Responding to COVID-19 by expanding the Camden Coalition’s HIE functionalities

Author
Christine McBride, Audrey Hendricks, and Natasha Dravid
Date
August 13, 2020

The Camden Coalition Health Information Exchange (HIE) is a collaborative data-sharing effort to improve care delivery in Camden. It’s a web-based application that offers Camden and regional healthcare providers real-time access to important medical information for patients, reducing the need for patients to catch providers up on their medical history. Data from the Camden Coalition HIE helps us identify individuals eligible for enrollment in our programs, guide us in the design of new initiatives, and provide us the information we need to evaluate our existing programs.

In response to COVID-19, we have been working with our vendor CareEvolution to develop new ways to use the Camden Coalition HIE to support participating providers as they provide care during the pandemic. In particular, we have used the Camden Coalition HIE to support the region’s quarantine hotel, make COVID-19 data more available to providers, and create dashboards that integrate clinical and demographic data to give broader insight into how COVID-19 is affecting New Jersey.

Rapidly building collaborative data collection for multi-agency quarantine workflows

As an initial response to COVID-19 community transmission, the Camden County Department of Health (CCDOH), Volunteers of America (VOA), and the Camden Coalition worked together to set up a hotel for individuals who needed a safe place to quarantine while recovering from COVID-19 awaiting the results of a test. The VOA and CCDOH managed the administration, intake, and onsite support to hotel residents, while Camden Coalition staff provided medical care. 

Because each of the three partnering organizations had different but essential roles to play, we built a shared form in the Camden Coalition HIE to track the referrals, intake process, and to document the patient’s care plan for quarantine. This form was embedded in patients’ existing records, so providers involved in the hotel quarantine process could see patients’ medical records alongside their COVID-19 care plans. To protect patient privacy, no other providers had access to this information.

Throughout this six-week intensive intervention, our three organizations learned how to pilot rapid data collection for multiple agencies with different roles in patients’ care. Each organization contributed and viewed data in the form, and reports built from the form gave staff an easy way to view their patient panel in real-time. This workflow is an example of how the Camden Coalition HIE can facilitate a secure, real-time way to communicate key information needed for care delivery and for determining the patient’s needs–especially in an emergency situation like the early weeks of a pandemic. Camden Coalition HIE allowed the providers involved to stay in communication and up to date on the process and patients’ status. 

New capabilities in the Camden Coalition HIE

To support our community as we work together to stop the spread of COVID-19, we created three new tools within the Camden Coalition HIE. These tools are designed to be easily adoptable so providers can complement their existing workflows with additional data and decision-making support.

One of these new capabilities is a report showing all COVID-19 lab results that are being tracked in the Camden Coalition HIE. It updates in real time as COVID-19 test results become available. Providers can use this report to monitor the patients with presumptive and confirmed positive COVID-19 tests and avoid duplicative testing. 

We also added COVID-19 lab and diagnosis information to existing reports so that providers can see which of their patients have been tested for and diagnosed with COVID-19. Providers at Cooper University Health Care and CAMcare are both using this functionality to find out their patients’ COVID-19 status. 

The Camden Coalition HIE also has the ability to flag individuals at highest risk for developing a severe response to COVID-19, using the CDC’s criteria for age and chronic illness. Providers can apply this functionality to any specified population. For example, health systems can look at their recently-discharged patients to see who is at high risk for COVID-19 complications, or a primary care practice can request a report from us that assists them in prioritizing telephonic system checks and appointments for people with higher medical risk

COVID-19 dashboards give a broad picture of South Jersey

All COVID-19 test results must be shared with the New Jersey Department of Health. This gives the state a comprehensive view of the results. Clinicians, however, are limited to seeing their own patients’ results, and may not be able to see data from test sites run by other organizations. and hospitals. The Camden Coalition HIE provides COVID-19 test result data alongside other clinical information, patient encounters, and important social indicators such as patients’ race and ZIP code. The aggregated data alongside patients’ clinical history and in-depth social information allows providers to have a clearer view of COVID-19’s impact. This makes the Camden Coalition HIE the holistic source of information about testing, percentage of positive results, illness severity, and mortality in South Jersey.

We have built unique dashboards specific to Camden, Gloucester, Burlington, and Salem counties to provide insight into how COVID-19 is affecting those counties. While the dashboards are currently designed for COVID-19 monitoring, the infrastructure that the Camden Coalition HIE has built now can be a vehicle for future public health surveillance efforts. The dashboards currently show:

  • Rates of new case identification
  • Testing rates
  • Geographic, demographic, and clinical trends in who is testing positive, who is requiring hospital-based care, ICU stays, and deaths 
  • Hospital bed capacity monitoring
  • Comorbidities for acute cases

Looking ahead

As communities discover the nuance and challenges of contact tracing, local HIEs like ours can play an important role in the reopening process. While the three pillars of the COVID-19 response have been testing, tracing and care coordination, we believe that information sharing is the fourth pillar that can make contact tracing efforts more successful. By implementing patient-centered data sharing practices that engage providers and care teams, we can amplify messages of harm reduction and health and we can ensure that critical information is delivered by trusted sources. 

To further this vision, we are partnering closely with the Camden County Department of Health to equip our local contact tracing teams with access to the Camden Coalition HIE and training on how to use it effectively in service of person-centered outreach.

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