A new biosurveillance system is helping Great Neck, NY-based Northwell Heath prepare for an influx of flu patients in the region. And that data is being shared with local authorities to pinpoint flu outbreaks in the community.
Just in time for the flu season, Northwell Health has a new dashboard that tracks and responds in real-time to the huge volume of influenza cases coming into its hospitals on Long Island and New York City.
Over the past week, the 12 Northwell hospitals that use the tracking system have seen more than 10,500 patients with flu-like symptoms, of which about 2,700 were admitted for inpatient treatment. Five other Northwell acute-care hospitals will be integrated into the system in the coming months.
Mark Swensen is an emergency management coordinator at Northwell and a member of the team that developed the dashboard. He spoke with HealthLeaders Media. The following is a lightly edited transcript.
HLM: How is Northwell's response different now using the dashboard?
Swensen: What we have now is a real-time look at case rate uptick and physical location of cases that we had no visibility for before. We are delayed by 24 hours, which is the time it takes our computer systems to sync the data into the data base. We're able to see, probably six to seven days ahead of time, where those cases rates upticks are more affecting our facilities and where we can devote resources.
HLM: What adjustments do you make when you have the data, that otherwise you would not be able to make?
Swensen: I credit our clinical staff in that they are capable of handling so much. We've been ready to deploy staffing but we haven't had to. We've moved some resources such as alcohol hand sanitizers and masks and courses of Tamiflu if necessary. We're prepared to act, as opposed to being reactionary. We've had plans in place if it continues to get worse. But because our staff is doing such a great job we haven't had to bring on additional staffing in anyone facility.
HLM: How does this dashboard work when a patient comes in with flu-like symptoms?
Swensen: All of our hospitals use electronic medical records. The dashboard uses text-based searching. The information is stored in the computer system based on chief complaint, admit or discharge diagnosis. We are using filters to capture people with things like fever, difficulty breathing, those types of influenza-like illnesses.
HLM: How do you determine ROI?
Swensen: That's a tough thing to quantify. If we are able to respond to the community and prevent additional exposures through education, because we're able to see where these case rate increases are happening, I would think the health system leadership would believe it pays for itself.
In terms of how much we spent on it, I can't answer that. This is one of a number of projects we are working on. All of these are investments in our health system and the community and it's important to spend the money and do these types of things because it helps us to be more proactive with public health.
HLM: What metrics do you use to determine if the dashboard is working?
Swensen: We're tracking emergency department hold times; the time it takes for a patient to be admitted until they find a bed. That's a good measure of hospital load. To be able to determine what the load is allows us to respond to the hospital. If we are able to prevent the load from exceeding certain markers, then we have used it to our advantage. If I am able to move resources in a controlled manner, then we’re taking advantage of the system, which is allowing us to respond more normally as opposed to reactively.
HLM: Can the dashboard be used to pinpoint flu outbreaks outside of the hospital walls?
Swensen: Our electronic record tracks the home Zip Code of the patient. So, we are able to determine where these cases are living, and in doing so we can determine which communities are more at risk. If we determined a community is more at risk we can notify schools, the local health department, and any number of agencies that can help with the education and the outreach.
HLM: Can you build a historical record on Northwell’s flu response that could be referenced in future years?
Swensen: Absolutely! We can't just flip the switch and start using it. We need a baseline. Over the past 24 months we've established the baseline and what is normal for our area. Without that baseline we don't have any visibility as to whether or not we are looking at something that could be abnormal.
HLM: Could the dashboard track other diseases?
Swensen: Yes, it could expand. This is filtering information in the medical record. If we change that filter to look at some other syndrome or chief complaint, we could use it in other areas. I don't know of any plans to do that at this time, but it's possible.
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.