Antibiotic Stewardship Tracker

The Antibiotic Stewardship Tracker compares antibiotic orders with culture and susceptibility results, and puts the patients who may need a change of therapy in front of your stewardship pharmacists and physicians. Recommendations to prescribers, their responses and the reasons are recorded in one place. Use and resistance data are summarized by unit and prescriber for your stewardship committee and prepared for your NHSN reporting.

The problem it solves

Stewardship teams usually find their patients by running EHR reports each morning, cross-checking microbiology results by hand and keeping interventions in a spreadsheet. Bug-drug mismatches and long courses of empiric therapy can be missed between reports, recommendations to prescribers are made by phone or page and rarely recorded consistently, and when a surveyor or the committee asks what the program achieved, someone assembles the numbers by hand.

Who it’s for

• 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

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

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.

Stewardship pharmacist

Works the review queue, makes and records recommendations, and handles restricted-agent requests

Physician lead

Leads the program, reviews complex patients, approves rules and restricted agents, and sees all reporting

Prescriber

Sees recommendations for their patients and records a response, where your organization enables it

Microbiology

Reviews susceptibility data and the cumulative antibiogram before it is published

Infection preventionist

Views resistance patterns and organisms of concern alongside stewardship data

Surveyor or auditor (read-only)

Views program records, reports and the audit trail, with no ability to change them

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.

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.

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.

Interface build

We connect to your EHR, laboratory and pharmacy systems and map orders, administrations and results. We need interface specifications and a contact from your integration team.

Rules and guidelines

Review rules, restricted agents and time-out points are configured to your local guidelines with your physician lead and stewardship pharmacists, and each rule is documented.

Validation against history

Rules are run against a period of past data and the flagged patients reviewed with your team before any rule is switched on.

Measures and AUR

Days of therapy and AUR location mapping are set up and checked against your existing figures with your NHSN users.

Workflow and roles

Queues, intervention types, response reasons, approval steps and roles are configured to match your program's procedures.

Training and go-live

Pharmacists, physicians and committee users are trained on their own workflows, and existing intervention records can be imported by agreement.

• 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.

• Run the review rules against a sample of your own de-identified orders and cultures and compare the flags with what your team found
• Ask a stewardship pharmacist to work a flag from queue to recorded intervention
• Check that days of therapy match the figures you currently report
• Review the AUR file preparation with your NHSN users
• Walk through a restricted-agent request and its follow-up review
• Confirm role separation: who can change rules, approve restricted agents and see which patients