One Health System’s Response to COVID-19: Report from Ground Zero

Over the past couple of months, the coronavirus, or COVID-19, has become the primary topic of conversation around the world, as the continues to infect more and more people around the globe. In the US, the first case was detected in Washington State, making that state Ground Zero for the pandemic’s rise in the US. 

Patient One came into one of Providence St. Joseph Health’s urgent care facilities on Jan. 19. This individual had recently returned to the US after traveling to Wuhan, China. Based on symptoms and history, the CDC was called for input. The patient was tested for coronavirus and admitted to a hospital the next day after testing positive for the virus.

How did the health system handle this patient and the subsequent demand for care? Providence St. Joseph Health had already built an infrastructure in response to earlier epidemics of SARS and Ebola. So they updated their infrastructure to apply to coronavirus, and had their EHR alert system ready to go in eight hours.

As the pandemic progressed and more patients were involved, the Providence team separated its efforts into three focus areas: triage, test and treat.

Triage:

The onset of the coronavirus occurred at a time when physicians are already busy due to influenza and other health issues. To ease the burden on providers, Providence used tech options such as a chatbot to help filter/direct inquiries regarding symptoms and other coronavirus information. The chatbot allows people to do a self-service triage to determine the type of care they need. The chatbot is linked to access to a clinician if the person’s symptoms warrant. The chatbot had over a half million visitors on the first day it was available and still has considerable traffic.

Testing:

Testing for coronavirus has been quite difficult in the initial period, due to a shortage of test kits. Providence has looked for a solution to this frustrating problem so more people can be tested faster. Since the end of February, more opportunities for testing have become available. And Providence has been working to develop its own test internally. They have come up with a test but are having difficulty getting the necessary reagents from Europe. The health system is planning to open drive-thru testing stations once they have the capacity to administer more tests.

Treatment:

 Statistics from other countries have revealed that 80% of people infected with coronavirus don’t get very sick and don’t need hospitalization. About 15% need hospitalization but are not critically ill. The remaining 5% do need more intensive interventions, such as care in an ICU and/or a ventilator to support breathing. This is good news, as it means that the majority of affected patients can be treated at home, with tech support.

Providence is boosting its telehealth presence to monitor coronavirus-positive patients at home. Hospital protocols have been changed to accommodate hospitalized patients, such as prohibiting visitors. To help combat the isolation of quarantined hospital patients, the health system has brought in iPads to keep those patients connected to family and friends. 

Sara Foster

The original version of this page was published at:  https://www.greystone.net/resources/blog/healthcare/2020/03/18/one-health-system-s-response-to-covid-19-report-from-ground-zero