Having up-to-date data gathered essentially in real time is going to be recognized as a key component to responding to the coronavirus. Contact tracing and sharing of key information about the potential spread of the virus is vital to arresting its spread.
The Montgomery County, Texas, Hospital District has deployed a system that facilitates the collection and analysis of information in near real time, allowing infectious disease specialists and other officials to make critical, informed decisions.
The district enlisted the enterprise software provider Laserfiche to help the district build an online employee symptom screening form; an automated contact tracing system; an online medical record-keeping system, as well as improve communication with employees and residents about the coronavirus by embedding a form on the county’s website that provides the direct contact to the right person for information. They also developed an e-voucher system for employees who qualify for free coronavirus testing to get an online voucher they can show at a testing site.
“It all comes down to information sharing,” said Montgomery County Hospital District Electronic Business Process Manager Shawn Henners, who helped develop the system. “And the best data you’re going to get is in real time. The faster we can get that data, the faster we can share it with the health department, the faster we can get accurate information to the public and the faster we can provide it to our counties so the county judge can make informed decisions.”
The Laserfishe system had been in place for about a year before the coronavirus outbreak, having been used by the district to develop an online presence for employee health and safety and emergency management.
The online symptoms screening form records data on every employee before during and after each shift. Upon arrival at work, each employee checks in by using a digital thermometer to record his or her temperature, which is saved on the screening form. Employees do this every 12 hours, so those with 12-hour shifts record their temperatures at the beginning and end of their shifts and those who work 24-hour shifts do this three times. The system advises employees on what to do if they become symptomatic. Only the infectious disease specialists have access to this data.
The information is pushed to a database and employees are monitored to make sure they are complying. If an employee misses the system will alert incident command, which will follow up. Also, there are specific instructions in the system for certain employees such as paramedics, who are considered high risk and candidates for workers’ comp. That information has to reach infection control officers. Others may just be sent home.
Case reports on each patient are developed in the system and include whether the patient was hospitalized, was intubated, died, discharged or is recovering from home. It includes all of the patient’s lab results, travel history and whether they were part of a cluster. “It’s been fantastic, Henners said. “It really helps us make decisions.”
The automated online tracing system was out of the gate early and has become optional. “People can use it to let us know if there are contacts of a known case,” Henners said. “They log in and let us know symptoms every 12 hours.
This is being used to monitor hundreds of case contacts and helps reduce the burden on the epidemiology team to do other work.
“Every positive case that we get, we do an investigation on it in the public health department and document,” said Henners.