Why hospitals need more digital preoperative assessment pathways


18 August 2022

Superbug MRSA (Methicillin-Resistant Staphylococcus Aureus) continues to cause significant morbidity and mortality worldwide, putting patients at risk and placing an onerous burden on healthcare. MRSA currently results in close to 18 000 deaths annually in the US1. People with nasal MRSA are 22 times more likely to develop an invasive infection and 36 times more likely to develop bacteremia in their bloodstream2. One solution could be remote screening and home treatment to eradicate MRSA prior to surgery. This could reduce the risk of hospital acquired infections, save lives and save the economy a fortune.

Why is it a problem when preoperative testing takes place too close to the time of surgery?

Patients who screen positive at admission won’t have time to eradicate MRSA, causing last-minute cancellation of surgery slots. Cancellations on the day of surgery are a major issue in healthcare systems, so remote MRSA screening and treatment would improve the use of operating rooms. If you can identify patients who are at risk of their surgery being cancelled much sooner, hospitals can increase patient throughput and ensure that every operation stands the best possible chance of going ahead as scheduled.

How could remote preoperative testing save hospitals and the broader economy money?

Remote preoperative testing could save hospitals and the wider economy a fortune. Medicare penalties for MRSA infections can cost hospitals hundreds of millions3. In the US, the lowest-performing 25% of hospitals who fail to prevent avoidable infections, including MRSA, are penalised by losing 1% of their Medicare payments. There’s also a cost to the wider economy - each year MRSA costs third-party payers, such as insurance companies, employers, and government agencies, $478 million-2.2 billion4. There is a massive cost to treating hospitalized MRSA patients, totalling $3.2 billion- $4.2 billion5. It leads to 2.7 million additional days in hospital, US$ 9.5 billion excess costs and at least 12 000 in-patient deaths6.

Remote pre-operative MRSA screening and decolonization improves operating room utilization and decreases cancelled surgeries.

Dangers of face-to-face MRSA screening 

It is critical hospitals minimize the number of face-to-face appointments and start implementing more digital pre-surgery pathways. Bringing in Covid-19 positive or MRSA colonized patients will increase the risk of shedding into the environment. Remote testing would avert any contact between potentially infectious patients and healthcare professionals, thus minimizing the risk of transmission and avoiding costly outbreaks. The swabbing procedure is simple and patients can do it easily at home, reducing unnecessary hospital appointments and freeing up time for healthcare professionals.

Certific’s technology can also help hospitals increase the number of virtual solutions available to patients and reduce the burden on healthcare systems that are already operating close to their maximum capacity.

Combining screening with technology and remote testing

Certific has launched a novel preoperative remote test-to-treat service to reduce the substantial clinical burden of MRSA, with tests conducted to medical standards. This means higher compliance rates so hospitals can minimise the risk of MRSA infections which are expensive to treat and possibly litigate. Certific’s technology can also help hospitals increase the number of virtual solutions available to patients and reduce the burden on healthcare systems that are already operating close to their maximum capacity. Hospitals that opt not to offer remote screening and treatment should expect to incur significantly higher costs due to MRSA infections.

Learn more about Certific's remote pre-oprative assesment & screening service!


  1. Morgenstern, M., Erichsen, C., Hackl, S., Mily, J., Militz, M., Friederichs, J., Hungerer, S., Bühren, V., Moriarty, T.F., Post, V. and Richards, R.G., 2016. Antibiotic resistance of commensal Staphylococcus aureus and coagulase-negative staphylococci in an international cohort of surgeons: a prospective point-prevalence study. PloS one, 11(2), p.e0148437.
  2. Hassoun, A., Linden, P.K. and Friedman, B., 2017. Incidence, prevalence, and management of MRSA bacteremia across patient populations—a review of recent developments in MRSA management and treatment. Critical care, 21(1), pp.1-10.
  3. Sannazzaro, A., 2015. MRSA: the superbug poised to cost hospitals super sums. Infection Control Today.
  4. Lee, B.Y., Singh, A., David, M.Z., Bartsch, S.M., Slayton, R.B., Huang, S.S., Zimmer, S.M., Potter, M.A., Macal, C.M., Lauderdale, D.S. and Miller, L.G., 2013. The economic burden of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA). Clinical Microbiology and Infection, 19(6), pp.528-536.
  5. Rojas, E. and Liu, L., 2005, May. Estimating the annual hospital excess cost of methicillin-resistant Staphylococcus aureus infections in the United States. In International Society for Pharmacoeconomics and Outcomes Research (IPSOR) Tenth Annual International Meeting, Washington, DC.
  6. Noskin, G.A., Rubin, R.J., Schentag, J.J., Kluytmans, J., Hedblom, E.C., Smulders, M., Lapetina, E. and Gemmen, E., 2005. The burden of Staphylococcus aureus infections on hospitals in the United States: an analysis of the 2000 and 2001 Nationwide Inpatient Sample Database. Archives of internal medicine, 165(15), pp.1756-1761.