Frequently Asked Questions

Can you describe how your TeleStewardship® service works?

Our TeleStewardship® service allows rural healthcare facilities to have access to Infectious Disease specialists and fulfills the antimicrobial stewardship requirements put forth by both CMS and The Joint Commission. One of the major interventions which improves antibiotic use is “prospective audit with feedback” which involves external reviews of antibiotic therapy by an expert. We will train pharmacists working at your facility to conduct “audits” by reviewing patients that are receiving antibiotics and identifying patients which may be receiving antibiotics incorrectly. At a scheduled time, your pharmacist will discuss these patients with our Infectious Disease Physician by video-conference. If a patient is in need of an intervention, we will call and discuss the case with the patient’s provider.

Does your service replace an Infectious Disease consult?

Antimicrobial Stewardship has very clearly shown multiple benefits, including improving patient care and reducing hospital costs. Antimicrobial stewardship, however, does not replace an Infectious Disease consult, and for some patients we will recommend an ID consult.  We will not contact providers if an Infectious Disease physician has been consulted.  Our services support local ID physicians (if available) and can have the effect of increasing ID consults, with the goal of improving patient care.

Is a stewardship note placed in the chart?

Our primary goal is to help support the correct use of antibiotics by providing education regarding antibiotics and infectious diseases. We do not place notes in the chart because we don’t want providers to worry that we are questioning/contradicting their judgement. We want rural providers to understand that they are not alone; we are available to answer questions about antibiotics and help with Infectious Disease Society of America (IDSA) guidelines and practice.  Providers in rural areas often lack support of specialists and can feel alone. We are here to help.

We don’t have dedicated pharmacist - can you perform the patient audits for our hospital?

We don’t perform daily audits, we educate/train your pharmacists and work with them as frequently as needed so they will be able to identify patients that require an intervention. We work with a friendly and knowledgeable Professor of Pharmacy that has been actively teaching pharmacists for many years. He will give a presentation by video-conference regarding the most common antibiotic mistakes and what to look for, and from there much of the training is in our scheduled stewardship meetings while we discuss patients. We are more than happy to give lectures on any topic if you would like to hear more.  We don’t charge a fee for a clinical pharmacist, and we provide your pharmacist training free of cost.

How many hours a year would your ID doctor spend with our hospital?

We don’t track our working hours because we don’t charge your hospital hourly. We encourage your hospital to contact us as frequently as needed without fear of increasing your costs. We bill by the CMS projected costs for the size of your hospital, and the fee remains constant regardless of how often we are contacted. CMS estimates that for a 124 bed hospital an ID physician would spend 200 hours per year performing antimicrobial stewardship.

How frequently will you schedule to meet with our pharmacists?

We schedule dedicated stewardship time to work with your pharmacists to discuss your patients.  The number of patients at your facility, and the level of stewardship training of your pharmacists are factors that determine how frequently we will meet to discuss patients.  In the beginning we will meet frequently for training/education, and as your pharmacy staff becomes more comfortable we may not need to meet as regularly. However, we meet as often as needed depending on your pharmacist’s comfort-level.

How many hours does CMS predict a clinical pharmacist would spend a year on antimicrobial stewardship?

CMS predicts a clinical pharmacist would spend 500 hours a year performing antimicrobial stewardship for a 124-bed hospital.

Can our pharmacists contact your ID physicians 24/7?

The goal of antimicrobial stewardship is to focus on the correct use of antibiotics, and the faster patients are on the correct antibiotics the better the patient outcomes are for your hospital.  Your pharmacists can contact us 24 hours a day, 7 days a week.

If we have most of the components of a stewardship team, but we are lacking a data analyst, can you provide only the data analyst component?

Yes. We will provide your hospital with our data sheets to collect the needed information and we will provide the data analyst component

If we asked you to start at our hospital, how long would it take you to begin?

We can begin in 30-90 days.

How much would your services cost for a facility of our size?

We are by far the lowest cost option available and cheaper than starting your own program. CMS has released an estimated cost of what they believe it takes to run a stewardship program. The CMS estimated cost includes the cost for an ID physician, clinical pharmacist, and network data analyst. We use the CMS formula, however we don’t include the cost for a clinical pharmacist (since we will be working with your pharmacists). We also provide your pharmacists training at no costs. Stewardship programs will often pay for themselves, both through savings in both antibiotic expenditures and indirect costs.