The right way for health systems to use data analytics in COVID-19 planning

The clinical data stored in EHRs can provide important insights into treating patients with the coronavirus, especially as hospitals are confronted with full capacity and a shortage of resources.

Health systems across the U.S. are working with their vendor partners as well as local and regional agencies for capacity planning and response management. They are converting both clinical and non-clinical space into hospital rooms for patients with COVID-19 so they can receive the appropriate treatment. In some cases, the treatment includes a diagnosis and discharge home to self-isolation and remote patient monitoring; in others, it includes spending time on a ventilator in the ICU. Allscripts established a COVID Response and Resiliency program to support community and health system efforts on patient engagement and triage, remote monitoring and treatment for patients at field hospitals or step-down units.

"In all cases, the critical component is access to data, enabling systems to deploy resources based on surge predictions and patient acuity, and leveraging various care settings to ensure all patients are cared for in a manner for full recovery," said Allscripts Vice President for Strategic Client Development Nicole Faucher. "Community wide data and referral networks ease patient transitions and facilitate provider resourcing, which contributes to broad unified patient care, easing the clinical and financial burden in any particular system. While telehealth has received much applause for the swift and effective response during this crisis, it is important to note the contributions core technologies have provided to the success and rapid response including EHR platforms, analytics, post-acute networks and patient engagement. All of these systems have been utilized to orchestrate the necessary actions to successfully treat and contain this virulent pandemic."

Allscripts subsidiary CarePort Health shared insights analyzed from deidentified EHR data on 6,479 patients from hospitals across the U.S. to help providers across the U.S. understand current trends. "Our analysis of COVID patients, while preliminary, points to the complex interplay between age, gender and underlying conditions in driving COVID outcomes such as mortality," said Lissy Hu, MD, CEO of CarePort Health. "Being able to understand how each of those attributes impact the risk of severe COVID disease can support clinicians as they are triaging patients – whether it is deciding on whom to admit or which patient to transfer."

The CarePort data includes thousands of COVID-19 patients, tracking information from the minute they arrive at the ED through their recovery. The aggregated data can assist healthcare providers with decision-making when the case is not clear-cut.

Hospital executives and administrators can use the data to plan for a potential surge in COVID-19 cases. They need to manage capacity and allocate resources appropriately. The more data they have, the better their models will be to ensure appropriate levels of patient care.

"For example, by knowing the average length of stay of a diabetic COVID patient versus a COPD COVID patient, administrators can plan on how many beds will be needed based on how many diabetic and COPD patients are hitting the ED," said Dr. Hu. "Administrators can anticipate patient care needs and allocate resources accordingly when they have access to aggregated utilization and outcome data on COVID patients. That's why having real-time data on COVID patient outcomes from hundreds of hospitals is so important."

Allscripts and CarePort decided to begin releasing their data as soon as possible to maximize its value during the pandemic. The company released insights first published in The Washington Post, which include:

1. Around 10 percent of middle-aged patients that are hospitalized with COVID-19 do not survive.

2. Patients with chronic kidney disease are 2.5 times more likely to die from COVID-19, regardless of their age.

3. The average age of patients hospitalized with the coronavirus is 59.6 years old, and 57 percent of the hospitalized patients are younger than 65 years old.

4. Mortality rates increase significantly with age among hospitalized patients.

5. Among patients with COVID-19, men are 1.3 times more likely to die in the hospital than women.

Other companies including Amazon and Google are making large datasets available to support hospitals in their COVID-19 response. There are many benefits to the large data pools, but also have drawbacks as the data is only as good as its source.

"Leaders need to make sure that the data is applicable to their hospital's patient population," said Dr. Hu. "The hospital course of COVID patients is very much dependent on their age and underlying conditions. Therefore instead of releasing averages, we broke down the risk of severe COVID disease by underlying health conditions and by age groups so that each hospital could apply our learnings to their unique patient mix."

Deidentified patient data has become very useful for caregivers, including data from wearables and iPhones. There is a tremendous amount of data available in the digitized, post-HITECH healthcare delivery space that spreads across many locations.

"That data can be important intel for healthcare professionals who are seeing them when it's converted into useful analytics, and it can also inform the patient themselves so they can make better decisions about their own care," said Allscripts CEO Paul Black. "Allscripts has been advocating that data be accessible in a safe and secure manner since 2007, via our open API platform, and while it's clear that health data privacy legislation could use an update to more accurately reflect the dynamics of a digitized health system, it's clear that there is far more benefit to patients and providers when data is more accessible."

More articles on health IT:
How Mayo Clinic created a digital toolset that can detect COVID-19 exposures within hours
How Mount Sinai's IT team is responding to COVID-19
Google rolls out tools in Search and Maps to connect people with physicians, telehealth

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