By Rick Halton, VP Product & Marketing, Lumeon
With the unprecedented growth in patients diagnosed with COVID-19, caused by the coronavirus 2 (SARS-CoV-2) [1], health systems are rapidly being overwhelmed. At the end of 2019 80,000 cases had been reported in China. We are now seeing this trend repeat itself in the western hemisphere. In Italy alone, the number of cases has grown from 322 and just two weeks later, by early March 2020, to 10,149 [2]. One of the most significant impacts of this disease is how rapidly it is consuming resources such as inpatient beds, intensive care ventilators, and staff. Bed capacity can typically run at 80% occupation, so only small increases in patients can swamp the system.
In this article, we examine five ways in which technology can ease the burden on health care by helping automate and coordinate care communication and tasks. By taking advantage of agile technology platforms, health systems can rapidly deploy new use cases to help deal with this crisis. Use cases can address many aspects of the COVID-19 patient journey from early risk identification, patient sign-posting, reducing anxiety, and helping patients self-manage and self-isolate.
What can you do as a health system leader to leverage technology and ease the COVID-19 burden on your staff and resources?
Here are five examples to get you on your way:
Automated Awareness Campaigns
Most health systems now have Population Health Management (PHM) or Business Intelligence (BI) software that can quickly create and segment cohorts of patients. Different cohorts with varying degrees of risk can be created, such as the frail elderly, those with a pre-existing disease such as respiratory problems, or in high-risk locations. Campaigns might cover common questions and answers, advice on how to prevent catching the virus, common myths about it, and how to self-manage symptoms. By leveraging communication preferences – often available in the Electronic Health Record (EHR) system – email, voice and SMS campaigns can be sent out to each cohort. Respecting the patients’ consent and opt-in/out preferences is of course essential.
Automated Proactive Screening
Extending the above use case for ‘at risk’ populations, we can proactively assess risk using a more comprehensive online screening tool [3]. A cohort of vulnerable patients is engaged automatically and screened for symptoms using a survey. Depending on results, patients may then be proactively monitored for the next 4 weeks to check for symptoms and escalate where appropriate. If the patient is symptomatic, they can be directed to a nearby clinic to positively identify the disease using a swab test. The system will automatically generate and send a list of potential clinics based on the patient’s zip code.
Automated Referral Screening
By assessing the patient risk of COVID-19 on referral and prior to arrival, we can rapidly inform and direct the patient to the most appropriate care setting. On receiving a patient referral, a short screening survey [4] is sent to the patient’s mobile phone over SMS or WhatsApp. This very simple, automated survey quickly assesses the patient’s risk of having contracted COVID-19 based on their recent travel patterns, potential exposure to the virus and flu-like symptoms. The patient can conveniently respond to each question with a numeric or keyword response. Once complete, the patient then receives further information subject to their level of risk.
Automated Sign-Posting
By assessing a patient prior to arrival, we have insight into their level of risk. We can now signpost the patient to an appropriate location in an attempt to reduce cross-contamination. The patient can receive special tailored instructions based on pre-existing medical conditions, age, and zip code. Instructions can be delivered by commonly available communication channels. Sign-posting may require that an existing appointment be rescheduled for a different provider or location. The platform would automatically tap into the scheduling system and look for alternative appointment slots and offer them to the patient. This all happens autonomously, with no need for manual intervention from the care team member or scheduler unless the patient requests help.
Automated Symptom Tracking
This use case helps patients self-track their symptoms at home, simultaneously engaging the care team so they can remotely monitor them. Daily voice or text messages are sent to the patient providing them with a short survey to complete. The survey assesses the patient’s disease progression and escalates patients with worsening symptom scores to the care team. The care team can then promptly call the patient or caregiver to assess their situation in detail or automatically direct the patient to a primary care provider.
Conclusion
Essential, but perhaps not immediately obvious in the above, is the need for a software platform that can integrate with the EHR and has a programmable pathway engine. A pathway engine allows the rapid deployment of automation logic. This capability enables new use cases to be quickly made available that coordinate care communication and tasks.
In summary, think about AUTOMATING repetitive, time consuming clinical and administrative tasks, freeing up scarce staff so they can focus on the patients who are most in need of their time.
For more information on how healthcare automation platforms can help, please visit our Coronavirus page.
References:
1, Q&A on coronaviruses (COVID-19), World Health Organization (WHO)
2. The Extraordinary Decisions Facing Italian Doctors, The Atlantic