Physicians of Southwest Washington has been implementing health IT vendor Innovaccer’s COVID-19 Management System, a tool the vendor has been offering provider organizations free to help manage and care for patients during the pandemic. The state of Washington is one of the areas in the U.S, hit worst by COVID-19.
The system is designed to enable provider organizations to drive self-assessments by individuals, educate high- and medium-risk individuals on next steps, help individuals navigate to care, offer telemedicine and virtual-triaging capabilities to doctors, and track and trace high-risk populations.
Before and after
Tamra Ruymann, Chief of Digital Health at Physicians of Southwest Washington, first explains how her caregiver colleagues are treating patients now, and then how they will treat them with the aid of this form of triage and telehealth IT once they begin deploying it in the immediate future.
“One of our larger independent clinics has nine clinicians; this clinic currently is performing triage with patients when they call in for an appointment,” she explained. “They are providing parking-lot visits, in-office visits and telehealth visits using a popular audio/video platform that can be used with iPhones, Androids and computers. This triage is being done through a paper questionnaire that the front desk employees are completing with each call.” Once triage is completed, employees have protocols in place that allow them to schedule the most appropriate visit type for each patient.
“This same questionnaire is the survey that is provided in the first step of the COVID-19 Management System,” Ruymann said. “The assistant, however, has an algorithm that allows for a low-, medium- or high-risk assignment for COVID-19, and can be used to help with visit-type determination. Using the system will allow this nine-clinician clinic to reduce the time of assessment, as well as the human error in risk calculation that is possible, and remove the paper-based workflow.”
Dealing with low-risk patients
Additionally, the front desk can use the system to generate informational links from the CDC that enable low-risk patients to be informed about how the virus spreads, how they can protect themselves and others and the importance of monitoring symptoms for worsening, she added. If a patient initially is deemed low-risk, the electronic survey can be sent to the patient via text message with a recommendation to take it daily so clinical staff can monitor the patient for worsening, she said.
“In another of our clinics, the only physician is working offsite and providing all care currently through telehealth or telephone visits for his patient population,” Ruymann explained.
“The determining factor for the type of visit is the technology available to the patient and their understanding or ability to use the technology. This requires time just to explain how to utilize the available audio/video systems, which can be abandoned due to lengthy processes for set-up.”
For this clinic, office staff currently are directing all patients with COVID-19 concerns or questions to the physician for communication, which requires a response from him for every call.
“The COVID-19 Management System could be used to send the assessment directly to the patients with smartphones for completion and risk assessment, and allow the physician to reach out to the medium- and high-risk patients, and move the outreach for the low-risk patients to the office staff,” she said.
Telehealth that is easy to use
Neither of the two clinics was set up with a telehealth platform. The COVID-19 Management System, she said, has incorporated a telehealth platform with simpler technology; the system involves the sort of audio/video capability included on a typical smartphone that will reduce the time to assist patients in app set-up.
Physicians of Southwest Washington already was a user of the Innovaccer healthcare IT platform. Its population health management department was provided two COVID-19 dashboards. These dashboards provide details on both confirmed and highly likely cases, as well as high-risk patient identification.
“Using this information, our care management team is working to implement remote patient-monitoring tools for the confirmed cases that are recovering in the home,” Ruymann explained. “Monitoring patients regularly using pulse oximeters and thermometers, along with outreach, will allow for the identification of patient-status changes requiring care-setting modifications and release of those who have fully recovered.”
With the high-risk patients, the care team is performing outreach to those most vulnerable and helping with items like medication, grocery and pet food delivery, she added. The provider organization can identify patients with multiple comorbidities and assist with everyday necessities in order to allow them the ability to remain at home, thereby reducing their risk of exposure, she concluded.
