Appl Clin Inform 2020; 11(05): 825-838
DOI: 10.1055/s-0040-1719179
State of the Art/Best Practice Paper

Rapid Implementation of a Complex, Multimodal Technology Response to COVID-19 at an Integrated Community-Based Health Care System

Andrew J. Knighton
1   Healthcare Delivery Institute, Intermountain Healthcare, Murray, Utah, United States
,
Pallavi Ranade-Kharkar
2   Care Transformation Information Systems, Intermountain Healthcare, Salt Lake City, Utah, United States
,
Kimberly D. Brunisholz
1   Healthcare Delivery Institute, Intermountain Healthcare, Murray, Utah, United States
,
Douglas Wolfe
1   Healthcare Delivery Institute, Intermountain Healthcare, Murray, Utah, United States
,
Lauren Allen
1   Healthcare Delivery Institute, Intermountain Healthcare, Murray, Utah, United States
,
Thomas W. Belnap
1   Healthcare Delivery Institute, Intermountain Healthcare, Murray, Utah, United States
,
Tamara Moores Todd
2   Care Transformation Information Systems, Intermountain Healthcare, Salt Lake City, Utah, United States
,
Rajendu Srivastava
1   Healthcare Delivery Institute, Intermountain Healthcare, Murray, Utah, United States
3   Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, United States
,
Seraphine Kapsandoy
2   Care Transformation Information Systems, Intermountain Healthcare, Salt Lake City, Utah, United States
,
Diego Ize-Ludlow
2   Care Transformation Information Systems, Intermountain Healthcare, Salt Lake City, Utah, United States
,
Todd L. Allen
1   Healthcare Delivery Institute, Intermountain Healthcare, Murray, Utah, United States
› Author Affiliations
Funding The analysis in this publication was supported (in part or in full) by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number KL2TR002539. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Research related to the section “Evidence-Based Care for Ventilated Patients with COVID-19 and Acute Respiratory Distress” was supported in part by the National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health under award number U-01HL143505 (ClinicalTrials.gov Identifiers NCT:03225807 and NCT:03984175). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Abstract

Background The rapid spread of severe acute respiratory syndrome coronavirus-2 or SARS-CoV-2 necessitated a scaled treatment response to the novel coronavirus disease 2019 (COVID-19).

Objective This study aimed to characterize the design and rapid implementation of a complex, multimodal, technology response to COVID-19 led by the Intermountain Healthcare's (Intermountain's) Care Transformation Information Systems (CTIS) organization to build pandemic surge capacity.

Methods Intermountain has active community-spread cases of COVID-19 that are increasing. We used the Centers for Disease Control and Prevention Pandemic Intervals Framework (the Framework) to characterize CTIS leadership's multimodal technology response to COVID-19 at Intermountain. We provide results on implementation feasibility and sustainability of health information technology (HIT) interventions as of June 30, 2020, characterize lessons learned and identify persistent barriers to sustained deployment.

Results We characterize the CTIS organization's multimodal technology response to COVID-19 in five relevant areas of the Framework enabling (1) incident management, (2) surveillance, (3) laboratory testing, (4) community mitigation, and (5) medical care and countermeasures. We are seeing increased use of traditionally slow-to-adopt technologies that create additional surge capacity while sustaining patient safety and care quality. CTIS leadership recognized early that a multimodal technology intervention could enable additional surge capacity for health care delivery systems with a broad geographic and service scope. A statewide central tracking system to coordinate capacity planning and management response is needed. Order interoperability between health care systems remains a barrier to an integrated response.

Conclusion The rate of future pandemics is estimated to increase. The pandemic response of health care systems, like Intermountain, offers a blueprint for the leadership role that HIT organizations can play in mainstream care delivery, enabling a nimbler, virtual health care delivery system that is more responsive to current and future needs.

Protection of Human and Animal Subjects

We reviewed this work with our Institutional Review Board and concluded it was not human subjects research.




Publication History

Received: 22 April 2020

Accepted: 24 September 2020

Article published online:
16 December 2020

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