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Rapid Implementation of a Complex,Multimodal Technology Response to COVID-19 at an Integrated Community-Based Health Care System
Authors:Andrew J Knighton  Pallavi Ranade-Kharkar  Kimberly D Brunisholz  Douglas Wolfe  Lauren Allen  Thomas W Belnap  Tamara Moores Todd  Rajendu Srivastava  Seraphine Kapsandoy  Diego Ize-Ludlow  Todd L Allen
Institution:1.Healthcare Delivery Institute, Intermountain Healthcare, Murray, Utah, United States;2.Care Transformation Information Systems, Intermountain Healthcare, Salt Lake City, Utah, United States;3.Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, United States
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.
Keywords:COVID-19  surge capacity  telemedicine  electronic medical record  health information interoperability
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