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

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.

[1]  R. Brook,et al.  Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing. , 2020, JAMA.

[2]  Feng He,et al.  Coronavirus disease 2019: What we know? , 2020, Journal of medical virology.

[3]  Donald Trump,et al.  Proclamation on Declaring a National Emergency Concerning the Novel Coronavirus Disease (COVID-19) Outbreak , 2020 .

[4]  G. Gao,et al.  A Novel Coronavirus from Patients with Pneumonia in China, 2019 , 2020, The New England journal of medicine.

[5]  Brian Clay,et al.  Personal Health Records: More Promising in the Smartphone Era? , 2019, JAMA.

[6]  Benjamin H. Slovis,et al.  Impact of Emergency Department Tele-intake on Left Without Being Seen and Throughput Metrics. , 2019, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[7]  Vineet Chopra,et al.  How Should U.S. Hospitals Prepare for Coronavirus Disease 2019 (COVID-19)? , 2020, Annals of Internal Medicine.

[8]  Tiffany Champagne-Langabeer,et al.  Telehealth-Enabled Emergency Medical Services Program Reduces Ambulance Transport to Urban Emergency Departments , 2016, The western journal of emergency medicine.

[9]  Zunyou Wu,et al.  Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. , 2020, JAMA.

[10]  K. Yuen,et al.  Clinical Characteristics of Coronavirus Disease 2019 in China , 2020, The New England journal of medicine.

[11]  E. Dong,et al.  An interactive web-based dashboard to track COVID-19 in real time , 2020, The Lancet Infectious Diseases.

[12]  Thomas V Inglesby,et al.  Priorities for the US Health Community Responding to COVID-19. , 2020, JAMA.

[13]  L. Koonin,et al.  Novel coronavirus disease (COVID-19) outbreak: Now is the time to refresh pandemic plans. , 2020, Journal of business continuity & emergency planning.

[14]  Robin N. Thompson Novel Coronavirus Outbreak in Wuhan, China, 2020: Intense Surveillance Is Vital for Preventing Sustained Transmission in New Locations , 2020, Journal of clinical medicine.

[15]  Daniel A Pollock,et al.  Opportunities and challenges in utilizing electronic health records for infection surveillance, prevention, and control , 2008, American Journal of Infection Control.

[16]  Brendan G Carr,et al.  The Role of Telehealth in the Medical Response to Disasters. , 2018, JAMA internal medicine.

[17]  Jing Zhao,et al.  Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia , 2020, The New England journal of medicine.

[18]  J. Hollander,et al.  Virtually Perfect? Telemedicine for Covid-19. , 2020, The New England journal of medicine.

[19]  Daniel Brodie,et al.  Preparing for the Most Critically Ill Patients With COVID-19: The Potential Role of Extracorporeal Membrane Oxygenation. , 2020, JAMA.

[20]  G. Leung,et al.  Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study , 2020, The Lancet.

[21]  Jessica S. Ancker,et al.  Redesigning electronic health record systems to support public health , 2007, J. Biomed. Informatics.

[22]  Lawrence O. Gostin,et al.  WHO’s Pandemic Influenza Preparedness Framework: A Milestone in Global Governance for Health , 2011, JAMA.

[23]  Yu Deng,et al.  Coronavirus Disease 2019 (COVID-19): What we know? , 2020 .