Infection Control and Antimicrobial Stewardship at Scale in Africa

Dr Darryl Vine1

1Medical Director, Intelligent Medical Systems (Pty) LTD, South Africa,


Introduction: Eight years ago, gram-negative Carbapenem resistance was identified as a major threat to patient safety across Southern Africa. Groundbreaking antimicrobial stewardship (AMS) work had been done but it was recognised that an integrated, electronic, infection control and AMS system was critical to further improve patient safety.

This presentation describes the methods used to plan and fine-tune system design, and the lessons learnt in the rollout of this solution to 72 hospitals across Southern Africa.

Methods: Existing infection control and AMS strengths and weaknesses across a large hospital group were critically investigated and analysed and initial decisions made. While the IT platform was being further developed, the investigative net was cast globally and hospitals in the UK, Australia, Canada and the United States were visited, often multiple times. Ideas were bought back home, implemented and tested by 2000 users across multiple iterations.

Results: Metrics were developed to accurately determine infection rates and to measure appropriate antimicrobial use and to report thereon. Workflow and clinical efficiency were standardised. Unique tools to focus on at-risk patients were developed and tested.

Conclusion: Over 8 years a unique, cloud-based, integrated infection control and AMS system has been researched, developed, tested and fine-tuned over multiple iterations across a large diverse group of hospitals. The solution is scalable, applicable to hospitals of all sizes and requires minimal hospital IT resources. The latest hospital to go live dropped their days of antibiotic therapy by 50% over the first 5 months.


Dr. Vine’s lifetime passion has been the development of systems that improve clinical efficiency and patient safety.

Canadian/South African OBGYN – Member Royal College of Surgeons of Canada. Multiple academic papers and prizes focussed on clinical metrics and improving clinical efficiency. In 1993 designed and implemented an EMR which is still in daily use. In 1995 designed and implemented one of the world’s first clinical data hubs allowing the secure transmission of lab results to medical practices.

1999 Founder and CEO of Intelligent Medical Systems (Pty) Ltd. On the back of that success was invited to present to the American College of Family Practitioners in 2005. In 2007 designed and implemented one of the first integrated RIS / PACS systems – see

Since 2011 his time has been dedicated to finding practical solutions to antimicrobial resistance in hospitals.

Those efforts resulted in Bluebird, a standardized, cloud based, integrated, infection control and antimicrobial stewardship system now used by more than 60 large hospitals and more than 130 ICU’s, including the largest in the Southern Hemisphere.

He tweets about Infection Control and Stewardship @EasyASP

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