Guest Column | July 11, 2019

The Growing Role Of Rapid Diagnostics And Digital Health In Long-Term Care

By Evan Jones, OpGen

Empowering Women’s Healthcare With Data Science And AI

Today the healthcare industry is facing numerous instances of drug-resistant, infectious disease outbreaks, many of which have been exacerbated by misdiagnosis and mistreatment with frontline antibiotics. Elderly individuals, particularly those living in long-term care facilities, are especially vulnerable to infections. In these settings, a delayed diagnosis or mistreatment gives drug-resistant pathogens an opportunity to spread rapidly, leading to an outbreak event that might otherwise have been avoided.

Fortunately, new technologies are emerging in the diagnostic and digital health space which enable doctors to properly identify infection strains faster than ever before and gain insights on which treatment courses will be most effective to not only eradicate the strain in the individual patient, but also to prevent transmission to other high-risk individuals and guide future outbreak response practices.

It’s Complicated: Diagnosing UTIs In High-Risk Patients

It’s no secret that an infection of any kind is incredibly disruptive to long-term care patients. Many nursing and long-term care facilities are already doing everything they can to limit transmission among the most vulnerable individuals under their care. This is no small task, however, as these patients are more likely to have lingering surgical complications, use medical devices and be cognitively and/or physically impaired and unable to discuss symptoms with caregivers.  

A common example which illustrates challenges presented by complicated, multi-drug resistant pathogens in long-term care facilities is urinary tract infections (UTI). Often, UTIs in elderly patients with comorbidities present drastically different symptoms than they would in a healthy person, leading caregivers to mistake the infection for another condition, such as dementia. In these scenarios, proper diagnosis and effective treatment can be delayed, during which time the patient is subjected to needless suffering and the infection may be transmitted to others living in the same facility.

Of nearly 10 million UTI cases identified each year, about nine million are adequately treated with frontline empiric antibiotic therapy. However, the other one million cases fall into the category of “complicated” UTIs, often harboring strains which most likely cannot be treated with the common courses of antibiotics that doctors and nurses are known to fall back on. Not only do these complicated infections impact high-risk long-term care patients at a higher rate, they are more likely to develop and spread resistance to antibiotics if treated incorrectly.

Delivering Faster Results And Faster Treatments

As doctors and researchers learn more about the dangers of complicated infections in high-risk populations, we’re seeing increased need for rapid diagnostic tests for UTIs and other drug-resistant pathogens, both in urine and blood samples. These tests are designed to significantly lower the time it takes for doctors and caregivers to accurately identify an infection strain – from days to just hours, in many instances. Receiving reliable diagnostics in a shorter time frame alters the caregiver’s treatment strategy, eliminating the common practice of administering frontline antibiotics before a diagnosis is reached and instead encouraging doctors and nurses to wait for the most-accurate results to make a more informed decision on the best course of treatment.  

When applied in a long-term care setting, the benefits of rapid diagnostic tests are myriad. Patients who are quickly and accurately diagnosed are less likely to endure days of incorrect treatments while waiting for test results. Similarly, it reduces the frustration that loved ones and caregivers experience when a patient goes through several cycles of incorrect treatments. In settings where many high-risk patients live in close quarters, applying the correct treatment in a shorter time frame can potentially reduce transmission rates and prevent an outbreak from occurring. Lastly, by pinpointing the correct treatment for a particular infection, incorrect use of frontline empiric antibiotic therapy can be decreased, which can help slow the spread of antibiotic resistance.

Preventing Outbreaks With Real-Time Data Sharing

Going beyond diagnostic times and high-risk factors in patients, managing medical records is still a challenge for healthcare facilities. Errors as well as missing or incorrect information about a patient’s history can be extremely detrimental in any scenario. But these issues become especially dangerous when they involve elderly patients who are more likely to have complicated health histories and preexisting conditions for which they are already being treated.

As the medical community works to cut down on the use of certain antibiotics in an effort to combat drug-resistant pathogens, access to complete and accurate infectious disease records becomes even more crucial. As mentioned before, even something as common as a UTI can be much more complicated and easier to misdiagnose.

To address this challenge, some biotechnology companies are introducing digital and cloud-based solutions which establish a database of infectious and antibiotic-resistant pathogens, gathered through rapid diagnostic tests. Such a system can be accessed to review an individual patient’s history but also to gain information on how to treat a particular infection strain, based on outcomes from other similar cases. When rolled out system-wide, this database also can provide valuable insights on how individual infections turn into transmission events, in an effort to improve infection control protocols and guard facilities against future outbreaks.

The future of infection prevention, particularly in high-risk patient populations, lies in a combination of rapid, accurate diagnostics and digital health applications. We’re already seeing hospital systems and state health departments adopt infectious disease surveillance and antibiotic stewardship programs, which incorporate these elements. As the use of real-time shared data streamlines the infectious disease treatment process in major health institutions, we can expect to see long-term care and geriatric medicine facilities explore these solutions as a way to prevent outbreaks, reduce antibiotic overuse and improve patient outcomes.

About The Author

Evan Jones is the CEO of OpGen, Inc., a pioneering informatics and genomic analysis company providing complete solutions for patient, hospital, and network-wide infection prevention and treatment.