Antibiotic Stewardship Tracker

Principal workflows

• Detect: Antibiotic orders, administrations and microbiology results flow in from your EHR and laboratory system, and rules you configure flag patients whose therapy may need review.
• Review: A stewardship pharmacist or physician works the queue, with the patient's antibiotic history, cultures, susceptibilities and relevant labs on one screen.
• Intervene: Recommendations to prescribers, such as de-escalation, stopping, changing the dose or switching to oral, are recorded with the prescriber's response and the reason.
• Measure and report: Days of therapy, intervention outcomes and resistance patterns are summarized for the committee, and AUR data is prepared for NHSN submission by your team.

Who uses it

• Antimicrobial stewardship pharmacists and physician leads in hospitals and health systems
• Infectious diseases physicians who advise on therapy
• Infection prevention and microbiology teams who share resistance data
• Quality, pharmacy and therapeutics, and medical staff committees who oversee the program
• Accreditation and compliance staff who prepare for surveys

Reporting

• Days of therapy by agent, class, unit and period
• Interventions made and accepted, by type, unit and prescriber group
• Open reviews and restricted-agent requests by age
• Cumulative antibiogram for microbiology review
• NHSN AUR files prepared and their submission status
• Review rule changes with who approved them

Features

• Culture and therapy matching: Each culture and susceptibility result is compared with the patient's active antibiotics, and possible mismatches are flagged with the organism and agent involved.
• Configurable review rules: Rules for de-escalation, duplicate coverage, IV-to-oral switch, prolonged therapy and restricted agents are set to your local guidelines and documented.
• Review queue: One queue of flagged patients by unit, flag type and age, so the team sees the day's work without running separate reports.
• Intervention log: Every recommendation recorded with its type, rationale, the prescriber's response and the reason, replacing spreadsheet tracking.
• Restricted-agent approvals: Requests for restricted antibiotics recorded with the indication, the approver and the decision, and a follow-up review scheduled.
• Antibiotic time-outs: Reminders for a therapy review at the point in the course your policy sets, with the outcome recorded.
• Days of therapy: Antibiotic use measured as days of therapy per patient days present, by agent, class, unit and period.
• Antibiogram preparation: Cumulative susceptibility data prepared from your laboratory results for microbiology and pharmacy to review and publish.
• NHSN AUR preparation: Antimicrobial use and resistance data prepared in the format the NHSN AUR Module accepts, for your team to validate and submit.
• Prescriber feedback: Summaries of interventions and use by prescriber group or service, for education and feedback conversations.
• Committee reporting: Program activity, use trends, intervention outcomes and resistance summaries packaged for your stewardship and P&T committees.
• Audit trail: Every flag, review, recommendation, response and rule change is logged with the person and time.

Integrations

• Electronic health record: Antibiotic orders, administrations, admissions and patient location through HL7 v2 or FHIR interfaces, mapped during implementation.
• Laboratory information system: Culture, organism and susceptibility results from microbiology, as they are finalized and as preliminary results where available.
• Pharmacy system: Antibiotic formulary, restricted-agent list and dispensing data where they sit outside the EHR.
• CDC NHSN: AUR data prepared as files in the format NHSN accepts, for your infection prevention or pharmacy team to review and upload.
• Integration engine: Feeds can be routed through the integration engine you already use, including a Moraph-managed integration engine.
• Single sign-on: Staff sign in through your identity provider (SAML or OpenID Connect).
• Work API: Intervention and use data available to your data warehouse and reporting tools through the Moraph Work API.

Deployment

• Moraph cloud: Hosted and operated by Moraph in the United States region. United Kingdom and Australia regions are available for organizations outside the US.
• Dedicated environment: A single-tenant environment for health systems whose policies require isolation, scoped in the proposal.
• With a managed service: Optionally run alongside Moraph's managed integration engine for interface monitoring and support.

Security and privacy

• Single sign-on: Staff sign in through your identity provider, so your password and multi-factor policies apply.
• Role-based access: What each person can see and do follows their role; changing a review rule is separate from working the queue.
• Business associate agreement: The Tracker handles protected health information, and Moraph signs a business associate agreement with you.
• Encryption and keys: Client data is encrypted, with keys Moraph staff cannot use without explicit, time-bound authorization.
• Complete audit trail: Every view of a patient record, change, recommendation and export is logged with the person and time, and cannot be edited.
• Data residency: Data stays in the hosting region you choose: the United States, the United Kingdom or Australia.

Limitations

• The Tracker does not change orders. Prescribers change therapy in the EHR, and the Tracker records recommendations and responses.
• It is decision support for your stewardship team, not a substitute for clinical judgment. Flags are prompts for review, and each recommendation is made by a clinician.
• Flags depend on timely, complete order, administration and microbiology feeds. Delayed or missing results mean delayed or missing flags.
• It does not submit to NHSN itself. Your team reviews and uploads the AUR files it prepares.
• Review rules reflect your local guidelines, which your program sets and maintains; the Tracker does not supply treatment guidelines.
• It is designed for inpatient and hospital-based programs. Outpatient and long-term care stewardship are not included.
• It is not a laboratory information system or an infection surveillance system, although it uses and shares their data.
• Published antibiograms are your microbiology and pharmacy teams' responsibility; the Tracker prepares the data for their review.

Next steps

Book a demonstration or a technical briefing at www.moraph.com/solutions/antibiotic-stewardship-tracker. Purchasing routes and company information: www.moraph.com/how-to-buy.