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Background: In the United States, the laundry industry has not reliably measured microbial levels on hygienically clean textiles. The aim of this study was to quantitatively measure the microbial levels found on a sample of hygienically clean textiles., Methods: Forty-eight health care textile samples were collected from hygienically clean linen scheduled to be used on 3 different patient care units. Samples were taken at 2 separate points in time representing laundry facility processing practices and hospital linen management practices. United States Pharmacopeia 61 testing was completed using a pour plate culturing method, producing a total aerobic microbial count and a total yeast and mold count., Results: Of the samples, only 27% had a total aerobic microbial count below the expected 100 colony-forming unit level (range, 9-40,000) versus 81% (range, 9-1,000) for total yeast and mold count. Median microbial counts for the 2 separate time points across the 3 different patient care units were also higher than expected., Conclusions: As far as we know, this study is a first step by the laundry industry to understand what quantitative microbial levels are currently found on hygienically clean health care textiles. These types of data can assist the industry in establishing appropriate outcome targets for process improvement initiatives., (Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Health information exchange is expected of all electronic health records (EHRs) in order to ensure safe, quality care coordination. The U.S. Department of Veterans Affairs (VA) has a long history of information exchange across VA facilities and with the U.S. Department of Defense (DoD). However, since a majority of VA and DoD patients receive a portion of their health care from the private sector, it is essential that both agencies enable health information exchange with private sector providers. This has been made possible by the use of the specifications and trust agreement developed by the Nationwide Health Information Network (NwHIN) initiative. Currently, VA has 12 medical centers exchanging information with the private sector and is evaluating the value of the exchange. The authors report on the success of these pilots as well as on the challenges, which include stricter technical specifications and a more efficient approach to patient identification (ID) matching and consent management.