Introduction

The DebugIT project is a large -scale integrating project funded within the 7th EU Framework Programme (FP7). The main objectives are to build IT tools that should have significant impacts for the monitoring and control of infectious diseases and antimicrobial resistances in Europe. This will be realized by building a technical and semantic infrastructure able to

a) share heterogeneous clinical data sets from different hospitals in different countries, with different languages and legislations,
b) analyze large amounts of this clinical data with advanced multimedia data mining, and
c) apply the obtained knowledge for clinical decisions and outcome monitoring.

 

Overview

After half a century of antibiotic use, medicine is facing an unexpected and increasingly critical challenge. Following the initial remarkable success of antibiotics, the emergence and spread of human pathogenic bacteria resistant to antibiotics has become a major phenomenon in the past decade.1

This is a particular cause for concern since the arrival of innovative classes of antibiotics has considerably slowed down in the past years. The impact of this phenomenon is most apparent in hospitals. However, community-based practice is not immune due to the increasing number and rapidity of exchanges between the two sectors. Hence, epidemics are a regular occurrence and may spread between continents, such as the methicillin-resistant Staphylococcus aureus several years ago or, more recently, vancomycin-resistant Enterococci or tuberculosis.2

Our vision of patient safety is to improve the overall quality and economic efficiency of care across the whole health value system. This implies attention to disease prevention and personal and societal risk assessment. There is a need for optimising medical interventions, personalised and continuing care, clinical research and training and education.

Real world examples include

  • Computerised Physician Order Entry (CPOE) systems, integrated with e.g. drug data bases and/or clinical decision support systems,
  • Adverse Drug Event (ADE) reporting solutions, and hospital-wide Clinical Information Systems (CIS), Health Database Systems (HDBS), or Electronic Health Record Systems (EHRS), and
  • Integration of knowledge translation and decision support into hospital and GP practice systems.

 

Overriding topic

The DebugIT project, with its innovative approach, is a prime example of how ICT tools can be used to address the emerging challenges in healthcare. The DebugIT project addresses several of the overriding call topics at once by tackling the problems around antibiotics and of antimicrobial resistance of infectious diseases in an international consortium uniting world class research facilities, SMEs and industry partners.

It is an example of partnering at the European level to keep pace with soaring research costs by making use of complex IT technology technologies. It addresses the main socio-economic challenge in healthcare, namely to make Europe's healthcare systems safer and sustainable.

The research consortium includes public and private research institutions, university and teaching hospitals, industry and SMEs. The results of the application of the RTD will lead to higher patient safety and thereby fewer, more targeted intervention and fewer days in hospital. It means improving the overall productivity and efficiency of healthcare systems, delivering more personalised care solutions by allowing the actual patient data to be fed immediately into the system. It will therefore improving the Qquality of Life for patients and save their lives due to better, shorter and more targeted treatment. Patient safety is optimised through medical interventions with respect to treatment of infectious diseases and prescribing and administering antibiotics. The decision support will help avoid medical and other healthcare errors.

 

Specific topic

The data repository component of the support system allows for the identification of common patterns in safety-relevant events. This works beyond merely reporting nosocomial infections and/or Adverse Drug Events (ADE). It represents a knowledge base which will be constantly fed with new information, because the results observed from the application of the decision support system are coming back into the data mining engine. It is thus an example of an alerting and management support system which incorporates new tools for prediction, detection and monitoring of events impacting on patient safety. DebugIT makes full use of emerging technologies like semantic mining and semantic information integration and will develop a validation scheme leading to quantitative clinical as well as socio-economic benefits.

DebugIT will contribute to achieving world-leading levels of patient safety with fewer medical errors and optimised medical interventions resulting in the saving of lives and built up resources. The learn-predict-prevent approach embodied in the knowledge base and the decision support system of DebugIT will contribute to effective and automated risk prediction.

 

  1. On this see also the DG SANCO supported research project Improving Patient Safety in Europe (IPSE). It focuses on nosocomial infections and antimicrobial resistance, and aims to resolve persisting differences in the variability of preventive practices and outcomes with respect to antibiotic resistance in Europe. See their annual report at: http://helics.univ-lyon1.fr/deliverables/IPSE_Annual_Report_2005_25oct06.pdf:
  2. Cf. Tackling tuberculosis - Forgotten, but not gone, in: The Economist, March 24th 2007: http://www.economist.com/science/displaystory.cfm?story_id=8909008