Healthcare facilities such as hospitals, nursing homes and surgery centers can look to DIATHERIX's diagnostic services to find solutions on how to:
Improving patient outcomes, reducing unnecessary costs and de-escalating drug therapies
By accurately identifying disease-producing pathogens early, our results can assist healthcare professionals in forming a more accurate diagnosis. This gives them the opportunity to use the diagnosis to determine the appropriate treatment rather than treating empirically. By enabling care givers to link diagnostics to therapeutics, DIATHERIX results can help get patients out of an acute care status and on the road to recovery in less time and without unnecessary treatments.
The following true story is an excellent example which came to us from the Chief of Surgery of a critical access hospital:
A 19 year old male presented to the ER without any significant previous medical history complaining about a painful lump in the left groin area. He was diagnosed with an ingrown hair, the area was incised and drained and the patient was discharged with a cephalosporin antibiotic. The next day the patient was readmitted with abdominal wall cellulitis involving his left abdomen and flank. The patient was started on broad spectrum antibiotics vancomycin, clindamycin and penicillin and a specimen was collected from the prior incision site and sent to Diatherix. The area of cellulitis was marked, but by the next morning it had advanced to the level of the patient's axilla. Since there was concern that this was a necrotizing soft tissue infection, the patient was taken to the OR for exploration and possible debridement. However, just before going into the OR, the Diatherix results returned stating the detection of MRSA, PVL gene and genetic drug resistances to cephalosporin and methicillin. Having these results before going into the OR allowed the physician to confidently make the decision to make two small incisions for drainage and lavage, rather than debriding the patient's abdominal wall. The physician also stopped the other two IV antibiotics and kept the patient solely on vancomycin. The patient did well and was discharged on post op day 4 with oral erythromycin and went on to make a full recovery. As a side note, the patient did not have health insurance. The Diatherix results allowed the physician to decrease the number of IV antibiotics and to discharge him before definitive results from a standard culture would have come back.
This true story illustrates the positive impact that DIATHERIX can have on patient outcomes and costs, including a reduction in the number of broad-spectrum antibiotics used. Broad-spectrum antibiotics can disrupt normal intestinal flora, leading to an overgrowth of C. difficile that may cause pseudomembranous colitis, therefore a reduction in both the number of antibiotics used and the time spent on antibiotics may reduce the occurrence of this increasingly prevalent condition. Reducing the use of antibiotics also gives pathogens less chance to develop resistance to the antibiotics. In a study with positive blood cultures at a large hospital, Tem-PCR provided information to justify de-escalation of antimicrobial therapy in 28% of the patients. By helping to slow the rising tide of antibiotic resistant pathogens, more time is made available to develop effective treatments against these superbugs.
Monitor for healthcare-associated infections
Given the current regulations in place regarding healthcare-associated infections, many healthcare facilities risk an unnecessary decline in reimbursement if effective identification and monitoring programs are not in place. By offering panels that cover a large number of pathogens, most notably MRSA and C.difficile, DIATHERIX can be a valuable asset for pre-admission and/or pre-surgical testing, in addition to regular inpatient testing. Our results are timely and accurate, permitting appropriate action to be taken to reduce the risk of spreading infection and lower length of stay. Another benefit of our Tem-PCR testing technology is that it accurately detects pathogens even in the presence of antibiotics. By identifying patients carrying infectious pathogens with the DIATHERIX test panels, healthcare facilities are enabled to both improve patient outcomes and preserve revenue.
Achieve correct reimbursements for complex pneumonias
Complex pneumonias represent a major cost and reimbursement concern for hospitals because often physicians and billing coders do not receive adequate and/or timely laboratory results. For the hospital to more effectively and accurately confirm a physician's diagnosis (ICD-9), laboratory testing must confirm the physician's diagnosis according to CMS coding guidelines. However, in some cases the microbiology laboratory does not have the tools to identify all possible pathogens required to confirm diagnoses, forcing hospitals to accept reimbursement for non-complex instead of complex pneumonias. The Respiratory Infections Panel offered by DIATHERIX offers timely and accurate results that can identify up to 23 different respiratory pathogens.
Identifying patients with pandemic pathogens
The DIATHERIX Tem-PCR technology permits us to accomplish significant goals when a new pandemic arises such as H1N1-09. First, we can quickly develop testing for the new pathogen. Once the genetic sequence of the pathogen is placed in a public database, we can isolate a section of the genome that is unique to that pathogen and quickly develop a target to use for identification. For example, DIATHERIX validated and began testing for the H1N1-09 virus within a few weeks of the initial outbreak of the new strain of influenza in spring 2009. Second, we can add the new test target to the appropriate pre-existing panel. This ability allows for the detection of other disease-causing pathogens and coinfections in conjunction with the pandemic pathogen. Coinfection in future pandemics may be as significant as it has been with H1N1-09. At the end of October 2009, DIATHERIX did an analysis of the more than 10,500 specimens we had tested for the H1N1-09 virus using the Respiratory Infections Panel. Of the 3,110 H1N1-09 positive specimens, 28% were found to have at least one other pathogen present in the specimen. It has been shown with autopsy studies from this and other influenza A pandemics that there is a link between viral influenza infection and secondary bacterial infection and increased mortality.