An application to support COVID-19 occupational health and patient tracking at a Veterans Affairs medical center

Abstract

Objective Reducing risk of coronavirus disease 2019 (COVID-19) infection among healthcare personnel requires a robust occupational health response involving multiple disciplines. We describe a flexible informatics solution to enable such coordination, and we make it available as open-source software. Materials and Methods We developed a stand-alone application that integrates data from several sources, including electronic health record data and data captured outside the electronic health record. Results The application facilitates workflows from different hospital departments, including Occupational Health and Infection Control, and has been used extensively. As of June 2020, 4629 employees and 7768 patients and have been added for tracking by the application, and the application has been accessed over 46 000 times. Discussion Data captured by the application provides both a historical and real-time view into the operational impact of COVID-19 within the hospital, enabling aggregate and patient-level reporting to support identification of new cases, contact tracing, outbreak investigations, and employee workforce management. Conclusions We have developed an open-source application that facilitates communication and workflow across multiple disciplines to manage hospital employees impacted by the COVID-19 pandemic.

Managing Pandemics with Health Informatics

“…A third group leveraged EHR systems and administrative information systems to better manage the internal operations of a hospital or health system. These papers often described a centralized incident command center or operations team that integrated data from multiple information systems to drive organizational decisions as the pandemic unfolded in their service area [ 16 , 17 ]. Rapid assessments and visualization of data were helpful to organizational leaders who used chains of command to distribute information quickly to service line leaders, enabling the organization to update clinical screening and therapeutic guidelines as the evidence evolved over the course of the pandemic.…”

Benefits and Challenges of Transitioning Occupational Health to an Enterprise Electronic Health Record

“…Furthermore, access to the worker’s genetic and disability history must be restricted in accordance with the Genetic Information Nondiscrimination Act (GINA) and Americans with Disabilities Act (ADA), which prohibits discrimination in hiring, firing, or promotion based on genetic information or disability 5,6 . In response to these challenges, many OH solutions rely on stand-alone EHRs, population management using spreadsheets, and purchasing third-party workflow specific software that enable basic patient care and compile necessary reports to governmental agencies and for institutional audits 4,7 …”

“…5,6 In response to these challenges, many OH solutions rely on stand-alone EHRs, population management using spreadsheets, and purchasing third-party workflow specific software that enable basic patient care and compile necessary reports to governmental agencies and for institutional audits. 4,7 The functionality limitations of OH specific EHRs were further highlighted during the COVID-19 pandemic-from challenges meeting a growing number of workplace injuries and illnesses to ordering COVID-19 testing to vaccinations to tracking those with potential exposures. The pandemic placed a particular strain on workers with nonfatal workplace injuries and illnesses in private industry increasing 32% compared with before the pandemic.…”

“…5 , 6 In response to these challenges, many OH solutions rely on stand-alone EHRs, population management using spreadsheets, and purchasing third-party workflow specific software that enable basic patient care and compile necessary reports to governmental agencies and for institutional audits. 4 , 7 …”