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. 2020 Jun 1;27(6):853-859.
doi: 10.1093/jamia/ocaa037.

Rapid response to COVID-19: health informatics support for outbreak management in an academic health system

J Jeffery Reeves  1 , Hannah M Hollandsworth  1 , Francesca J Torriani  2 , Randy Taplitz  2 , Shira Abeles  2 , Ming Tai-Seale  3 , Marlene Millen  4 , Brian J Clay  4 , Christopher A Longhurst  4
Affiliations

Rapid response to COVID-19: health informatics support for outbreak management in an academic health system

J Jeffery Reeves et al. J Am Med Inform Assoc. .

Abstract

Objective: To describe the implementation of technological support important for optimizing clinical management of the COVID-19 pandemic.

Materials and methods: Our health system has confirmed prior and current cases of COVID-19. An Incident Command Center was established early in the crisis and helped identify electronic health record (EHR)-based tools to support clinical care.

Results: We outline the design and implementation of EHR-based rapid screening processes, laboratory testing, clinical decision support, reporting tools, and patient-facing technology related to COVID-19.

Discussion: The EHR is a useful tool to enable rapid deployment of standardized processes. UC San Diego Health built multiple COVID-19-specific tools to support outbreak management, including scripted triaging, electronic check-in, standard ordering and documentation, secure messaging, real-time data analytics, and telemedicine capabilities. Challenges included the need to frequently adjust build to meet rapidly evolving requirements, communication, and adoption, and to coordinate the needs of multiple stakeholders while maintaining high-quality, prepandemic medical care.

Conclusion: The EHR is an essential tool in supporting the clinical needs of a health system managing the COVID-19 pandemic.

Keywords: clinical informatics; coronavirus; electronic health record; pandemic; telemedicine.

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Figures

Figure 1.
Figure 1.
Travel and symptom screening. The above screenshot demonstrates the required screening, as viewed by front desk staff, that was added to the registration/check-in process for all patients.
Figure 2.
Figure 2.
COVID-19 outbreak management dashboard. This dashboard was created and utilized by the Incident Command Center, institutional leaders, nursing supervisors, and other healthcare providers to monitor COVID-19 patient volume and distribution across the health system, COVID-19 test results, intensive care unit and ventilator use and availability, and the impact of the outbreak on daily ambulatory visits. The right side of the middle panel shows the number of ventilated patients; highlighted in red are ventilated patients who are COVID-19 positive versus non-COVID-19 ventilated patients.
Figure 3.
Figure 3.
Telemedicine - Video Visit. Graphic displaying the layout of UC San Diego’s virtual visit encounter.
See this image and copyright information in PMC

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