Clinical informatics accelerates health system adaptation to the COVID-19 pandemic: examples from Colorado

J Am Med Inform Assoc. 2020 Dec 9;27(12):1955-1963. doi: 10.1093/jamia/ocaa171.

Abstract

Objective: Large health systems responding to the coronavirus disease 2019 (COVID-19) pandemic face a broad range of challenges; we describe 14 examples of innovative and effective informatics interventions.

Materials and methods: A team of 30 physician and 17 nurse informaticists with an electronic health record (EHR) and associated informatics tools.

Results: To meet the demands posed by the influx of patients with COVID-19 into the health system, the team built solutions to accomplish the following goals: 1) train physicians and nurses quickly to manage a potential surge of hospital patients; 2) build and adjust interactive visual pathways to guide decisions; 3) scale up video visits and teach best-practice communication; 4) use tablets and remote monitors to improve in-hospital and posthospital patient connections; 5) allow hundreds of physicians to build rapid consensus; 6) improve the use of advance care planning; 7) keep clinicians aware of patients' changing COVID-19 status; 8) connect nurses and families in new ways; 9) semi-automate Crisis Standards of Care; and 10) predict future hospitalizations.

Discussion: During the onset of the COVID-19 pandemic, the UCHealth Joint Informatics Group applied a strategy of "practical informatics" to rapidly translate critical leadership decisions into understandable guidance and effective tools for patient care.

Conclusion: Informatics-trained physicians and nurses drew upon their trusted relationships with multiple teams within the organization to create practical solutions for onboarding, clinical decision-making, telehealth, and predictive analytics.

Keywords: COVID-19 pandemic; advance care planning; clinical decision support; clinical pathways; crisis standards of care; electronic health records; onboard training; patient wearables; predictive analytics; telehealth; virtual healthcare.

MeSH terms

  • Aftercare
  • COVID-19* / epidemiology
  • COVID-19* / therapy
  • Decision Support Systems, Clinical
  • Delivery of Health Care, Integrated
  • Electronic Health Records
  • Humans
  • Medical Informatics*
  • Pandemics*
  • Telemedicine*
  • United States