Becker's Hospital Review

51 Executive Briefing Sponsored by: A t the height of the coronavirus pandemic in April, the director of the CDC offered a grim warning: a resurgence of COVID-19 this winter could hit the United States healthcare system harder than the first wave. Of course, knowledge is power. Healthcare providers agree that one reason COVID-19 was so devastating was the lack of precedent and the fact that the pandemic required immediate firefighting, leaving less space in the early days for coordination across government, providers, stakeholders and private entities. Today, with the cognizance that COVID-19 may surge again as the nation heads into flu season, providers can take all the actions they need now to ensure they're prepared for the future. Clinically prepare with an early notification system Providers have an integrated, near real-time surveillance system at their fingertips. More than 1,200 hospitals across the country already have in place the technology to surveil COVID-19 suspected and confirmed cases, predict disease progression and surge, determine the supplies necessary to care for the infected population, improve the quality of medical interventions and ultimately prevent the spread of the disease. Fueled by national and local sources of data, this technology enables providers to predict COVID-19 surge in a specific locality and forecast disease progression. Foresight is crucial. One of the earliest warning signs that can signal a future pandemic hot zone is a sharp increase in specific COVID-19 symptoms within a defined community. This technology is already integrated within all major EHR systems and will further be used by approximately 150,000 clinicians to predict future cases. They are enabled to do this with natural language processing and machine learning, two technological capabilities that look for signs and symptoms that are often recorded within physician's notes. Even better, this technology's predictive analytics are customized for each facility, indicating the health systems' projected caseload for five to seven days. When health systems can predict where COVID-19 cases will increase, down to the county and facility, they can adjust staffing levels, coordinate with their supply chains to assure access to proper equipment and pharmaceuticals, align COVID-19 testing protocols, and prepare to limit nonessential services as needed. Predict and manage cases In a clinical setting, COVID-19 information offered at the point of care allows providers to initiate the right treatment for the right patient at the right time. From the height of the pandemic, infection preventionists were able to utilize clinical surveillance intelligence that includes COVID-19- specific alerts and patient flags for tracking and analytics. Alerts for suspected or positive cases enabled infection preventionists to isolate patients appropriately to prevent disease transmission or spread. This clinical surveillance technology continues to be the key to success in identifying potential cases and reacting appropriately. Furthermore, providers have been leveraging clinical decision support technology that is powered by natural language processing and machine learning to flag suspected or confirmed COVID-19 patient cases directly in the EHR, regardless of the site of care. This is critical because patients who have early symptoms of COVID-19 are more likely to seek a primary care visit than present to the hospital. Premier's clinical decision support intelligence extends beyond the functions of current-day EHRs by reading free text, including clinical symptoms recorded within the treating clinician's notes. With this ability, providers can assess if medical practices within a specific zip code are noting upticks in COVID-19 symptoms — say, fever, cough and loss of smell — and can react appropriately. Anticipate supply needs and capacity Model-based tools available today will aggregate clinical and supply chain data and apply the insights to individual hospitals, offering near real-time information to guide decision-makers' preparations for surges in bed and supply capacity. Providers need this capability so they can adequately anticipate surges in COVID-19 along with the implications for supplies, including personal protective equipment (PPE), therapeutics and blood needed by the providers. Providers rely on these insights to manage patient care needs and supply inventory during any potential future surges. A supply chain forecasting solution helps providers anticipate their PPE requirements, along with other equipment necessary for treating patients. Ideally, providers are enabled with a supply allocation model that predicts the number of disease cases across a seven-day period by county and models the supply levels a healthcare provider will need based on estimated case volume and typical surge demand. Premier members shared that one of the most effective tactics during the height of the pandemic was a daily capacity management huddle, in which caregivers from across the hospital discussed patient volumes, beds and staffing. During these huddles, multidisciplinary teams collaborated on processes the teams could employ to meet the daily demands and displayed visual management tools that collated all the pertinent information into a snapshot. Readiness for a resurgence

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