists’ recommendations and became more confident in their ability to determine the best way to use antibiotics.

The prevalence of drug-resistant organisms has driven providers to use antibiotics more cautiously in an attempt to reduce the emergence of multi-drug-resistant organisms, but, as study author Lauren Stevens PhD explained, when antibiotic stewardship programs are managed by someone who has not received the appropriate training, issues are more likely to arise and the program may become ineffective.

The VA’s pilot program sought to overcome this problem by creating Videoconference Antimicrobial Stewardship Teams (VAST). The VAST teams met via telemedicine weekly to discuss best practices and review difficult or troubling cases. Participants reported greater awareness of antibiotic stewardship principles and thus improved practice patterns, as well as increased ability to make more targeted antibiotic choices, reduce the length of time a patient takes antibiotics, and use more effective methods when possible.

These results are great news for the industry since many remote and rural health systems have a shortage of infectious disease-trained physicians and pharmacists. A 2012 survey revealed that 40 percent of the VA hospitals providing inpatient care did not have a full-time ID physician on staff. The success of the VA’s pilot program suggests that infectious disease telemedicine may present a viable method for an ID specialist to oversee more health facilities in a larger geographic area, thus relieving the shortage of specialists.

To learn more about the VA pilot program and read about other programs using infectious disease telemedicine, visit mHealthIntelligence here.

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