How Interoperability Can Ease the Strain of Flu Season in the COVID-19 Era
Lucienne Ide
Executive, physician scientist, health IT enthusiast, entrepreneur, problem solver. Passionate about making healthcare better for all of us.
The key will be effective use of integrated technologies to streamline workflow and automate time-consuming processes.
(Originally published in Physicians Practice Nov 2020)
Hospitals are facing numerous new challenges as a result of the global coronavirus pandemic. For starters, the ever-evolving situation has required new workflows and adjustments to address continuous changes to guidelines and regulations. Adding to the complexity, critical resources, like personal protective equipment (PPE), hospital beds, ventilators, and medication has had to be strategically allocated due to periods of short supply. As winter approaches, hospitals can expect further upheaval – especially as the annual flu season kicks into high gear.
In addition to dealing with new COVID-19 cases, providing general health screenings and ongoing patient care, providers will soon also be juggling an annual surge in flu-related emergency department visits and hospitalizations. Because of this, the U.S. Department of Health and Human Services is adding mandatory influenza data reporting requirements to its existing COVID-19 reporting requirements in order to inform allocation of supplies, treatments and other resources from a federal level. Failure to report these data could result in termination for both Medicare and Medicaid, meaning the hospital would not receive reimbursement from these programs.
For hospital leaders, the question remains: How can we effectively manage all these moving parts, ensuring our staff stays safe, patients get the care they need, and reimbursements continue to flow? The key will be effective use of integrated technologies to streamline workflow and automate time-consuming processes.
COVID-19 and Flu Season: The Impact on Hospitals and Healthcare Workers
The thought of an active flu season is a nightmare scenario for hospitals. Combined demand from individuals suffering from COVID-19 and the flu could easily overwhelm hospitals and ICUs.
There is some speculation that the flu may not be as bad as previous years, since people are wearing masks, social distancing, not traveling as much, taking greater care with personal hygiene and getting their annual flu shot. Yet, hospitals will be faced with even more screening to test for both coronavirus and the flu, administering vaccinations and ensuring they're prepared for spikes of either illness across the population.
In addition to caring for patients, hospitals are now being required to report flu, as well as COVID-19, data. And they have 14 weeks (until mid-January) to comply with these new guidelines, which include wide-ranging data that needs to be submitted daily or weekly, or risk losing Medicare and Medicaid funds.
In the height of any health crisis – whether it is the continuing COVID-19 pandemic, or the seasonal flu – the primary concern for hospitals is ensuring patients receive the care they need. Our hospitals need support operationalizing in order to provide the best care both at a population and individual patient level.
COVID-19 Reporting and Vaccination Updates are Underway
Since July, hospitals have faced new requirements for reporting COVID stats, all of which became mandatory last month. The need to report data, such as the number of coronavirus patients and ventilators, tied to the threat of reduced reimbursement as a penalty for not doing so, have added to hospitals’ concerns at a time when resources are already stretched thin because of the current pandemic.
The prospect of one or more vaccines coming to market in the near future will add to this complexity. Typically a 10- to 15-year process including three stages of clinical trials, the U.S. government is now pushing to develop and deliver more than 300 million doses of a new COVID-19 vaccine to market in a matter of months. Currently more than 150 coronavirus vaccines are in development worldwide, 11 of which are in the last stage of pre-approval clinical trials. With such progress being made, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Congress in late September that there was optimism one or more safe, effective vaccine would be developed soon, with sufficient doses available in the U.S. by April.
However, once a vaccine is available, determining who should get it and when will exacerbate the administrative work for providers. The National Academies of Sciences, Engineering, and Medicine offered a framework to prioritize vaccine recipients once they are available, while state and local health departments will play a deciding role, too. It’s likely that healthcare workers, high-risk patients and those in nursing homes will be first in line for vaccines, with healthier individuals required to wait.
Many of the potential COVID-19 vaccines will likely require two doses from the same manufacturer, delivered a few weeks apart. Already overwhelmed providers will be tasked with managing the process to ensure patients get a complete course of treatment. This is a challenge, even with long-used vaccines, as studies show that patients are not compliant with completing multidose vaccines for conditions such as for varicella, hepatitis A, and hepatitis B, often leaving too long of an interval between doses, if they complete the course at all. The prospects of complying with a new vaccine are likely even lower, which can be especially detrimental in underserved populations already hit harder by COVID.
The Benefits of Innovative, Interoperable Tech Now and Beyond COVID-19
To ease the strain, hospitals should rely on technology to help efficiently screen and triage at-risk populations for COVID-19, identify patients who have tested positive for COVID-19 or the flu, to help manage vaccine schedules and to support resource allocation decisions. This real-time data reporting allows for identification of new hotspots for both the flu and COVID-19, enabling public health officials to update local policies and to make resource allocation decisions.
With the majority of patient data stored in the electronic health record, it’s crucial that core systems are able to integrate seamlessly with other clinical apps involved with testing, biometric monitoring and patient care. Having this information available in one place not only eases some of the administrative work on healthcare staff, but such solutions available today can also help hospitals proactively screen at-risk populations, monitor them for exposure to COVID-19 or the flu and ensure they get their results and the proper care as quickly as possible. Furthermore, innovative and interoperable technology can aid in streamlining follow-up processes and automating outreach to those who need to self-isolate, repeat testing, or receive their second vaccination dose.
The COVID-19 pandemic has accelerated healthIT innovation and adoption by years. As a result, we are in a position to arm our healthcare providers with the tools and solutions they need to continually fight and control COVID-19 and other epidemics so they can focus less on paperwork and administrative tasks, and more on providing quality patient care.