Electronic Health Records (EHR, EMR)Population HealthTelehealthWorkflowWorkforceOn the frontlines of the coronavirus pandemic, UW has ramped up telemedicine capabilities and made immediate changes to its EHR to support COVID-19 care.Eric J. Neil
UW Medicine was one of the first healthcare systems on the front line of the global COVID-19 pandemic in the United States. Its rapid response underscored the importance of preparing to address unique IT challenges associated with viral outbreaks.
Those challenges include the need to rapidly expand telemedicine capabilities, shifting a large portion of hospital staff to teleworking, and immediate changes in the electronic health record to support COVID-19 care.
“Unlike a weather event or a shooting, our response to COVID-19 is a continuously evolving process that has no endpoint and requires us to adapt by the hour,” said Dr. Jane Fellner, a UW Medicine physician who provides clinical guidance for EHR changes.
“Infection concerns drive us to be creative with the use of remote options to provide services, and there are access and supply issues for necessary IT tools just as there are for clinical infection control supplies.”
Actions you can take now
UW Medicine IT Services recommends healthcare organizations take the following actions now to prepare their IT services for COVID-19. Additional details can be found on the UW Medicine COVID-19 Resource Site.
Establish your incident command structure.
Once enacted, establish your new or evaluate your existing IT response structure. Be sure that points of contact and processes will work for this situation. Plan for the long haul. You will need staff to surge support for weeks or months. Ensure you have a deep bench of experts in key areas to sustain the demand.
Get ready to quickly update your systems
Clinical staff will need immediate changes to the EHR to facilitate COVID-19-related documentation. These updates must be quickly evaluated, implemented, and centrally disseminated as quickly as possible. Your IT personnel must be able to do this around-the-clock.
Ensure that your Information Security team has a rapid process to assess, document, and approve risk decisions and exceptions during the emergency.
Be ready to support surging personnel
Assess how your organization can be nimble with granting access to systems and sites in emergencies. Start planning now for emergency-level access that allows people to surge and flow between sites in a triage situation.
Telehealth is critical – build capability now
Quickly prepare multiple sites with telehealth capability. This will allow patients and providers to flow between different sites. Begin training and privileging your providers now.
Assess remote user capability, licenses, software, hardware and bandwidth limitations to connect to your systems to ensure your systems can handle the influx of users and increased utilization of your network and resources. Assessing this capacity also applies to your telework capacity.
Ensure you can support telework
Plan for large scale remote work. This will require workforce provisioning of equipment and policies and procedures for managing a remote workforce.
Managers must be prepared to triage telework requests from personnel who may require transitioning to telework in the early stages of the crisis, before the rest of the organization. Make sure they are prepared to manage and stay engaged with a teleworking workforce.
Consider hosting a drill where all non-essential staff work from home.
Reduce community transmission with patient self-screening
Make patient screening tools accessible prior to presenting. Priority needs to be on ensuring your patients know how to self-screen. This requires quickly putting guidance on patient-facing websites, portals, and other outreach mechanisms to direct patients to appropriate resources.
Help your Help Desk
Prepare for increased Help Desk support requirements, and ensure your staff are prepared to answer questions and quickly resolve issues with clinicians using new telehealth capabilities, and newly teleworking employees.
Keep everyone connected and regularly updated
Establish a centralized intranet site for disaster management and communication. This includes an incident command dashboard of automated metrics to help assess the evolving situation.
Identify the role of IT in sending communication to the workforce. Test dissemination methods to ensure they reach your entire workforce. Review communication distribution lists to ensure that they accurately reflect the internal, external, partner, and other groups that are critical to your response.
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