We played a leading role in statewide COVID-19 Rapid Response.
IN LIKE A LION
Days into March, the New York State Department of Health (DOH) asked for our help tracking early COVID-19 cases in the region. With some preliminary research already underway— and using our annual flu tracking process as a starting point—we were quickly able to dedicate resources to fulfilling the request.
We worked with DOH to determine what information would be most helpful in identifying potentially undiagnosed cases of the new virus, which didn’t yet have a standard code that we could search through the health information network (HIN). In consultation with our experts and our lab and hospital partners, we learned what diagnosis codes were most common among patients with COVID-19—such as those for upper respiratory infections, pneumonia and similar infectious diseases, like SARS. When clusters of these codes appeared in an individual patient record, we flagged potential COVID-19 transmission. Initially, we sent reports to DOH weekly, adjusting them as new information arose.
When COVID-19 testing became available in New York State, DOH asked us to monitor daily test results, compare them to information available through the HIN, and then provide the more informed data to DOH to help their teams predict where and when resources might be needed.
At the time, testing was only being done at a few sites—which were not connected to Hixny— and DOH was being inundated with positive or negative results that didn’t help them predict care needs. The first part of the solution was to connect testing sites to the HIN through the state’s Electronic Clinical Laboratory Reporting System (ECLRS) so that information could be analyzed in context.
We began cross-referencing COVID test results with lab and diagnosis codes, emergency room reports and comorbid conditions, and then reported the combined information to DOH daily. On any given day, that allowed DOH to see who tested positive, how many of them had been hospitalized, how many had comorbid indicators— such as diabetes or hypertension—and how many required time in the intensive care unit.
This work, which we shared with our fellow state-qualified entities as they came onboard, formed the foundation of standardized reporting guidelines and directly informed decisions DOH made about resource allocation. While the constant flow of new information required ongoing pivots and reprioritization, to say we are proud of our work is an understatement.
As we developed the reports for DOH, we realized that a subset of the information could be helpful to payers. That scaled-down daily report included the names of patients enrolled in their plans who had a positive COVID-19 diagnosis, along with any hospitalization information. Almost immediately, we began to see positive—and sometimes even emotionally impactful—reactions.
One of those payers contacted us to say the report allowed them to proactively reach out to members who’d been positively diagnosed. Through some of those interactions they discovered ways to further support members. When a payer reached out and discovered a member was hospitalized, the family sometimes responded as if they were a lifeline—remember, at the time, hospitals were not allowing anyone to be by the patient’s side.
Hixny also worked to expand the availability of COVID-19 test results through the provider portal’s reporting functionality. This proved to be important beyond patient care.
“We were able to log into Hixny and quickly identify if an incoming patient had been tested for COVID, allowing us to confirm we had the necessary personal protective equipment (PPE),” said Michelle Mazzacco, vice president of St. Peter’s Health Partners’ community services division. “For our visiting nurse staff and hospice clinicians, this was incredibly important and helped put their minds at ease because they were showing up to patient homes fully informed of the potential risk and equipped to take every necessary precaution.”
Remember that first email to our staff in March? We did all of this work remotely and will continue to operate this way until at least April 2021. There’s no reason to rush back to the office when productivity remains high—and when we can help protect our staff’s health so we can all continue to support the front line workers and public health officials battling the pandemic. While tiny hands sometimes wave at the screen during meetings and dogs may bark during phone calls, we’ve established an increased level of trust.
And while the situation with COVID-19 evolves almost daily, we have hit our stride and are well-equipped to respond immediately to requests that come our way—even as the pandemic accompanies us through flu season.