A systematic review of digital healthcare associated infection surveillance methods - comparisons and considerations...

Surveillance of healthcare associated infections is core to infection prevention and control however traditional methods are manual and resource intensive. Digital solutions may reduce workload and improve responsiveness, but design elements and their impact remain poorly understood. This review aimed to identify clinical and technical design elements used in digital surveillance solutions and associated impacts.

A systematic search identified original research describing digital healthcare associated infection (HAI) surveillance in hospitals. Studies were included if they incorporated at least one digital element fully developed at time of publication. Data on study characteristics, system features, implementation and outcomes were extracted and a narrative synthesis conducted, with findings mapped to the research questions.

Forty-seven studies met the eligibility criteria, most were from Europe (n=28) or the USA (n=10). Design elements were commonly associated with detection, validation, automation and data integration. Digital systems were predominantly internally developed and government funded. HAI outcome reporting was heterogeneous, with limited evaluation of patient impact, implementation or sustainability. System integration into routine clinical practice was rarely described.

This review identified considerable variation in the clinical and technical design of digital HAI surveillance systems, with limited evidence of integration into clinical practice. While some studies reported improved surveillance efficiency, the absence of patient, quality and safety outcomes means it remains unclear which design approaches deliver the greatest clinical value. Future research should prioritise implementation, clinical integration and patient-centred outcomes to identify digital surveillance designs most likely to improve infection prevention practice and patient care.