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Image of doctors and nurses surrounding a laptop. Image of doctors and nurses surrounding a laptop.

Spotlight on an epidemiologist—care team coordination and patient engagement in times of crisis

The COVID-19 outbreak is the challenge of a lifetime for government officials, public health workers, and healthcare providers. The pandemic presents immense challenges for doctors and other health workers to screen, diagnose, and care for patients with the disease all while needing to stay healthy themselves. It presents communications, coordination, and logistical burdens for hospitals, public health departments, and government agencies trying to manage the outbreak.

To gain a firsthand view of how COVID-19 is impacting healthcare organizations, we spent some time with Dr. Mike Myint, an infectious diseases specialist and the Physician Executive for Population Health at MultiCare Health System based in Washington State. MultiCare operates seven hospitals with 1,500 employed physicians, 3,000 affiliated physicians and a large clinical network including free-standing emergency departments, urgent care, and virtual care. Below, I’m sharing Dr. Myint’s observations from the interview—he covers everything from the human impact of COVID-19 to the technology his team uses to help combat it. I hope you’ll find his comments as insightful as I did. Over to Dr. Myint.

COVID-19 is unlike any epidemic we’ve seen before. Our patients and communities have a lot of concerns. And in the internet age, there’s a lot of information available. Some of it is good, and some of it is unhelpful. We are very focused on sharing accurate information that helps people stay healthy and ensures that our medical resources are being saved for the people who need them.

This pandemic has affected all of us, and some of the impacts are really hard. For parents, it has been hard to have schools close. Our elderly and at-risk populations are particularly worried, and most of us know someone who falls into that category. Many people in the gig economy and who work in the service industry have lost their incomes. So this is very destabilizing for many people.

From the medical side, the lack of testing has been a real challenge, and it’s only improving slowly. Our healthcare workers are mission-driven people and they come to work every day to help people. We have to focus on keeping our workforce safe, and we are.

In a disaster, we move from care of the individual to maximizing care to the entire population. We have to think about individual health and population health. Our clinicians are very focused on taking care of the patient in front of them, and that continues, but we also have to look at the entire picture, especially during a surge where equipment may be limited. I also worry about the impact of this crisis on people who are dependent on our care, such as dialysis patients.

Coordination and technology to address the crisis

We are using many digital tools, such as teleconferencing, electronic health records, and email. It’s critical that we get the right information and the right messages to the right people, and that’s hard when things are changing daily. The tools are helping, but there is room for improvement.

We are seeing some very positive uses of technology during the COVID-19 pandemic. We can use bots to screen patients and identify the ones who need urgent care. We’ve seen virtual visits with doctors explode—in our system, there is a 1,200 percent increase in virtual visits.

Virtual visits are great because they allow us to continue to treat chronic care patients who have cancer or diabetes, and we can see them safely. And we find that many of our older patients are comfortable with virtual visits because they have smartphones. The video aspect of the visits makes people feel like they are really interacting with their provider.

How we use technology

We are moving so quickly in this crisis that it’s been very helpful to have online communication and collaboration tools. They allow us to co-edit documents, such as personal protective equipment (PPE) use policies. In quieter times, we were able to send drafts back and forth to each other, but we don’t have time for that now. The availability of masks and other PPE equipment changes daily, so our policies need to adapt quickly. Many health workers are not very comfortable with these tools, and it’s hard to get people to start using them in a crisis, so that’s a challenge. Once you get people to use these tools, it is easier to develop, collaborate, and deploy information into the system.

Data usage and systems

I think that the testing delays we’ve seen will come to define the COVID-19 response. For example, it can still take 5–7 days to get a COVID test result, and it often takes time for a result to work through the system to the patient’s bedside. During this time, we may be using PPE that was unnecessary because the patient is negative, and that costs us valuable PPE. More seamless lab results and integration of systems will save us valuable supplies. Interoperability between the different systems would allow the nurses and doctors to see and act on the results more quickly.

The supply chain has been a big challenge for the hospitals. We’ve had to create some tools for predictive modeling using our spreadsheets. We can look at how much PPE we have, and the rate we are going through it, and look at infection rates, and make some predictions on how long our supply will last. We are creating these models from scratch and inventory management systems would really help us.

We have a lot of data, but a lot of it is manual. We need to develop a “smart hospital”—collecting information about beds, equipment, supplies, and workers into one database. We could use that, along with disease modeling and testing information to monitor infection rates, plan for patient surges, and deploy equipment the best way possible. We know that the tools exist for this, but they haven’t been deployed. This could save lives, because we could ensure that ventilators are available where they are needed, and not waiting in hospitals that don’t need them. Using predictive algorithms and machine learning would make a huge difference.

Across systems, all of the data, except test results, is available. We need better ways to visualize it, collaborate at scale, and use the data effectively.

Final thoughts

Most urgently, we need free, readily available access to COVID testing. People need to continue social distancing, and we need to focus on isolating patients who have the disease. Learning from successful countries like Singapore, Hong Kong, and South Korea, we can bend the curve and end this pandemic.

I am hopeful that we will get through this, and we will deal with the economic and other consequences of this pandemic. There will be other epidemics or pandemics, hopefully not as bad as this one, so I hope we take the lessons we are learning today to develop the tools and public health infrastructure to stop them early. We have the data and the tools, and I believe we can use them more effectively to keep people safe.

We are grateful to the government and healthcare professionals on the front lines of COVID-19, and look forward to bringing you more tips, stories, information, and resources in the coming days. If you’d like to learn more about how Microsoft can help empower healthcare organizations to provide the best possible care, this site offers all the details.

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