CAVSNET Overview

CAVSNET can increase the value of any EHR system by providing the capability for participating clinics to track their own practice data, benchmark practices against those of other clinics, and contribute to disease surveillance that benefits animal health and the entire veterinary community. The CAVSNET system overcomes the barriers of clinic ownership, geographic location, varied software systems, and facility technical expertise and capacity to collect data from diverse veterinary clinics with minimal resource investment. Incorporation of CAVSNET provides EHR systems with the value-added ability to track, benchmark, and set goals for only the expense of the programming time that it takes to become CAVSNET-compatible.

In the U.S., no national or state-level programs are in place to track companion animal disease, despite the positive impact that such surveillance might have on animal health, and the importance of these species to human health and wellbeing. CAVSNET takes a step toward filling this gap, and CAVSNET partners will be recognized for their contributions to the broad mission of improving animal health and advancing the veterinary profession. Additionally, should reporting of practice (e.g., antibiotic prescribing) or animal disease be mandated in the future, CAVSNET-capable EHR systems will likely be well-positioned to meet those requirements.

Antibiotics are critical for medicine, but the problem of antimicrobial resistance threatens the effectiveness of these valuable drugs. Widespread use of antibiotics is a major driver of resistance, because bacteria adapt over time to evade antibiotic effects. In human and animal health settings, the problem of antimicrobial resistance has led to infections that are more difficult to treat. The Centers for Disease Control and Prevention and the World Health Organization have identified essential strategies to combat antimicrobial resistance, including improvement of how antibiotics are used (antimicrobial stewardship). Measurement and tracking of antimicrobial use and resistant organisms is critical to our ability to practice antimicrobial stewardship. In the U.S., no national or state-level programs are in place to track antimicrobial use in companion animals, despite the acknowledged importance of this sector to both the antimicrobial resistance problem and the solution of antimicrobial stewardship.

The CAVSNET and point prevalence survey approaches allows us to overcome barriers to antimicrobial use and resistance tracking, including information technology challenges, human resource constraints, lack of standardized clinical and laboratory documentation, and nascent awareness of antimicrobial stewardship in clinical practice.

Individual clinics and clinic groups participating in CAVSNET can view their own data (e.g., diagnoses, prescribing, patient demographics), access benchmarking metrics showing how their practices compare to those of others, and set targets for practice initiatives. In a March 2018 survey of Minnesota veterinarians, 85% of respondents agreed that benchmarking against anonymized peers would be useful. In addition to these individual benefits, CAVSNET provides valuable near real-time information to the wider veterinary profession about companion animal disease. Clinicians and other animal health professionals can use the CAVSNET website to visualize syndromic (e.g., gastrointestinal, respiratory) and disease-specific (e.g., multidrug-resistant infection) incidence data in their area. This information provides situational awareness and empowers clinicians to use data to communicate the importance of disease prevention to pet owners.

Antimicrobial use data acquired through CAVSNET can be used to support antimicrobial stewardship action in individual veterinary practices. For example, antibiotic drug class data can be used to track the impact of efforts to align empiric prescribing with recommendations for first-line antibiotic use.Benchmarking of antimicrobial use in comparison to anonymized peers can help clinics to identify areas where they might be able to improve prescribing practice. CAVSNET antimicrobial use data can be analyzed by drug class, route (e.g., oral, topical), priority (WHO: Highest Priority Critically Important Antibiotics), and species. An example report can be downloaded at SAVSNET: mySAVSNET AMR example feedback report.

In addition to individual clinic access to their antimicrobial use and disease data for internal tracking and external benchmarking, the CAVSNET Team will develop aggregate summaries of antimicrobial use, antimicrobial resistance, and related clinical practices, and is developing resources and tools to support antimicrobial resistance programs in companion animal clinics. These resources will be freely available on a veterinary antimicrobial stewardship website and will be distributed at professional conferences and meetings and through professional groups. By compiling aggregate antimicrobial use and antimicrobial resistance data summaries, CAVSNET will help define baseline practice and measure antimicrobial stewardship progress of the profession over time.

De-identified data will also be used to guide U.S. research and veterinary priorities in the areas of antimicrobial stewardship, antimicrobial use, and antimicrobial resistance. SAVSNET has harnessed U.K. data to describe how antibiotics are used and to identify opportunities for improvement.