Responding to COVID-19: The UW Medicine Information Technology Services Experience

Abstract

Background UW Medicine was one of the first health systems to encounter and treat COVID-19 patients in the United States, starting in late February 2020.

Objective Here we describe the rapid rollout of capabilities by UW Medicine Information Technology Services (ITS) to support our clinical response to the COVID-19 pandemic and provide recommendations for health systems to urgently consider, as they plan their own response to this and potentially other future pandemics.

Methods Our recommendations include establishing a hospital incident command structure that includes tight integration with IT, creating automated dashboards for incident command, optimizing emergency communication to staff and patients, and preparing human resources, security, other policies, and equipment to support the transition of all nonessential staff to telework.

We describe how UW Medicine quickly expanded telemedicine capabilities to include most primary care providers and increasing numbers of specialty providers. We look at how we managed expedited change control processes to quickly update electronic health records (EHR) with new COVID-19 laboratory and clinical workflows. We also examine the integration of new technology such as tele–intensive care (ICU) equipment and improved integration with teleconferencing software into our EHR. To support the rapid preparation for COVID-19 at other health systems, we include samples of the UW Medicine's COVID-19 order set, COVID-19 documentation template, dashboard metric categories, and a list of the top 10 things your health care IT organization can do now to prepare.

Conclusion The COVID-19 response requires new and expedited ways of approaching ITS support to clinical needs. UW Medicine ITS leadership hope that by quickly sharing our nimble response to clinical and operational requests, we can help other systems prepare to respond to this public health emergency.

Keywords

COVID-19 - health information technology - public health

Note

A previous version of this work is available on the UW Medicine COVID-19 web site at https://covid-19.uwmedicine.org/. In the interest to publish this paper while the COVID-19 pandemic is still ongoing to share lessons learned with others as quickly as possible, this paper has undergone an abbreviated and unblinded peer review. Users are advised to use the recommendations in this paper in a judicious manner.

Protection of Human and Animal Subjects

We reviewed this work with our Human Subjects Division. They concluded it was not human subject research.

• References

• 1 Bhadelia N. Coronavirus: hospitals must learn from past pandemics. Nature 2020; 578 (7794): 193
• 2 Holshue ML, DeBolt C, Lindquist S. , et al; Washington State 2019-nCoV Case Investigation Team. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020; 382 (10) 929-936
• 3 Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19) cases in the U.S. Available at: http://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html . Accessed March 17, 2020
• 4 Persoff J, Ornoff D, Little C. The role of hospital medicine in emergency preparedness: a framework for hospitalist leadership in disaster preparedness, response, and recovery. J Hosp Med 2018; 13 (10) 713-718
• 5 Chacko S, Randolph R, Morsch G. Disaster medicine: public health preparedness for natural disasters. FP Essent 2019; 487: 17-22
• 6 Bryson-Cahn C, Duchin J, Makarewicz VA. , et al. A Novel Approach for a Novel Pathogen: using a home assessment team to evaluate patients for 2019 novel coronavirus (SARS-CoV-2). Clin Infect Dis 2020; DOI: 10.1093/cid/ciaa256.
• 7 UW Medicine. COVID-19 resource site. Available at: https://covid-19.uwmedicine.org/Pages/default.aspx . Accessed March 22, 2020
• 8 Washington State Hospital Association. WA Collaborative Health Care Professional Telehealth Training_Jan2019_final_video. Available at: https://vimeo.com/344187400 . Accessed March 23, 2020
• 9 Washington State Hospital Association. Washington State Telehealth Collaborative. Available at: https://www.wsha.org/policy-advocacy/issues/telemedicine/washington-state-telemedicine-collaborative/ . Accessed March 22, 2020
• 10 Teladoc Health. InTouch Lite. Available at: https://intouchhealth.com/telehealth-devices/intouch-lite-and-lite-with-boom/ . Accessed March 23, 2020
• 11 Cao Y, Li Q, Chen J. , et al. Hospital emergency management plan during the COVID-19 epidemic. Acad Emerg Med 2020 . Doi: 10.1111/acem.13951
• 12 Liew MF, Siow WT, MacLaren G, See KC. Preparing for COVID-19: early experience from an intensive care unit in Singapore. Crit Care 2020; 24 (01) 83