The last global pandemic was in 2009, when there was an outbreak of H1N1, known as the swine flu, which infected 60.8 million and caused 12,469 deaths in the U.S. Back then there was panic around the best treatment and prevention options and much of the information was input manually.
Times have changed.
Eleven years later, healthcare organizations are able to quickly gather and update patient information about the current pandemic, COVID-19. Patients can screen for symptoms remotely and then be triaged for testing and future care. Healthcare providers can also spread information and lessons learned more quickly amongst their peers and develop educational tools for patients to combat the spread of misinformation.
Hospital employees who aren't delivering patient care can work remotely and the infrastructure exists in many places for an influx of telehealth visits and chat bots to connect with patients virtually so they don't have to risk further spreading the virus.
"This is a complete paradigm shift," said Becca Bartles, executive director of infectious disease management and prevention at Renton, Wash.-based Providence. "Our response to the pandemic is informed by technology and we have great tools including the one from Johns Hopkins that help us understand the global picture and be predictive. We also have tools within our enterprise that help us see increases in influenza-like illness. We can predict where we may next see a surge because of the predictive capabilities of our analytics team."
Ms. Bartles said Providence is also using technology to keep patients out of the hospital and reserve space for people who are truly sick using chat bots on the hospitals' websites to help concerned patients determine whether their symptoms are likely connected to the coronavirus and their risk level. It also connects high risk individuals with developing symptoms and comorbidities with the nurse triage line so they can get the right level of care. Those patients then either go to virtual express-care where they can video call with physicians or to the hospital.
"I think this is an inflection point and could be a catalyst for doing things differently," said Ms. Bartles. "We've been building these technologies for a while and there is a large portion of the population that is comfortable with telehealth. I think this will help folks become more comfortable with telehealth and virtual care in the future."
On the flip side, if the system identifies someone in the ER with a confirmed coronavirus case or expected case based on epidemiological risk, those patients are provided technology for remote monitoring including pulsometers and thermometers to track their symptoms from home. The information is then reported through the telehealth software and nurses work around the clock to make sure the symptoms don't progress. Providence is selective about who receives the technology, based on positive test results or known exposure, and focused on the populations with the highest risk for severe disease.
"We don't want to keep someone otherwise healthy in the hospital, particularly those that are older and have more comorbidities," she said. "We are trying to get ahead of the supply chain and be predictive with our response. We ordered more of the technology we needed when we decided to create the home monitoring process. There is a lot of tech in the work management and supply chain management process."
For healthcare providers, it's challenging to predict what personal protective equipment will be used and how a surge will affect the normal supply chain. "There is always a utilization bump when there is something new and different going around and we adjust based on the CDC guidelines. We've been working hard to message within our facilities about what is the right PPE to use and ensure we keep our folks safe and be good stewards of our resources and not use things excessively or inappropriately," said Ms. Bartles.
The health system is also routinely monitoring caregivers who interact with patients for symptoms at the start of every shift and repeat at 12 hour intervals, and when caregivers have symptoms of the coronavirus they are sent home.
Beyond the healthcare environment, many others are self-quarantined and working remotely to curb the spread, made possible by accessible wireless internet networks, video conferencing and online office communication tools. Chicago-based Rush University Medical Center has launched an app with 16,000 adopters that enables virtual visits and patient education. The app also supports internal communication and has analytics around case prediction and regional hot spots so nurses and physicians can treat patients appropriately. CIO Shafiq Rab, MBBS, is supporting the system's response to resource management and potential staffing shortages as well.
"The city of Chicago depends on us," said Dr. Rab. "We are taking this not as a burden, but as a challenge and opportunity to serve patients. We believe our No. 1 job is to serve patients and then our physicians, caregivers, communities and then our organization. That is the mentality we have at Rush."
As of noon CDT, there were 7,324 cases of COVID-19 in the U.S. and 115 deaths. The peak may be yet to come, and technology will continue to play a big role in supporting caregivers and Americans during this outbreak.