Program Schedule

1710
Using Information Technology (IT) to Facilitate Infection Prevention and Control (IP&C) and Communication during a Measles Outbreak

Session: Poster Abstract Session: Public Health
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • Measles Poster Upload.pdf (1.4 MB)
  • Background: Our multi-campus medical center responded to a rapidly evolving measles outbreak in New York (NYC).  We have >25,000 healthcare providers (HCPs) at 5 acute care facilities, 5 Emergency Departments (EDs) with >275,000 annual visits and >1.8 million ambulatory visits. We describe innovative uses of IT to facilitate communication for:  1) measles exposures 2) managing suspected measles and 3) increasing vaccination.

    Methods: From 2/5/14 – 4/29/14, there were 26 cases of measles in NYC; we saw 13 (10 children, 3 adults; 4 months – 35 years). IT resources mobilized for our medical center response were: intranet website for HCPs, IP&C's electronic surveillance system (EpiPortal), patient and HCP electronic health records (EHR), linked immunization registries, and text messaging.

    Results: We disseminated educational materials to HCPs via a measles intranet site.  In response to measles exposures, our immunization registry was synchronized with the NYC registry to assess the vaccination status of 537 potentially exposed patients. Knowing that some of the 287 exposed patients with no/unknown immunity might return during their communicable periods (CP), we configured an EpiPortal alert within the EHR for Airborne Isolation if exposed patients returned (Figure). In all, 57 (20%) exposed patients returned during their CP (16 ED, 35 ambulatory, 6 inpatient). The HCP EHR identified 8 non-immune HCPs; all had medical contraindications to vaccination. We created a measles order set in the patient EHR to prompt HCPs to order the correct tests and included hyperlinks to Department of Health specimen forms.  This order set was linked to EpiPortal, which can generate a list of tested patients to alert IP&C of suspect cases.  The hospital immunization registry identified 266 patients 12-72 months old who had not received measles vaccination. We sent text messages asking these families to return to have their child vaccinated urgently and providing walk-in hours; to date, 127 (48%) have been vaccinated.

    Conclusion: Given the complexity of our medical center, IT resources were invaluable in communication and implementing our comprehensive response. No healthcare-associated measles was identified. Processes established during this outbreak can be modified for future outbreaks.

    Description: G:\Epidemiology-West\Epidemiology\Measles\Mealses Abstract\Measles Micro-Epi tab.jpg

    Maria Messina, RN, BSN, CIC1, Lesley Covington, MSPH, CIC1, Barbara Ross, RN, BSN, CIC2, Melissa Stockwell, MD, MPH3,4, Mariellen Lane, MD5, Diane Mangino, RN, MSN, CIC1, Nancy Schneider, RN, MS, CIC1, Krystal Balzer, RN, MSN1, Lilibeth Andrada, RN, MA, CIC, PNP1, Lisa Covington, RN, MPH, CIC1, John D'agostino, RN, MSN, CIC1, Patrice Russell, RN, MSN, CIC1, Jean-Marie Cannon, RN, BSN, CIC1, Rohit Chaudhry, MS6, Steven Kaplan, MD7,8, Helen Lee, MD, MPH9, David P. Calfee, MD, MS, FIDSA, FSHEA10, Philip Graham III, MD, Msc11, Lisa Saiman, MD MPH3,12 and E. Yoko Furuya, MD, MS13,14, (1)Infection Prevention and Control, NewYork-Presbyterian Hospital, New York, NY, (2)Infection Control and Prevention, NewYork-Presbyterian Hospital, New York, NY, (3)Department of Pediatrics, Columbia University Medical Center, New York, NY, (4)Department of Population and Family Health, Mailman School of Public Health-Columbia University, New York, NY, (5)Columbia University, New York, NY, (6)IT-Business Solutions, NewYork-Presbyterian Hospital, New York, NY, (7)Weill Cornell Medical Collge, New York, NY, (8)NewYork-Presbyterian Hospital, New York, NY, (9)Workforce Health and Safety, NewYork-Presbyterian Hospital, New York, NY, (10)Medicine/Infectious Diseases, Weill Cornell Medical Center, Newyork-Presbyterian Hospital, New York, NY, (11)Division of Pediatric Infectious Diseases, Department of Pediatrics, Infection Prevention and Control, Division of Quality and Patient Safety, Columbia University, Weil Cornell Medical College, NewYork-Presbyterian Hospital, New York, NY, (12)Infection Prevention & Control, NewYork-Presbyterian Hospital, New York, NY, (13)Columbia University Medical Center, Division of Infectious Diseases, New York, NY, (14)Infection Prevention & Control, Newyork-Presbyterian Hosp. (NYPH), New York, NY

    Disclosures:

    M. Messina, None

    L. Covington, None

    B. Ross, None

    M. Stockwell, None

    M. Lane, None

    D. Mangino, None

    N. Schneider, None

    K. Balzer, None

    L. Andrada, None

    L. Covington, None

    J. D'agostino, None

    P. Russell, None

    J. M. Cannon, None

    R. Chaudhry, None

    S. Kaplan, None

    H. Lee, None

    D. P. Calfee, None

    P. Graham III, None

    L. Saiman, Cystic Fibrosis Foundation: Collaborator, Consultant and Scientific Advisor, Consulting fee and Salary

    E. Y. Furuya, None

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