...
High risk settings (use the phone screening criteria to start)
Known positive contact
Anonymous exposure notification
No known high risk settings or positive contacts
Diagnostic Testing PerformedTest Order:
Type of test-- code that describes specific test
Rapid or not
Lot info?
Location to perform test?
Rationale
Ordering provider
Contact info
Contact for patient follow up?
Diagnostic Testing Results:
Test specimen--sample source
Test date
Test product-- code that describes specific test
Lot info?
Test locationfacility
Test result
Test pending
Test negative
Test positive
Inconclusive test
History of Positive Diagnostic Test
Reporting confirmed to health department and CDC?
Antibody Testing:
Type of test-- code that describes specific test
Rapid or not?
Lot info?
Location
Rationale
Ordering provider
Contact for follow up
Rapid or not?
Antibody Test Results:
Test specimen- -sample source
Test date
Test product-- code that describes specific test
Lot info?
Test facility
Test result
Test pending
Test negative
Test positive
Inconclusive test
History of Positive Antibody Test
Reporting confirmed to health department and CDC?
Patient Identifiers and Contact Information:
Name
Address-- physical, facilities
...
Email
Cell phone
Phone 2
Emergency Contact
EC phone
DOB
MRN/ID
Link to family members?
Status:
No known risk, symptoms, testing or exposure-- have you ever tested positive, had illness consistent with COVID-19, been exposed to positive case or high risk person/location?
History of risk factors but without symptoms and with negative diagnostic test result
History of risk factors including symptoms and no history of testing
Currently At Risk for COVID-19:
Symptom Screen Positive
Patient needs evaluation from a medical professional
Need for testing
Patient tested positive
...
Test ordered/pending
Significant Exposure History
Patient needs evaluation from a medical professional
Test ordered/pending
Diagnosis of COVID-19
Patient tested positive at some point
Patient presumed positive despite negative test or lack of test
Patient presumed recovered
Patient tested as convalescent--
negative diagnostic test for formerly positive case?
positive antibody test only
COVID-19 Disease Severity: (Use ED group severity scale)*
Follow Up Step:
Next Action or Contact
Date
Accountable party
Issues for Follow Up:
Deduplication-- failure to identify same patient across encounters
Need for accurate contact information
Recording multiple test results over time
Do antibody tests require reporting
Get ED severity numbers
Is reporting at local, CDC level or both?
Current approaches to case management in and outside of EHR
Confirming patient reported positive diagnostic and antibody testing
Order and complete testing- order sets, CDS to suggest testing, instructions and referrals for tested patients, quarantine instructions - 2
Follow up test results and referrals – receipt of test results internal or external, other required follow up - 3
Case Reporting and Contact Tracing - eCR, paper reporting, contact identification, contact follow up - 2
Risk Calculation or Stratification - tools to evaluate risk and respond to high risk patients, need for social and medical services to keep patients healthy in quarantine - 2
Update Case Status--> Initiate Outpatient Case Monitoring of Positive or Probable Cases in Quarantine - 4
Inpatient/Outpatient handoffs - coordinate with ED/Inpatient group -
Convalescence - follow up testing, clinical research and plasma donation, identification of presumed low risk for future clinical activities - 1
...
Great Public Health Medical Center has set up a method to track patients positive for and suspected with COVID-19 and assess their needs. They need a method to provide case management and outpatient monitoring for these patients to know when they should come to the clinic or go to the hospital or go for repeat testing. The tool would help monitor vital signs like oxygen saturation if available and symptoms including a walk test and provide feedback to the team. The tool would allow case managers to get remote feedback from patients and call those who have issues or fail to check in remotely.
Subcomponent 1: Tooling to Support COVID-19 Case Management
Users:
Nurse/Case Managers
Physicians/APRNs/PAs
Other care team members?
Community Health Workers?
Requirements:
Filter patients by status, demographics, case manager, follow up action
Open/link to individual patient from dashboard
Generate reports
Workflow:
Subcomponent 2: Risk Calculator for Existing Patients and Follow-Up Risk Reduction Tool (NACHC)
...
Link to the use case 2 for home care as an outcome
SDOH typical stakeholders supporting social and community needs are currently overburdened or not operating at normal capacity (Hassanah)https://www.ajmc.com/newsroom/how-can-employers-address-social-determinants-of-health-exacerbated-by-covid19
https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/assessing-risk-factors.html
Subcomponent 1: