Congress Seeks to Boost Hospital Reporting of Antibiotic Use
Improved tracking would protect patient health and help stem the rise of superbugs
Congress has provided $21 million in fiscal year 2020 funding to drive efforts to increase hospital reporting of antibiotic use and resistance to the U.S. Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN).
With a final vote in the Senate on Dec. 19, lawmakers provided the same amount as in fiscal 2019 for this critical health care-associated infection tracking system. The money is part of the appropriations legislation for the Departments of Labor, Health and Human Services, and Education and Related Agencies (LHHS).
The CDC has said that reporting antibiotic use into NHSN is fundamental to effective stewardship programs, which are designed to ensure antibiotics are used only when needed and prescribed at the proper dose for the right duration. However, according to the agency, fewer than 20 percent of hospitals nationwide were reporting antibiotic use into NHSN as of July 2019.
What is the National Healthcare Safety Network?
NHSN is a tool that hospitals can use to track and report antibiotic use, compare their use against that of other hospitals, detect areas where interventions may be needed to reduce inappropriate prescribing, and measure how well such interventions are working. Widespread reporting of antibiotic use data to the network also helps public health agencies identify inappropriate prescribing patterns at the national, state, and local levels and develop strategies to improve prescribing and combat resistance.
Coordinated federal action needed to increase reporting
Hospitals—particularly smaller ones, those with limited resources, and those in rural areas—have faced barriers in reporting their antibiotic use to NHSN. For example, the changes needed to electronic health records (EHRs) to automatically collect and submit this data are costly. Many hospitals also lack dedicated funding, staff time, and expertise to validate and interpret NHSN data to inform stewardship activities effectively. Congressional appropriations for the network will enable CDC to provide the critical technical assistance and resource support these hospitals need to report antibiotic use and improve their stewardship programs.
Encouragingly, along with the appropriation, Congress directed CDC to collaborate with the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information and Technology (ONC) to develop and implement a multiyear strategy to increase antibiotic use reporting to the safety network. This is an important step and should be followed by additional actions, including:
- CMS should require antibiotic use reporting to NHSN through existing regulatory programs for acute care hospitals.
- CDC should continue demonstrating to hospitals how NHSN antibiotic use reports can be interpreted and applied to inform stewardship activities.
- CDC and CMS should consider grants to regional stakeholders that could provide financial support and technical assistance to help facilities in reporting antibiotic use to NHSN.
- Congress should consider the assessment that CDC, CMS, and ONC are expected to produce within the next year that identifies the additional resources needed to increase hospital antibiotic use reporting—and lawmakers should boost appropriations as necessary.
Pew commends Congress for taking concrete action to spur antibiotic use reporting to NHSN as part of lawmakers’ ongoing, bipartisan commitment to combating antibiotic-resistant bacteria. The 2020 funding is an important step toward successful antibiotic stewardship, and Pew will continue to collaborate with policymakers at all levels to drive progress in tackling this significant public health threat.
David Hyun, M.D., is a senior officer and Ariana Olshan is a senior associate with The Pew Charitable Trusts’ antibiotic resistance project.