Preparedness and innovation drive Intermountain Healthcare’s COVID-19 response
When COVID-19 appeared in the U.S., Intermountain Healthcare was prepared with a business disaster response. Leaders quickly triggered their reaction structure and enacted a comprehensive prepare for fighting the virus. They leveraged the organization’s aptitude for health care development to automate the strategy where possible, effectively test patients for the virus and focus on whole-person wellness in attempting times.
“We attempt to constantly prepare for the unforeseen, so we’re prepared to adapt and innovate in emergency situation situations,” said Diego Ize-Ludlow, MD, Intermountain primary health info officer. “This minute– when resources worldwide are extended especially thin– just stresses the need for thoughtful readiness and development to drive security and effectiveness.”
Enacting the catastrophe action structure
Intermountain leaders established repeating huddles throughout the business and a virtual COVID-19 Health center Occurrence Command to organize their pandemic reaction.
The health system’s IT company hosts a day-to-day bridge call to examine COVID-19 jobs and address concerns, concerns or escalating problems. An event management leader drives the call and engages agents from pertinent groups, including medical, technical, customer experience, training and communications. The conference has devoted times for participants to share updates, but the Incident Command IT Area bridge call stays open all day to facilitate constant interaction and ensure that somebody is always available to help if immediate problems emerge.
Reducing direct exposure with virtual care and online resources
Intermountain’s culture of innovation helped the health system quickly adjust to the pandemic. As caregivers began working from another location, groups transformed arranged appointments to video check outs utilizing a combination of their Intermountain Connect Care telehealth platform, powered by Amwell, in addition to consumer and business videoconferencing tools like FaceTime, Google Duo and WebEx.
“We’re carrying out more than 17,000 video check outs each week– roughly 85 times more than we did before COVID-19,” stated Craig Jacobsen, Intermountain’s assistant vice president of application delivery. “We’ve expedited strategies for broadening telehealth innovations to additional clinics and service lines. In the meantime, we’ve deployed alternative technologies to rapidly reach clients.”
The organization also introduced a COVID-19 site to link the community to educational resources and care channels. An online symptom-checker chatbot uses expert system to assist people assess their danger for the infection and figure out proper next actions, based on guidelines from the U.S. Centers for Illness Control and Prevention, the World Health Organization and Intermountain scientific protocols.
“The tools are created to help us share details broadly while limiting exposure and conserving resources for individuals who need instant care,” stated Seraphine Kapsandoy, PhD, RN, Intermountain chief scientific info officer. “For instance, we rapidly released an ordering workflow with an embedded PowerForm to focus on screening. Information from that PowerForm has been valuable as we progress our screening technique. We also extended telehealth technologies inside the severe place to interact with our patients while decreasing PPE use.”
Testing clients effectively
To further reduce exposure and reserve urgent care resources for patients who need them most, Intermountain personnel and Cerner associates developed a curbside testing workflow. Clients with COVID-19 symptoms engage caregivers through video or by calling the company’s COVID-19 hotline for screening. If the patient needs testing based on an approved universal medical decision support protocol constructed straight into the electronic health record (EHR), a COVID-19 hotline nurse puts the order and directs the patient to one of Intermountain’s 27 curbside screening sites.
Patients follow three different workflows to curbside screening. Some receive a screening order in the EHR throughout a telehealth check out or hotline call. Others are evaluated by an affiliated company, who faxes the paper order to an Intermountain testing website. Patients who have actually not had a video visit or hotline call can receive screening on-site.
Throughout the screening procedure, Intermountain teams utilize unique EHR workflows and clinical choice assistance to drive performance and prioritize care for seriously ill clients. As caregivers go into COVID-19 test orders, a complex rule-based algorithm analyzes EHR information– including the client’s signs, location, co-morbidities, degree of illness, level of direct exposure to somebody with COVID-19 and other danger aspects– then instantly designates a numerical priority level to each test. After testing, laboratory services teams utilize an MPage® to dynamically direct tests to particular laboratories based on their top priority level, laboratory capability and test turn-around time– factors that can change frequently.
“The flexible process offers high volumes of screening, makes sure connection by utilizing universal sophisticated clinical decision support, reduces caretaker direct exposure, significantly accelerates the process and assists keep us arranged while checking more than 1,500 individuals daily, usually,” said Tamara Moores-Todd, MD, Intermountain CTIS informatics task lead for COVID-19 testing.
The 27 curbside websites utilize FirstNet® tracking lists to keep testing queues and record a client’s progress through the process. After outcomes are all set, caregivers use the Outcomes Callback MPage in their Cerner Centuries® EHR to track client follow-ups. Those who check positive for COVID-19 get quarantine education and directions for pursuing additional care.
Facilitating proper care documents
Behind the scenes, the EHR helps caregivers expedite screening workflows by automatically developing a care encounter in combination with each COVID-19 screening order.
“We’re checking 1,000 to 2,000 people a day, so any time savings is significant,” said Moores-Todd. “Getting rid of steps in the process assists us test and look after more individuals, more secure and much faster.”
After seeing each client, Intermountain groups guarantee they’ve appropriately recorded care using the current COVID-19 diagnosis and billing codes from the Centers for Medicare & & Medicaid Services (CMS).
“This circumstance established so quickly that it took a few weeks for CMS coding guidance to catch up,” stated Jacobsen. “A surge in scientific care creates a rise in claims, and it’s valuable having the choice to slow chart evaluations up until we can properly code. Taking this action now enhances efficiency by helping us prevent a rise in rejections and corrections later.”
Focusing on whole-person wellness
Intermountain’s COVID-19 response exceeds patients’ physical care to include the wellness of caregivers and the neighborhood. The organization has a complimentary Emotional Health Relief Hotline and publishes blog sites with useful advice on subjects like handling stress and sleep, remaining active from house and practicing mindfulness throughout the pandemic.
Caretakers receive additional assistance, and the healthcare system redeployed caregivers from areas where work has actually briefly slowed to locations where work grew due to COVID-19. The company increased dexterity by creating a single nursing function in its Cerner options, offering nurses throughout the enterprise access to any workflow they may experience throughout redeployment.
Intermountain likewise changed its compensation policies to safeguard personnel who may work less, as the company delays elective treatments to help minimize transmission and save personal protective equipment.
“This duration of rapid modification has made readiness, development and flexibility more important than ever,” said Ize-Ludlow. “We’re constantly adapting to fulfill our mission– helping individuals live the healthiest lives possible.”