It’s a story that might be all-too familiar to someone who works in a long-term care facility: A patient who typically has normal cognition suddenly begins displaying worrisome symptoms such as confusion and memory loss. Caregivers are at a loss when the individual doesn’t respond to the usual treatment for these symptoms and eventually ends up at the hospital, undergoing many rounds of testing before an unexpected cause is identified – a urinary tract infection.
UTIs are merely one example of how disruptive an infection can be to an individual living in long-term care. Healthcare institutions are currently grappling with a challenge – how can we diagnose and limit the transmission of pathogens more effectively? Elderly patients are considered high-risk when it comes to multi-drug resistant pathogens (MDROs) – they are more likely to be using medical devices, such as catheters, and can be physically or cognitively impaired and unable to effectively communicate symptoms and discomfort to their caregivers and doctors.
The benefits of proper infection control are well-known in the long-term care community. Reducing transmission and limiting the number of patients afflicted by a particular strain are primary goals. Additionally, a facility with a lower infection rate will draw more patients and skilled nursing talent, which has a positive impact on business overall. Not to mention, spotting and treating infections faster and more effectively cuts down on costs by limiting the number of antibiotics used and hours of productivity spent trying to find an accurate diagnosis.
Save time to save lives
New and emerging technologies in the diagnostic space enable us to properly identify infection strains earlier and tap into patient data to gain insights into which treatment courses might be most effective.
Let’s revisit the UTI example briefly. Currently, there are about 10 million UTI cases each year, roughly nine million of which are routinely manageable and can typically be treated with frontline antibiotics. However, one million or more cases are considered “complicated” and generally won’t respond to the same courses of antibiotics that doctors and nurses fall back on. Unsurprisingly, high-risk patients in long-term care are more likely to be afflicted with complicated UTIs. Mismanagement of these infections and misuse of antibiotics result in dangerous cognitive side-effects, lengthy hospital stays and increased risk of transmission.
There’s a growing need for rapid diagnostic tests to help manage UTIs and other drug-resistant pathogens, which drastically cut down on the time it takes to identify an infection. While “getting ahead of the infection” with frontline antibiotics before you have a confirmed diagnosis might seem like an easy solution, treating a patient before you know the exact cause of their symptoms can be ineffective and even dangerous, leading to the development of an antibiotic-resistant pathogen. With faster diagnostic tests, nurses and doctors will be encouraged to wait for results and identify a more-effective treatment that can eradicate what might be a complicated UTI before it further progresses. Rapid tests also help prevent transmission through a facility.
Digital records provide an LTC solution
Some biotechnology companies are taking rapid diagnostics one step further by incorporating digital health into the equation. We’re well into the 21st Century, yet managing medical records is still a challenge for many healthcare institutions. A patient’s information might be digitally recorded in the office of their primary care physician, who can access their medical history at the push of a button when they visit. But what happens if this patient comes down with an urgent illness or injury while visiting another state? An emergency room or urgent care center might not have access to any of this information and time might be lost gathering pertinent details when the patient is checked in.
This same issue occurs at nursing facilities and long-term care centers. Comprehensive records are kept on all the patients and residents but they aren’t easily transferrable should a patient need to visit the hospital in an emergency. Similarly, records for infections and drug-resistant pathogens are lacking. Many of these infections present themselves in similar ways but have distinct differences that could impact whether or not a particular treatment will be effective. Additionally, long-term care patients are more likely to have comorbidities and pre-existing conditions that need to be considered, and which they might not be able to communicate due to their age or cognitive abilities.
Companies are developing solutions that allow the results of rapid diagnostic tests and treatments used to be gathered in a digital database or patient registry. These applications are already being adopted at major hospitals in the U.S. and can be used to track pathogens across multiple systems and even between facilities using digital records. One key result is potentially improved outcomes at the patient level, due to more accurate diagnosis and treatment suggestions. On a broader scale, this technology can protect entire health systems from infection outbreaks by predicting when a patient is afflicted with a similar infection strain and recommending treatment courses that have worked on that strain in the past.
As pathogen identification and surveillance software becomes more widespread in hospitals and urgent care centers, we can expect it to be adopted by long-term care facilities to help bridge the records gap and allow insights on high-risk infection patients to become more accessible, leading to improved outcomes and cutting down on time and money lost during the diagnostic process.
Evan Jones is the CEO of OpGen, Inc., an informatics and genomic analysis company.