Tracking COVID-19 is not just of interest to public health entities. Health systems are also investing in virus surveillance efforts.
One such effort is contact tracing, a method of infectious disease control that has been around for decades and remains largely manual. The idea is to identify the relationships between infected people and those with whom they have been in contact while they were contagious. Raising awareness of potential exposure can help slow the spread of the virus.
Tech companies are building platforms that digitize certain contact tracing methods. Apple and Google recently released a draft version of their Bluetooth-enabled exposure notification API, aimed at helping public health entities notify individuals of potential exposure through apps and detailing next steps. Other providers take a different approach to contact tracing. Sentinel Healthcare, for example, has created a HIPAA-compliant platform to monitor people exposed to COVID-19.
Regardless of methodology, the potential for tracing exposure to COVID-19 raises concerns for healthcare CIOs and public health systems, including patient privacy and obtaining user buy-in. . Still, keeping track of the evolution of the virus will be essential to reopening health systems, as well as the economy.
Contact tracing at UT Health Austin
UT Health Austin in Texas, the clinical practice of Dell Medical School, is using Sentinel Healthcare’s platform to monitor both healthcare workers and patients who have been exposed to COVID-19.
Aaron Miri, CIO at UT Health Austin, said the Sentinel Healthcare platform provides home monitoring and contact tracing capabilities for COVID-19 patients. He decided to invest in technology to manage the patient population during the COVID-19 crisis.
Sentinel Healthcare platform users can access the platform through a mobile app. The app prompts users to log their symptoms and temperature regularly. Exposed individuals can be provided with a digital thermometer that integrates with the platform.
The platform’s algorithms keep tabs on the data and can detect when an individual’s symptoms worsen. Real-time alerts are then sent to the appropriate healthcare professionals, who decide whether the patient should go to the hospital or if they should receive care in another way, such as a telehealth visit. The app also tracks diagnostic labs for drive-through testing site patients.
After the health system confirms that a patient has been diagnosed with COVID-19, staff at a remote call center contacts anyone the patient has recently been in contact with.
jeffrey becker
Jeffrey Becker, healthcare analyst at Forrester Research, said the tools that healthcare CIOs invest in, like the Sentinel Healthcare platform and infectious disease surveillance tools from leading EHR vendors, can make the research process more effective contacts.
“There are tools to build that list and it’s still just a manual call center,” Becker said. “This should be viewed as an improvement to an existing capability, not the introduction of net new capability.”
As UT Health Austin collects data on COVID-19 patients and who they have been in contact with, Miri said data sharing becomes critically important.
“It’s largely a workflow,” he said. “What data do you need to capture that goes into CDC forms, what data do you need to capture that goes into Austin public health forms, what questions should you ask, considering things like HIPAA ?… All of this has to happen and work to make contact tracing work.”
For hospital systems, the real value is monitoring the spread of COVID within the organization.
jeffrey beckerHealth Analyst, Forrester Research
Miri is not alone in her efforts to monitor COVID-19 within a healthcare system. Cletis Earle, CIO at Penn State Health and Penn State College of Medicine in Hershey, Pennsylvania, is also exploring tools that can help digitize parts of the contact tracing process, especially as the country begins to think about reopening. The reintroduction of healthcare workers who were working remotely into the healthcare system to conduct normal operations makes it essential to have a way to track employees and potential exposure to COVID-19.
Cletis Earle
“We are trying to look at different solutions that can help track our own employees to ensure they stay healthy and safe throughout the protracted component of this pandemic,” he said.
Becker said contact tracing is beneficial to health systems because it goes beyond traditional disease surveillance and aims to capture cases of person-to-person contact lasting longer than 15 minutes. Through contact tracing, health systems can identify exposed clinicians if a patient is diagnosed with COVID-19.
“For hospital systems, the real value is monitoring the spread of COVID within the organization,” Becker said. “It protects workers; it prevents the spread of COVID-19 from patient to patient, worker to worker.”
Nationwide digital contact tracing
Health systems see an immediate benefit in implementing their own tools to help with contact tracing, but the benefits of a national public health contact tracing effort are mostly theoretical, as large-scale diagnostic testing for COVID-19 and a comprehensive contact tracing program do not. still exist, Becker said.
Tech companies are hoping to change that. Google and Apple, for example, have developed an exposure notification API, a contact tracing initiative for public health agencies. Public health departments can use the API to build contact tracing apps that notify users when they’ve been exposed to someone diagnosed with the virus, which would typically be done through a phone call. However, it would be up to people using the app to confirm whether they tested positive for COVID-19.
Becker said the capacity would be valuable as the economy reopens and people begin to travel, return to work, use public transportation and interact with the general public.
“Six months from now, you could be sitting on a plane within six feet of nine people you don’t know,” Becker said. “Therefore, it is useful to create technologies that will allow your phone to passively capture the identifying information of people you meet and do not know. With diagnostic tests and a comprehensive contact tracing program, we can start reopening the economy and have a plan in place that will still allow us to isolate the virus.”
But, for a digital contact tracing program to work effectively, it would need widespread use so that it can capture as many encounters between an infected person and an uninfected person as possible. For that to happen, Becker said it would require significant citizen engagement, as everyone would have to sign up and activate the contact tracing app, as well as submit if they’ve tested positive for COVID-19. Getting people to buy into this type of monitoring will be a barrier to wide adoption and a barrier to the effectiveness of the technology, Becker said.
“If you only get 20% of the population to use the app, you only get 20% of the transmissions,” Becker said. “If you’re only getting 20% of the transmissions, that’s not an effective strategy to reopen the economy.”
Another challenge facing the adoption of such tools is privacy, Becker said. For patients who have been diagnosed with COVID-19 but are later returning to work, anyone in the workplace who has downloaded the app will light up with notifications if that person also has their app running. execution.
“It’s a real-time, very invasive process,” Becker said. “People diagnosed who don’t have a choice to be in the community are just going to turn it off and withdraw, because otherwise they’re going to walk around the community in real time watching people being told they’re ‘I’ have been exposed.”
In the first phase of Google and Apple’s initiative, users will be able to download contact tracing apps to their phones. In the second phase, the tech giants plan to build the capability directly into the device’s operating system to help ensure wide adoption, but users will still need to sign up.
Becker said he’s interested to see how adoption of such apps pans out in the United States — something he says won’t go very far unless it’s mandated.
“I think at this level it’s not going to be the magic bullet that gets awarded to him,” Becker said. “Unless there’s a way it becomes mandatory, which would never fly in the US…it’s going to remain an opt-in [option] and it’s going to receive relatively low adoption and the impact will be quite drastically reduced.”
Cletis Earle
Comments are closed.