Collaboration to Harmonize AntiMicrobial Registry Measures (CHARM)
A 360° View of Outpatient Antimicrobial Prescribing Practices
CHARM utilizes existing data from partner institution's electronic medical records (EMR) to quantify and assess local antimicrobial prescribing practices. With this data, we are promoting awareness, supporting research, and disseminating best practices surrounding outpatient antibiotic utilization.
Who We Are
CHARM is a collaborative effort to quantify and assess prescribing practices. By helping clinics understand their current prescribing practices, stewardship opportunities can be identified and the impact of initiatives measured. The registry also allows participating clinics to benchmark their usage patterns against other clinics across the state.
Our Mission Statement
Promote antimicrobial stewardship efforts by providing clinicians with current prescribing practices in a timely, standardized, and user-friendly format.
How To Get Started
Contact [email protected] to schedule an initial consultation and determine the best way to get your clinic involved.
FAQS
Data can be transferred securely in one of three ways:
- SFTP (secure file transfer protocol),
- secure email, or
- loading files directly to a private OneDrive for Business folder maintained behind HIPAA-compliant firewall on the Ferris secure server.
Transferred data is maintained behind a Ferris HIPAA-compliant firewall. After the initial extract, additional data can be transferred on a monthly or quarterly basis to be reflected in the dashboard.
Yes, you can download template DUAs for use with Michigan and Illinois partners, or contact us to request a DUA for use in other states. The agreement specifies the extent to which the data is used, and the list of data fields that are extracted from EHR. The CHARM project is reviewed and monitored by the Ferris State University Institutional Review Board (IRB).
CHARM is supported by a grant from the Michigan Department of Health and Human Services Surveillance for Healthcare-Associated & Resistant Pathogens (SHARP) Unit as well as the Illinois Department of Public Health. As a result, participation and basic reporting services are provided at no charge for health systems and clinics located in Michigan and Illinois. Fees for out-of-state facilities may apply.
Your institution will receive a highly interactive, health system specific dashboard. Within the dashboard, you can apply filters to obtain granular insight into your providers’ antibiotic prescribing practices. You will be able to determine your prescribers’ adherence to published or institutional guidelines and benchmark performance internally among prescribers and externally against other health systems in the state. Depending on the data provided, these reports may include progress toward HEDIS metrics. You can review a quick six minute overview here.
Contact the CHARM team to schedule an initial consultation dashboard demonstration.
Tracking and monitoring outpatient antibiotic use is an element of performance (EP) in the Joint Commission’s Antimicrobial Stewardship in Ambulatory Health Care requirements. Participation in CHARM fulfills this EP.
Data from CHARM allows for generation of antibiotic usage reports that can be used to identify antimicrobial stewardship initiatives and measure the impact of stewardship initiatives. Additionally provides insights into institutional progress in meeting HEDIS measures.
Our quarterly "CHARM Notes" newsletter can be found at:
CHARM Presentations & Publications
- Kushal Dahal, Michael Klepser, Benjamin Pontefract, Minji Sohn. Collaboration to Harmonize Antimicrobial Registry Measures (CHARM). American Medical Informatics Association. May 21, 2024. Minneapolis, Minnesota.
- Michael Klepser. Illinois Department of Public Health and CHARM Partnership to Track and Assess Concordance of Outpatient Antibiotic Use in Illinois. Illinois Summit on Antimicrobial Stewardship. July 17, 2024. Chicago, Illinois.
- Tiasha Nandi, K Pawlowski, Benjamin Pontefract, Michael Klepser, Minji Sohn. Patterns of Clostridioides difficile Treatment in Outpatient Settings Using the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM). ID Week. October 17 and 19, 2024. Los Angeles, California.
- H Mishreky, C Smith, Minji Sohn, Benjamin Pontefract, Kushal Dahal, Michael Klepser. Use of Collaboration to Harmonize Antimicrobial Registry Measures (CHARM) to Assess Antibiotic Prescribing in Dental Practices. ID Week. October 17 and 19, 2024. Los Angeles, California.
- B VanHouten, O Eckardt, Benjamin Pontefract, Minji Sohn, Michael Klepser. Comparison of Antibiotic Prescribing for Urinary Tract Infections (UTI), Sinusitis, Group A Streptococcal Pharyngitis, and Pyelonephritis by Provider Type. ID Week. October 17 and 19, 2024. Los Angeles, California.
- Tiasha Nandi, K Pawlowski, Benjamin Pontefract, Michael Klepser, Minji Sohn. Patterns of Clostridioides difficile Treatment in Outpatient Settings Using the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM). WMRUGS. November 2, 2024. Grand Rapids, Michigan.
- Michael Klepser. Use of Collaboration to Harmonize Antimicrobial Registry Measures (CHARM) to Track Outpatient Antibiotic Use. Chicago Department of Public Health Inaugural One Health Conference. November 19, 2024. Chicago, Illinois.
- Cameron Lakatos, J. Swailes, Kushal Dahal, Michael Klepser, Minji Sohn. Tracking Healthcare Effectiveness Data and Information Set (HEDIS) measures for Acute Bronchitis with the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM). American Society of Health-system Pharmacists Midyear. December 9, 2024. New Orleans, Louisiana.
- J Swailes, Cameron Lakatos, Kushal Dahal, Michael Klepser, Minji Sohn. Use of Collaboration to Harmonize Antimicrobial Registry Measure (CHARM) to Track and Assess the Appropriate Treatment for Upper Respiratory Infection HEDIS Measure (URI). American Society of Health-system Pharmacists Midyear. December 9, 2024. New Orleans, Louisiana.
- Elaine Bailey, A Schneider, Kaylee Caniff, Minji Sohn, Kushal Dahal, Michael Klepser. Data for action – measuring antibiotic prescribing to improve antibiotic use in integrated delivery systems. Association for Dental Safety Annual Conference. May 2025. Orlando, Florida.
- Minji Sohn, Kushal Dahal, Michael Klepser. Enhancing Outpatient Antibiotic Stewardship through the CHARMProject: A Collaborative Initiative between Ferris State University(FSU) and Michigan Department of Health and Human Services(MDHHS). Council of State and Territorial Epidemiologists (CSTE). June 9, 2025. Grand Rapids, Michigan.
- Minji Sohn, Michael Klepser. Enhancing Outpatient Antibiotic Stewardship through the CHARM Project: A Collaborative Initiative between Ferris State University (FSU) and Illinois Department of Public Health (IDPH). IL Antimicrobial Stewardship Summit. July 10, 2025. Champaign, Illinois.
- Kayla Backus, Nicholas Torney, C Nichols. Antibiotic Prescription Rate for Viral Respiratory Infections After a Viral Care Package Intervention and Provider Education in the Urgent Care Setting. ID Week.
- Tan Vo, Kushal Dahal, Michael Klepser, Benjamin Pontefract, Kaylee Caniff, Minji Sohn. Evaluation of Large Language Models for Antimicrobial Classification: Implications for Antimicrobial Stewardship Programs. American College of Clinical Pharmacy (ACCP) Annual Meeting. October 18, 2025. Minneapolis, Minnesota.
- Kaylee Caniff, Michael Klepser, Kushal Dahal, Jenna Wilkerson, Madelyn Koski, Minji Sohn. Examining Outpatient Antibiotic Prescribing Trends and Guideline Concordance Across Urban and Rural Healthcare Facilities. IDWeek. October 21, 2025. Atlanta, GA.
- Tan Vo, Kushal Dahal, Michael Klepser, Benjamin Pontefract, Minji Sohn. Collaboration to Harmonize Antimicrobial Registry Measures (CHARM) Database Analysis of Antibiotic Prescribing in Urgent and Non-urgent Care: A Retrospective Study on Demographic Factors. American Public Health Association Annual Meeting. November 2, 2025. Washington, D.C.
- Jonathan Guerin, Kushal Dahal, Michael Klepser, Benjamin Pontefract, Minji Sohn. “Use of Healthcare Effectiveness Data and Information Set (HEDIS) through Collaboration to Harmonize Antimicrobial Registry Measure (CHARM) to Assess Differences in Prescribing Patterns Among Patient Populations For Upper Respiratory Infections.” American Public Health Association Annual Meeting. November 2, 2025. Washington, D.C.
- Madeline Gardner, Benjamin Pontefract, Kushal Dahal, Minji Sohn, Michael Klepser. Assessment of Disparities in Antibiotic Avoidance for Acute Bronchitis. West Michigan Regional Undergraduate Science (WMRUGS) Research Conference. November 8, 2025. Grand Rapids, Michigan.
- Tan Vo, Kushal Dahal, Michael Klepser, Benjamin Pontefract, Kaylee Caniff, Minji Sohn. Collaboration to Harmonize Antimicrobial Registry Measure (CHARM) Database Analysis of Antibiotic Prescribing in Urgent and Non-Urgent Care: A Retrospective Study on Demographic Factors. West Michigan Regional Undergraduate Science (WMRUGS) Research Conference. November 8, 2025. Grand Rapids, Michigan.
- Cameron Lakatos, Benjamin Pontefract. Reliability of ICD-10 coding for the identification of bacterial sinusitis. ASHP Midyear 2025. December 6, 2025.
- Tan Vo, Michael Klepser, Minji Sohn, Margaret deVoest. Antibiotic Stewardship in Transitions of Care: Concordance Pattern Analysis using Collaboration to Harmonize Antimicrobial Registry Measure Dashboard. American Pharmacists Association (APhA) Annual Meeting & Exposition. March 28, 2026 (accepted). Los Angeles, California.
- Tan Vo, Jonathan Guerin, Madeline Gardner, Cameron Lakatos, Michael Klepser, Minji Sohn. Antimicrobial Prescribing Patterns in Dogs and Cats at a Michigan Veterinary Medical Center. The Society for Healthcare Epidemiology of America (SHEA) Spring Conference. April 10, 2026 (accepted). Chicago, Illinois.
- Klepser M, Rauch H, Woodwyk A, Altom A, Schauer M, MacCallum C, Klepser D. Benchmarking outpatient antibiotic prescribing patterns and adherence to published guidelines in an academic medical clinic. American College of Clinical Pharmacy 2017 Annual Meeting. Phoenix, Arizona.
- Woodwyk A, Rauch H, Schauer M, Wan F, Dregansky G, Klepser M. Assessment of Oral Antibiotic Prescribing Practices in WMed Outpatient Clinics. 36th Annual Kalamazoo Community Medical and Health Sciences Research Day. May 2, 2018. Kalamazoo, Michigan.
- Woodwyk A, Rauch H, Schauer M, Wan F, Dregansky G, Klepser M. Assessment of Oral Antibiotic Prescribing Practices in WMed Outpatient Clinics. 2018 Women in Statistics and Data Science Conference. October 19, 2018. Cincinnati, Ohio.
- Hammershaimb B, Chung D, Tracey J, Dregansky G, Schauer M, Woodwyk A, Rauch H, Klepser ME. Assessment of Outpatient Antibiotic Prescribing to Guide Antibiotic Stewardship Initiatives at University Affiliated Health Clinics. American College of Clinical Pharmacy 2018 Annual Meeting. October 20, 2018. Seattle, Washington.
- Bixman L, Tran S, DeShelter M, Bates J, Wolfe A, Woodwyk A, Rauch H, Elder J, Klepser M. Comparison of Outpatient Antimicrobial Usage Among Ambulatory Clinics using Standardized Methods. American College of Clinical Pharmacy 2018 Annual Meeting. October 20, 2018. Seattle, Washington.
- Hammershaimb B, Winterholler JE, Chung D, Tracey J, Dregansky G, Schauer M, Woodwyk A, Rauch H, Klepser ME. Assessment of Outpatient Antibiotic Prescribing to Guide Antibiotic Stewardship Initiatives at University Affiliated Health Clinics. MSMS Foundation Annual Scientific Meeting. October 26, 2018. Novi, Michigan.
- Winterholler JE, Hammershaimb B, Leist C, Kucera M, Trombley M, Rauch H, Woodwyk A, VanLoo D, Klesper ME. Assessment of Antimicrobial Prescribing Patterns in an Outpatient Clinic System to Promote Outpatient Antimicrobial Stewardship. MSMS Foundation Annual Scientific Meeting. October 26, 2018. Novi, Michigan.
- Leist C, Kucera M, Trombley M, Winterholler J, Rauch H, Woodwyk A, VanLoo D, Klesper ME. Retrospective Assessment of Antimicrobial Prescribing Patterns in an Outpatient Clinic System. American Pharmacists Association Annual Meeting and Exposition. March 23, 2019. Seattle, Washington.
- Stultz-Griffey H, Weaver P, Woodwyk A, Sohn M, Wallington D, Warner A, VanLoo D, Klepser M. Impact of pharmacist-led education and prescriber report cards as outpatient antimicrobial stewardship initiatives in a community health system. American College of Clinical Pharmacy Annual Meeting. October 26-28, 2019. New York, New York.
- Goldsworthy J, Elliott M, Woodwyk A, Dregansky G, Sohn M, Klepser ME. Impact of prescriber education and report cards on outpatient antibiotic prescribing for UTIs at a Federally Qualified Health Clinic (FQHC). American College of Clinical Pharmacy Annual Meeting. October 26-28, 2019. New York, New York.
- Grubbs E, Ford J, Ho H, Sohn M, Klepser M. Utilization of the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM) Dashboard To Support Outpatient Antimicrobial Stewardship. American Pharmacists Association Annual Meeting and Exposition. 2021.
- Sohn M, Dubbert C, Dixon G, Pontefract B, Van Loo D, Klepser M. CHARM Dashboard: A standardized tool for state-wide benchmarking of outpatient antibiotic use. American College of Clinical Pharmacy Annual Meeting. October 2021.
- Grubbs E, Pontefract B, Sohn M, Ford J, Klepser M. Leveraging visual data through CHARM dashboards to identify and track the impact of stewardship interventions. American College of Clinical Pharmacy Annual Meeting. October 2022. San Francisco, California.
- McDonnell J, Pontefract B, Sohn M, Klepser M. Infectious Diagnoses and Antibiotic Concordance Compared Between White and Non-White Populations Within Three Michigan Health Systems. American Society of Health Systems Pharmacists MidYear Clinical Meeting. December 4-8, 2022. Las Vegas, Nevada.
- Randall Parat, Kyle Andrew Brillantes, Paul Thill, Michael E. Klepser. Concordance of Pediatric Amoxicillin-Clavulanate Suspension Formulation Selection and Dosing Regimen. American Society of Health Systems Pharmacists MidYear Clinical Meeting. December 10, 2023. Anaheim, California.
- Claire Richardson, Kayla Backus, Michael Klepser, Benjamin Pontefract, Kushal Dahal, Minji Sohn. Low Rate of Concordant Antibiotic Selection among Ambulatory Patients with Renal Impairment. American Society of Health Systems Pharmacists MidYear Clinical Meeting. December 10, 2023. Anaheim, California.
- Hollyann Holmquist, Ashley Mesman, Minji Sohn, Michael Klepser. Utilizing Collaboration to Harmonize Antimicrobial Registry Measures (CHARM) Data to Assess Trends of Sexually Transmitted Infections in Outpatient Clinics. American Society of Health Systems Pharmacists MidYear Clinical Meeting. December 10, 2023. Anaheim, California.
- Michael Hallada, Andrew de Voest, Jeffery Sundell, Minji Sohn, Michael Klepser. Validation of CHARM at Trinity Health Muskegon. American Society of Health Systems Pharmacists MidYear Clinical Meeting. December 10, 2023. Anaheim, California.
- Hollyann Holmquist, Minji Sohn, Michael E. Klepser. “Utilizing the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM) Data to assess prescribing trends for amoxicillin during a shortage.” Academy of Managed Care Pharmacy. April, 17, 2024. New Orleans, Louisiana.
- Sydney Starmer, Michael Klepser, Benjamin Pontefract, Kushal Dahal, Nicholas Torney, Minji Sohn. Outpatient Fluoroquinolone use in a Michigan Health System. Academy of Managed Care Pharmacy. April, 17, 2024. New Orleans, Louisiana.
- Kushal Dahal, Michael Klepser, Benjamin Pontefract, Minji Sohn. Collaboration to Harmonize Antimicrobial Registry Measures (CHARM). American Medical Informatics Association. May 21, 2024. Minneapolis, Minnesota.
- Tiasha Nandi, Kathryn, M. Pawlowski, Benjamin Pontefract, Michael Klepser, Minji Sohn. Patterns of Clostridioides difficile Treatment in Outpatient Settings Using the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM). ID Week. October 17, 2024. Anaheim, California.
- Helen Mishreky, Cameron Smith, Minji Sohn, Benjamin Pontefract, Kushal Dashal, Michael Klepser. Use of Collaboration to Harmonize Antimicrobial Registry Measures (CHARM) to Assess Antibiotic Prescribing in Dental Practices. ID Week. October 17, 2024. Anaheim, California.
- Brianna VanHouten, Owen Eckardt, Benjamin Pontefract, Minji Sohn, Michael E. Klepser. Comparison of Antibiotic Prescribing for Urinary Tract Infections (UTI), Sinusitis, Group A Streptococcal Pharyngitis, and Pyelonephritis by Provider Type. ID Week. October 17, 2024. Anaheim, California.
- Ben M Zalupski, Zeina S Elroumi, Austin Brown, Minji Sohn, Michael E. Klepser. Association Between Maintenance Medication Adherence and the Likelihood of Receiving Antibiotics Among Adults. American Society of Health Systems Pharmacists MidYear Clinical Meeting. December 9, 2024. New Orleans, Louisiana.
- Cameron Lakatos, Jessica Swailes, Kushal Dahal, Minji Sohn, Michael Klepser. Tracking HEDIS measures for Acute Bronchitis with the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM). American Society of Health Systems Pharmacists MidYear Clinical Meeting. December 9, 2024. New Orleans, Louisiana.
- Tiasha Nandi, Kathryn, M. Pawlowski, Benjamin Pontefract, Michael Klepser, Minji Sohn. Patterns of Clostridioides difficile Treatment in Outpatient Settings Using the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM). American Pharmacists Association Annual Meeting and Exposition 2025. March 22, 2025. Nashville, Tennessee.
- Helen Mishreky, Cameron Smith, Minji Sohn, Benjamin Pontefract, Kushal Dashal, Michael Klepser. Use of Collaboration to Harmonize Antimicrobial Registry Measures (CHARM) to Assess Antibiotic Prescribing in Dental Practices. American Pharmacists Association Annual Meeting and Exposition 2025. March 22, 2025. Nashville, Tennessee.
- Brianna VanHouten, Owen Eckardt, Benjamin Pontefract, Minji Sohn, Michael E. Klepser. Comparison of Antibiotic Prescribing for Urinary Tract Infections (UTI), Sinusitis, Group A Streptococcal Pharyngitis, and Pyelonephritis by Provider Type. American Pharmacists Association Annual Meeting and Exposition 2025. March 22, 2025. Nashville, Tennessee.
- Minji Sohn, Anne Hadaad, Kushal Dahal, Brenda Brennan, Michael Klepser. Enhancing Outpatient Antibiotic Stewardship through the CHARM Project: A Collaborative Initiative between Ferris State University and Michigan Department of Health and Human Services. Council of State and Territorial Epidemiologists Annual Conference. June 9, 2025. Grand Rapids, Michigan.
- Michael Klepser and Minji Sohn. Collaboration to Harmonize Antimicrobial Registry Measures (CHARM). EpiVision Session. Council of State and Territorial Epidemiologists Annual Conference. June 10, 2025. Grand Rapids, Michigan.
- Kaylee Caniff and Michael Klepser. Improving Antibiotic Use in Oral Health Practice. Webinar. Michigan Oral Health Coalition. October 9, 2025. Online.
- Benjamin Pontefract and Kaylee Caniff. CHARM Updates. OASIS. August 14, 2025. Grand Rapids, Michigan.
- Kushal Dahal and Evan Schulte. CHARM GPT (Locally hosted LLM Model). GR Tech Week. 9/16/2025. Grand Rapids, Michigan.
- Madeline Gardner, Minji Sohn, Benjamin Pontefract, Kushal Dahal, Michael E. Klepser. “Disparities in Antibiotic Avoidance for Acute Bronchitis: The Role of Patient Race and Insurance Status.” American Public Health Association Annual Meeting. November 4, 2025. Washington, D.C.
- Evan Schulte. Automated Extraction of Dosage Information From Unstructured Healthcare Data Using Large Language Models. WMRUGS. November 8, 2025. Grand Rapids, Michigan.
- Tan Vo, Kushal Dahal, Michael Klepser, Benjamin Pontefract, Kaylee Caniff, Minji Sohn. Evaluation of Large Language Models for Antimicrobial Classification: Implications for Antimicrobial Stewardship Programs. WMSHP Student Research Meeting. 3/12/2026 (accepted). Kalamazoo, Michigan.
- Klepser ME, Altom A, MacCallum C, Nordquist E, Klepser DG. Description of the methods for describing and assessing the appropriateness of antibiotic prescribing and adherence to published treatment guidelines in an academic medical clinic. Innovations in Pharmacy. 2016;7:1-8.
- Sohn M, Chung D, Winterholler JE, Hammershaimb B, Leist C, Kucera M, Trombley M, Tracey J, Dregansky G, Schauer M, Rauch H, Woodwyk A, VanLoo D, Warner A, Klepser ME. Assessment of antibiotic use and concordance with practice guidelines within three diverse ambulatory clinic systems. JAPhA. 2020;60:930-6.
- Sohn M, Pontefract B, Dahal K. Klepser M. Outpatient Antibiotic Stewardship during the COVID-19 era: Analysis of Prescribing Trends and Guideline Compliance. Antimicrobial Stewardship and Healthcare Epidemiology. 2025. doi:10.1017/ash.2025.10081
- Pontefract B, Dahal K, McDonnell J, Klepser M, Sohn M. Innov Pharm. Accepted September 24, 2025.
- Vo T, Dahal K, Klepser M, Pontefract B, Caniff K, Sohn M. Collaboration to harmonize antimicrobial registry measures (CHARM) database analysis of antibiotic prescribing in urgent and non-urgent care: a retrospective study on demographic factors. Antimicrobial Stewardship & Healthcare Epidemiology. 2025. doi.org/10.1017/ash.2025.10197
- Vo T, Dahal K, Klepser M, Pontefract B, Caniff KE, Sohn M. Evaluation of large language models for antimicrobial classification: implications for antimicrobial stewardship programs. Antimicrobial Stewardship & Healthcare Epidemiology. 2025;5(1):e324. https://doi.org/10.1017/ash.2025.10235
Try out the Michigan Statewide dashboard
Contact Us
CHARM Core Team
Minji Sohn, PhD
Director
[email protected]
Michael Klepser, PharmD
Senior Director
[email protected]
Benjamin Pontefract, PharmD
Director of Research
[email protected]
Kaylee Caniff, PharmD
Member
[email protected]
Kushal Dahal, MS
Data Analyst
[email protected]
Sampada, MS
Data Analyst
[email protected]
Elianna Bootzin
Research Assistant
[email protected]