Accelerating Data into Action: A New Data Exchange for Improved Communication about Multi-Drug Resistant Organism (MDRO) Exposure in Orange County, California

The Covid-19 pandemic awakened public health agencies to new aspects of disease surveillance and highlighted the need to modernize infrastructure to better prepare for the next public health crisis.  A critical impetus for this modernization effort is the threat of antibiotic resistance within the U.S. health care system, a concern acknowledged by the Centers for Disease Control and Prevention (CDC) and the Infectious Disease Society of America. According to the CDC, each year two million Americans nationwide contract infections from bacteria resistant to antibiotics, resulting in the deaths of 23,000 individuals.

To address this threat, the Orange County Health Care Agency’s (HCA) Public Health Services is collaborating with Altarum to develop a MDRO data exchange, called MDRO Xchange. The data exchange will better safeguard public health by minimizing inadvertent exposures to MDROs. The centralized system aligns with the goal of CDC’s Data Modernization Initiative to provide actionable insights faster for decision-making at all levels of public health. 

Orange County’s Public Health Services serves a population of 3.2 million in the third largest county in California. MDRO Xchange will allow acute care hospitals, long-term acute care hospitals, skilled nursing facilities, and local public health agencies throughout Orange County to enter, store, and access data with minimal latency, providing near-real-time updates for patients who test positive for MDROs. The data exchange will have the flexibility to accommodate various logical workflows to ensure the appropriate handling of patients. 

Initially, we are partnering with Orange County’s Hoag Health System and will steadily incorporate other inpatient health care facilities in the county into the data exchange.

“We are committed to assisting facilities in swiftly identifying incoming patients carrying MDROs to implement necessary precautions, thereby preventing the spread of these resistant organisms,” says Harrison Kerschner, Altarum Product Manager. “The inpatient facilities will have the ability to check our data exchange to find outliers: people coming from other treatment areas” where MDRO status may not be recorded. 

The data exchange will be able to track new outbreaks and exposure events, securely transmit and receive data in multiple formats, and integrate with other data systems. It will include patient demographics, facility and laboratory data, case/investigation data, diagnoses, healthcare-associated infection and pathogen data, treatment, and procedures for patients who test positive for MDROs, including C. auris, MRSA, ESBL, VRE, and CRE. These data can demonstrate possible transmission within a facility or system, support the implementation of better infection control practices, protect the health of patients and residents, and minimize (or potentially eliminate) inadvertent MDRO exposures. 

“When facilities know they are dealing with MDRO exposure, their approach can be preventative, rather than reactive,” says Raj Borde, Software Engineering Director, Public Health Interoperability and IT Systems at Altarum. “In addition to protecting the community and care team members, it is going to save the in-patient facilities throughout Orange County time, energy, and money.”

For nearly two decades, Altarum has worked to incorporate patient information from multiple sources while helping public health programs integrate data into their systems. We have hands-on experience developing Fast Healthcare Interoperability Resources (FHIR) solutions, collaborating with major electronic health record (EHR) vendors, and working closely with interoperability standards organizations. Our team has specialized expertise in healthcare-associated infection data exchanges, including creating and parsing antimicrobial use and resistance reporting requirements for CDC’s National Healthcare Safety Network.  

The new MDRO data exchange offers a high-quality user experience, along with a modern architecture and security infrastructure to future-proof the system. Altarum is honored to leverage our expertise to benefit the Orange County community, to improve health equity, and promote population health.