Tele antimicrobial stewardship software and the telestewardship tools a remote program needs for every partner hospital
A remote stewardship team works through the partner hospital's EHR, a surveillance list and an antibiogram for each site. Here is the software each job needs, what the published programs used, and where the gaps usually are.
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Tele antimicrobial stewardship software is the set of tools a remote stewardship team uses to review patients, recommend changes and report results for hospitals it does not staff in person. In practice that is remote access to each partner's EHR with secure messaging, a daily list of patients on targeted antibiotics, a way to document interventions, NHSN antimicrobial use and resistance reporting, and a current antibiogram for every partner hospital. The first four usually come with the EHR or a surveillance platform. The antibiogram is the piece most programs still build by hand.
This guide is for the infectious diseases pharmacist or physician who runs, or is about to run, telestewardship for a group of small hospitals, and for the pharmacy director at a hub health system or private ID practice deciding what to buy. Program details below come from the published studies named inline.
Who runs tele antimicrobial stewardship
Three kinds of organization run these programs. An academic medical center or large health system covers its own small affiliates or contracted community hospitals. A private infectious diseases practice sells stewardship as a service. And telehealth companies add stewardship to remote pharmacy or ID consult services. The buyer on the other side is almost always a hospital under 100 beds that must meet the CMS stewardship condition of participation without an ID specialist on staff.
The models differ in how much work happens on site. In a fully remote program the off-site team does prospective audit and feedback and talks to local prescribers by phone, chat or chart notes. In an integrated model the remote experts meet the local pharmacists at least weekly, and local pharmacists do most of the daily work.
Two recent programs show what the work looks like. Ross and Chandorkar (Antimicrobial Stewardship and Healthcare Epidemiology, 2024) described a fully remote program run from the University of Minnesota Medical Center for two M Health Fairview hospitals with 21 and 49 beds. It was staffed with 0.5 FTE of ID pharmacist and 0.1 FTE of ID physician time, reviewed 2,249 patients and made 789 interventions in two years, with 85.6% accepted. Baus and colleagues (Open Forum Infectious Diseases, 2025) described UW Health's redesigned telestewardship offer in three tiers, Consultative, Partnership and Comprehensive, with data analysis and reporting from the middle tier up.
What software does a tele antimicrobial stewardship program need?
It needs five things: remote EHR access with secure messaging, a daily patient list, intervention documentation, NHSN AUR reporting, and an antibiogram for each partner. The table shows where each usually comes from and where programs run short.
The surveillance platforms are compared in Sentri7 vs TheraDoc vs VigiLanz, and the AUR vendors in NHSN AUR reporting software compared.
| Job | Usual tool | Who pays | Common gap |
|---|---|---|---|
| Chart access and messaging | Partner EHR remote login, secure chat | Partner hospital | A different EHR at every partner |
| Daily patient list | EHR report, or Sentri7, VigiLanz or TheraDoc | Partner or hub | Platform license per hospital |
| Intervention log | EHR note template or surveillance platform | Included | Monthly acceptance counts by hand |
| NHSN AUR files | Certified EHR or surveillance vendor | Partner hospital | Small EHRs rely on a partner product |
| Antibiogram per partner | Lab report and Excel, WHONET | Remote team's hours | Too few isolates, a new sheet per site |
Why the antibiogram is the weak point in remote programs
Every partner hospital needs its own antibiogram, because its prescribers choose empiric therapy from local resistance, not from the hub's. And almost no partner has enough isolates for a full one. A 25-bed critical access hospital reaches 30 isolates a year for E. coli and perhaps Staph aureus, and for little else, so the table needs pooled years, a pooled regional view, or both.
Data also comes from more places than the EHR. In the Minnesota program many microbiology tests from the two small sites were processed by the academic center's central lab. Other partners send cultures to a commercial reference lab. Each source exports a different file, so a remote team covering eight hospitals on three EHRs often keeps eight spreadsheets with eight versions of the counting rules.
That is where Antimicrobe fits. The remote team uploads each partner's susceptibility CSV into a facility workspace, the same CLSI M39 rules apply to every site (first isolate per patient, no percentage on fewer than 30 isolates, pooled years labeled), and the Network plan adds a pooled regional antibiogram across partners. One rule set, one place, a print page for each hospital's committee.
How thin small hospital data is handled is covered on critical access hospital antibiogram software, and pooling across sites in regional antibiogram software for health systems.
Partners on different EHRs
A hub on Epic can use Epic tools inside its own affiliates. The Minnesota program pulled restricted antimicrobial days of therapy from Epic's Bugsy module and used Epic note templates. But a contracted partner is often on a small hospital EHR such as MEDHOST, CPSI or Paragon, with its own reports and its own AUR route. The remote pharmacist then logs into a second or third system just to see the patient, and there is no common place to build the numbers.
A file-based antibiogram tool avoids that problem because it does not care which EHR produced the export. The rules live in the tool, so the report for a MEDHOST hospital and the report for an Epic affiliate are counted the same way.
Export notes per system are on MEDHOST antibiogram software, CPSI EHR antibiogram software and Paragon EHR antibiogram software.
How much does tele antimicrobial stewardship cost?
Telestewardship providers rarely publish fees, so expect a quote per partner hospital, usually priced on the ID pharmacist and physician time involved. Baus and colleagues note that physician time is the most expensive part of the service and that savings typically take one to two years to show. The Minnesota program reported antimicrobial spending per patient day falling 64.8% at the 21-bed site and 52% at the 49-bed site between 2019 and mid-2022, while noting that patient volume rose over the same period.
Software is a separate and much smaller line. Antimicrobe publishes its price: Stewardship is $749 a month for up to three facilities, with unit cuts, syndrome groups and quarterly trends, and Network is $2,400 a month for twelve facilities plus cross-facility comparison and the pooled regional report. Annual billing is half the monthly price. A program with one partner can start on the Lab plan at $249 a month by card.
What enterprise platforms and implementation cost for the same work is in how much antibiogram software costs, and every plan limit is on the pricing page.
Which setup fits which program
- One hub covering one or two affiliates on the same EHR: use the EHR's stewardship tools for daily work and the Lab or Stewardship plan for the antibiograms
- A private ID practice with three to twelve contracted hospitals on mixed EHRs: Network, so each hospital has its own antibiogram and the practice has one pooled view
- A state or regional collaborative pooling many small hospitals: Network or Enterprise, with the regional report as the shared product
- A partner that already licenses Sentri7, VigiLanz or TheraDoc: keep its platform for alerts and AUR, and check whether its antibiogram covers small counts before adding anything
Questions to settle before signing a telestewardship contract
Most of these answers sit in documents the partner already has: its stewardship policy, restricted antimicrobial list, order sets and last committee minutes. Loading that stack into a tool that lets you chat with PDF files is a quick way to find what each policy actually says before the first meeting, and the list below covers what the contract should spell out.
- Whose EHR login and messaging does the remote team use, and who provisions it?
- Which patients are reviewed daily, and does the list come from the EHR or a surveillance platform?
- Who builds each partner's antibiogram, from which lab files, and on what schedule?
- Who submits NHSN AUR data, and through which certified product?
- What does the partner receive each month, and in what format for its committee?
- Who owns the data and the reports if the contract ends?
Related on this site: critical access hospital antibiogram software, antibiotic stewardship software for critical access hospitals, regional antibiogram software for health systems, MEDHOST antibiogram software.