Design & development of customizable web API for interoperability of antimicrobial resistance data

Factors Influencing Clinicians' Use of Hospital Information Systems for Infection Prevention and Control: Cross-Sectional Study Based on the Extended DeLone and McLean Model

BACKGROUND

Healthcare-associated infections have become a serious public health problem. Various types of information systems have begun to be applied in hospital infection prevention and control (IPC) practice. Clinicians are the key users of these systems, but few studies have assessed the use of infection prevention and control information systems (IPCISs) from their perspective.

OBJECTIVE

This study aimed to (1) apply the extended DeLone and McLean Information Systems Success model (D&M model) that incorporates IPC culture to examine how technical factors like information quality, system quality, and service quality, as well as organizational culture factors affect clinicians' use intention, satisfaction, and perceived net benefits, and (2) identify which factors are the most important for clinicians' use intention.

METHODS

A total of 12,317 clinicians from secondary and tertiary hospitals were surveyed online. Data were analyzed using partial least squares-structural equation modeling and the importance-performance matrix analysis.

RESULTS

Among the technical factors, system quality (β=.089-.252; P<.001), information quality (β=.294-.102; P<.001), and service quality (β=.126-.411; P<.001) were significantly related to user satisfaction (R2=0.833), use intention (R2=0.821), and perceived net benefits (communication benefits [R2=0.676], decision-making benefits [R2=0.624], and organizational benefits [R2=0.656]). IPC culture had an effect on use intention (β=.059; P<.001), and it also indirectly affected perceived net benefits (β=.461-.474; P<.001). In the importance-performance matrix analysis, the attributes of service quality (providing user training) and information quality (readability) were present in the fourth quadrant, indicating their high importance and low performance.

CONCLUSIONS

This study provides valuable insights into IPCIS usage among clinicians from the perspectives of technology and organization culture factors. It found that technical factors (system quality, information quality, and service quality) and hospital IPC culture have an impact on the successful use of IPCISs after evaluating the application of IPCISs based on the extended D&M model. Furthermore, service quality and information quality showed higher importance and lower performance for use intention. These findings provide empirical evidence and specific practical directions for further improving the construction of IPCISs.

Integrative Digital Tools to Strengthen Data Management for Antimicrobial Resistance Surveillance in the "One Health" Domain in Nepal

Antimicrobial resistance (AMR) is increasing and represents one of the greatest public health challenges of our time, accounting for considerable morbidity and mortality globally. A "One Health" surveillance strategy, which integrates data concerning the resistant organisms circulating in humans, animals, and the environment, is required to monitor this issue and enable effective interventions. The timely collection, processing, analysis, and reporting of AMR surveillance data are necessary for the effective delivery of the information generated from such surveillance. Nepal has greatly improved its surveillance activities through a network of human and animal health laboratories; however, the data reported by sentinel laboratories are often inconsistent, incomplete, and delayed, causing challenges in terms of data cleaning, standardization, and visualization on a national level. To overcome these issues, innovative methods and procedures have been adopted in Nepal, with the development and customization of digital tools that reduce the human time and effort spent on data cleaning and standardization, with concomitant improvements in the accuracy of data. These standardized data can be uploaded to the district health information system 2 (DHIS2) One Health AMR surveillance portal, enabling the generation of reports that will help decision-makers and policy planners to combat the global problem of AMR.

Strengthening the Surveillance of Antimicrobial Resistance in India Using Integrative Technologies

Background

The antimicrobial resistance (AMR) situation in India is alarming. In the absence of newer antibiotics, the best possible approach is to efficiently use the existing antimicrobials through surveillance of resistance. The data generated by AMR surveillance across the country has immense potential to drive policy decisions. However, this data is available in a variety of sources. It is imperative to have tools to integrate the data generated across the country into a single data repository.

Methods

An ensemble of tools (i-AMRSS, i-DIA, and i-AMRIT) have been designed and developed by the data management team at the Indian Council of Medical Research (ICMR) to strengthen surveillance of antimicrobial resistance in India.

Results

The i-AMRSS is a web-based ICMR's AMR surveillance system, collecting data from tertiary care centers across the country and sending it to the one-stop data repository. The i-DIA is a web-based API that simplifies the AMR data interoperability by seamlessly importing most of the LIS / HIS data from CSV files into a central, one-stop data repository. The i-AMRIT is a standalone ICMR's AMR surveillance system using integrative technologies, collecting data from all the labs across the country and sending the lab-specific cumulative data to the one-stop data repository.

Discussion

The tools are being used in ICMR's AMR Network and have collected over 0.4 million patient records to date. The complete system is presently being used to capture human susceptibility testing data and can be extended for capturing data using the 'One Health' approach. The authors plan to make the system compliant with FHIR standards to enable interoperability with other countries.