Use Health IT to Reinforce COVID-19 Recommendations
Healthcare Triangle • Mar 09, 2020
In addition to recommendations for individuals to keep themselves healthy, Interim Guidance for Healthcare Facilities: Preparing for Community Transmission of COVID-19 in the United States has been released by the Centers for Disease Control and Prevention. Now is the time to ensure your EHR tools support patients and clinicians by aligning to these recommendations.
Screening and Decision Support Tools
EHR vendors including Epic and Meditech have released functionality and information to support screening for the virus consistent with CDC guidelines and updated as the situation evolves.
- Epic. Epic has updated its standard travel screening questionnaire and released Best Practice Advisories to prompt full patient screenings as well as ordering of isolation, testing, and treatment protocols where appropriate. If you have customized the travel screening in your organization, some extra validation will be needed. Be sure appropriate infection control reports are showing suspected and confirmed cases of COVID-19 as well.
- Meditech. In any arrival setting — inpatient, ED, or clinic — site-defined queries can prompt documentation of a patient’s symptoms and travel history. This documentation provides clinical decision support — which includes guidance on how to build and implement a series of queries, orders, and an order set; connect those queries to questionnaires and orders; and create logic that can be used to alert and notify appropriate staff.
Nurse Triage
The CDC recommends healthcare facilities identify staff to conduct telephonic and telehealth interactions with patients as well as develop protocols so that staff can triage and assess patients quickly. If you have a Nurse Triage workflow in your EHR now, validate that all the tools for screening and clinical decision support for COVID-19 are available within it. This is also a great opportunity to stand up a lean nurse triage workflow if you do not have one in place.
The Digital Front Door
Recommendations have been widely circulated asking patients to call their healthcare provider before going to the hospital or office if they are experiencing symptoms that might signal the Coronavirus. But if you a digital front door for patients, they may be looking to connect with your organization that way.
- Patient Portal and Website. Provide patients instructions on how you want them to connect with your organization on your website as well as front and center in the patient portal. I checked on healthcare organizations local to me or where I have portal accounts, and I saw this in only 1 of 5 cases.
- Online Scheduling. Consider scheduling questions or other updates to online scheduling configuration to help manage potentially infected patients. Many of the self-service scheduling tools I have tested this week make no mention of the virus. One allowed me to make an appointment within the hour at a family medicine practice nearby with hypothetical respiratory illness.
Virtual Care for Mildly Ill COVD-19 Patients
The CDC recommends that if possible, healthcare facilities should identify staff who can monitor patients at home with daily “check-ins” using telephone calls, text, patient portals or other means.
- Telemedicine or Telephone Encounters. Ensure the same screening and clinical decision support tools available for an in-person encounter can be used when connecting with a patient by phone or through a virtual visit.
- COVID-19 Specific Encounter Types. It may make sense to create a specific encounter type for interactions with these patients. As billing rules seem to be changing rapidly, this will allow them to be more easily managed as it becomes clearer how your organization would like to handle them.
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