Patient and Contact Tracking Application for Ottawa County’s Department of Public Health

One Public Health Department. One Patient and Contact Tracking Application. Thousands of Hours Cycled Back into Patient Care.

“We can use this for so much more than COVID-19,” said a nurse on Ottawa County Michigan’s Coronavirus Taskforce.

This nurse’s hopeful sentiment came after only a demonstration of the completely digital patient and contact tracking application built by Michigan’s Ottawa County Department of Public Health (OCDPH). Since then, it’s been the sole tool supporting the county’s efforts in mitigating the spread of COVID-19.

The story starts back when the first few cases of novel Coronavirus began sweeping our nation. Stitched together by nurse’s handwritten notes, widely inaccessible Excel spreadsheets and temperamental, antiquated log-in systems, Ottawa County knew its current, legacy process was not the tool needed to respond to the rapidly evolving COVID-19 pandemic. A multi-department collaboration established a team that was able to combine knowledge and experiences from past implementations of OnBase solutions in seemingly unrelated programs. OCDPH pulled on experience from the Environmental Health team and Application Specialist Marshall Boyd, and were able to create a digitalized, end-to-end patient and contact tracking application within just a few weeks. Due the nature of the pandemic, swift and nimble adaptation of the system was achieved through continued feedback and collaboration of Ottawa County’s environmental health team, nurses, epidemiologists and other users. “Bringing multiple teams together facilitated a solution built on the unique skills and experiences of varied departments that wouldn’t have been accomplished by any team individually,” said Adeline Hambley, Environmental Health Manager with OCDPH. “Our hope is that, by sharing our story, other government agencies will see how quickly and easy it is to make a difference when you have the right tools and a collective approach to solving a problem.”

“Do You Want to Build a Similar Application?”

Integrated with the Michigan Disease Surveillance System (MDSS), Michigan’s public health record database, Ottawa County’s public health team is alerted of all new cases reported in the county. With a centralized Workview dashboard, nurses have immediate visibility of incoming cases. The nurse pulls new cases from the “Incoming Cases” queue and calls the patient to determine symptoms and all close contacts. This data is entered into the patient’s record, and the case is submitted to the “clerical initial case” queue. From there, support teams email the case information regarding isolation requirements and COVID-19 precautions. All contacts of a case are identified and entered into the system. These contacts are attached to the case and enter into their own contact workflow. Nurses use the “Incoming Contacts” queue to complete interviews with close contacts and, based on the information, can recommend next steps, be it COVID testing or just symptom monitoring and quarantine. The case’s contacts are asked to take necessary safety measures and submit daily symptom monitoring. Because the application is also integrated with ESRI, the epidemiologists can geographically monitor all cases and contacts in the community to better visualize disease spread. The community’s collected data is updated daily and available as charts, graphs and other illustrative representations, which can be easily exported and shared with other health professionals, circulated among teams and is available to the public on this page.

Fueling much of the application is its streamlined data capture and automated reporting, which is possible through integration with Qualtrics, a virtual survey system. Each day, cases and contacts are sent a two-question questionnaire asking about symptoms and how the respondent is feeling. Integration between OnBase and Qualtrics allows survey answers to be directly linked to the respondent’s file for a nurse’s review. Pre-determined triggers automatically prompt nurses to check in with a case or contact if he/she hasn’t responded within a certain timeframe, or if symptoms are worsening. This automation empowers the nurses in more ways than one. Significantly less time is spent on data entry so that more time is devoted to case investigations and patient care, which also helps medical personnel best prioritize their time by determining which patients need urgent attention, who is doing well and, hopefully, who can be sent to the “monitoring complete” queue. To date, 91 percent of the more than 20,000 surveys administered have been completed, returning more than 2,800 hours back to patient care.

With so many curiosities on how the agency was able to quickly and effectively standup this robust case manager, the OCPHD team has filmed a short miniseries on the system’s ins-and-outs. From integrating with state reporting systems and case queue reviews to moving cases through proper sequences and turning contacts into cases, you can watch the short, targeted demonstrations here.

“We made the conscious decision to leverage technology so that we could breakdown information silos and establish an interconnected approach to mitigating the spread,” said Matthew Allen, Environmental Health Supervisor for Ottawa County Department of Public Health. “Not only does this case management system have the capacity to scale up our approach and meet the challenges of a global health pandemic, but it allows us to do so safely from remote locations.”

Looking “Ahead of the Curve”

As the Coronavirus curve continues to flatten, the patient and contact tracking system will stay employed. Many nurses on Ottawa County’s team have already voiced excitement for new opportunities and look forward to leveraging the case manager wherever needed to continue encouraging healthier communities.

“Many people shy away from technology because of perceptions of steep learning curves and risky implementations, but that’s not how it has to be,” said Marshall Boyd. “In just a few weeks, we were able to stand this system up with no outside support – this was a completely internal effort. Immediately, nurses jumped on board because the solution transformed and expanded how they were able to go about caring for people, and much of the learning was intuitive. Now we’re talking about how else we can use the application to make people’s lives better – we couldn’t have done any of this had we dug our heels in the ground about digital transformation.”

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