MDRO Xchange: Reducing Interfacility MDRO Transmission Through Data Exchange

MDRO Xchange improves clinical decision-making and infection-prevention workflows, strengthening prevention of antibiotic-resistant infections and disease surveillance.

When patients transfer between hospitals and long-term care facilities, critical infection information often doesn't follow them. MDRO Xchange closes this gap.

By securely sharing patient multidrug-resistant organism (MDRO) status at admission or transfer, the platform helps facilities take steps to prevent transmission, strengthening protection for patients, staff, and communities.

MDRO Xchange is Altarum's antimicrobial resistance surveillance platform that connects public health agencies, hospitals, long-term care facilities, and other care settings in near real-time. The system alerts facilities to a patient’s MDRO status at admission or transfer, enabling the timely deployment of appropriate infection-prevention measures.

The Growing Threat of MDROs

MDROs remain an urgent public health challenge:

  • 2.8 million antimicrobial-resistant infections occur annually in the U.S.1
  • More than 35,000 deaths each year are directly attributed to antimicrobial-resistant infections. Some estimates suggest this could exceed 150,000 deaths when accounting for all MDRO-related mortality.2,3
  • Approximately 1 in 10 inpatient hospital stays with bacterial infection shows evidence of one or more MDROs.4
  • Candida auris continues to surge, with at least 90% of isolates resistant to at least one antifungal.5

Because patients frequently move across care settings, communication between facilities is often incomplete. As a result, MDROs can spread before anyone knows to take precautions. MDRO Xchange closes this gap by facilitating the exchange of MDRO status between facilities, laboratories, and public health.

Notification of MDRO Status on Arrival

Developed by Altarum in collaboration with the Orange County Health Care Agency (OCHCA), MDRO Xchange is a patient-centric data exchange that enables facilities to identify a patient’s MDRO status before or at arrival, ensuring appropriate precautions can be taken to prevent transmission.

How Are Facilities Notified?

  1. Upload: Facilities upload patient admission or census lists automatically via integration with EHRs or manually via flat file.
  2. Match: MDRO Xchange uses a finely tuned matching algorithm to identify patients with a known MDRO history.
  3. Alert: Staff receive near real-time, secure alerts with actionable information.

This timely information supports safer transitions, helps prevent inadvertent exposure, and strengthens infection-prevention workflows across care environments. In addition to hospitals and long-term care, the platform can support ambulance services, PACE (Program of All-Inclusive Care for the Elderly) centers, and dialysis centers, improving visibility of healthcare-associated infections (HAI) across the care continuum.

Proven Impact in Orange County

Altarum and OCHCA launched MDRO Xchange in December 2024, and it has already demonstrated measurable value for a county of 3.2 million residents.

As of January 2026, 19 facilities, including major health systems and long-term care providers, have workflow-friendly access to patient MDRO status during admissions, transfers, and daily operations. These facilities report receiving information about MDRO status that they would have otherwise missed, illustrating MDRO Xchange’s role in supporting HAI prevention.

Built for Interoperability & Data Modernization

MDRO Xchange supports national data exchange standards, including HL7v2, eCR, and FHIR, enabling direct connection with EHRs, laboratories, surveillance systems, and public health data pipelines. The initial Orange County implementation leverages existing data flows for reportable conditions, allowing deployment without extensive onboarding for each facility.

MDRO Xchange is purpose-built to exchange data related to multidrug-resistant organisms, including Candida auris (C. auris), carbapenemase-producing organisms (CPO) and vancomycin-resistant Enterococcus (VRE). It can be easily customized to add new conditions.

The system is built on a modern, cloud-based architecture aligning with CDC's Data Modernization Initiative, helping jurisdictions produce faster, more actionable insights for infection prevention and response.

Why Altarum?

Altarum has partnered with public health agencies for more than two decades to strengthen disease surveillance, epidemiology, and population health response. Our approach emphasizes:

  • Human-centered design that supports real-world clinical and public-health workflows
  • Security and compliance built into every layer
  • Seamless interoperability with provider, laboratory, and public health systems
  • Scalable solutions that can expand statewide or nationwide

We are committed to building modern, resilient public health IT systems that accelerate early detection, reduce disease transmission, and support frontline infection-prevention workforces.

Request a Demo or Learn More

If you would like more information about MDRO Xchange or are interested in a demonstration, please contact Cecilia Kretz, Vice President of Growth at cecilia.kretz@altarum.org. 

 

1 Centers for Disease Control and Prevention. (2019). Antibiotic Resistance Threats in the United States, 2019. Atlanta, GA: U.S. Department of Health and Human Services, CDC. https://www.cdc.gov/drugresistance/biggest-threats.html

2 Centers for Disease Control and Prevention. (2024). Antimicrobial Resistance Facts and Stats. https://www.cdc.gov/antimicrobial-resistance/data-research/facts-stats/index.html

3 Burnham, J.P., Olsen, M.A., & Kollef, M.H. (2019). Re-estimating annual deaths due to multidrug-resistant organism infections. Infection Control & Hospital Epidemiology 40(1) 112-113. https://doi.org/10.1017/ice.2018.304

4 Johnston, K.J., Thorpe, K.E., Jacob, J.T., & Murphy, D.J. (2019). The incremental cost of infections associated with multidrug-resistant organisms in the inpatient hospital setting—A national estimate. Health Services Research, 54(4), 782-792. https://doi.org/10.1111/1475-6773.13135

5 Bhargava, A., Klamer, K., Sharma, M., Ortiz, D., & Saravolatz, L. (2025). Candida auris: A Continuing Threat. Microorganisms, 13(3), 652. https://doi.org/10.3390/microorganisms13030652

Focus Areas

Public Health Information Technology

FAQs

1. What is MDRO Xchange?

MDRO Xchange is a near real-time antimicrobial-resistance data exchange platform that alerts hospitals, long-term care facilities, and public health agencies when patients with MDRO history are admitted or transferred.

2. How does MDRO Xchange help prevent spread during patient transfers?

Facilities receive alerts when a patient with a known MDRO history is identified, allowing staff to take appropriate precautions before exposure occurs.

3. What systems can MDRO Xchange connect with?

MDRO Xchange connects with EHRs, laboratory information systems, public health surveillance platforms, and health information exchanges through HL7v2 ELR, electronic case reporting, and FHIR standards.

4. Who can benefit from MDRO Xchange?

The platform supports hospitals, long-term care facilities, skilled nursing facilities, ambulance services, dialysis centers, PACE centers, and public health agencies, improving infection-control visibility across the care continuum.

Focus Areas

Public Health Information Technology