LifeBridge's 5 key innovation projects in response to COVID-19

Baltimore-based LifeBridge Health Chief Innovation Officer Daniel Durand, MD, has been working non-stop with his team to support the health system's response to COVID-19.

In many cases, that has meant helping other departments close existing efforts and re-focus on patients with the coronavirus. It takes a nimble and open mindset to make these changes in a timely manner, and Dr. Durand's team is on the frontlines to coordinate those efforts.

Here are five things the system did:

1. Transitioned all research and clinical trials to focus on COVID-19. The health system shuttered all ongoing clinical trials and focused research on gathering information for the compassionate use trials for COVID-19, which include drugs and therapies as well as plans to gather convalescent plasma from individuals who had the disease and are now immune. "We are broadly knowledgeable about the different trials going on across the U.S. and as we take on more COVID-19 patients we'll get more participation," said Dr. Durand.

2. Used the digital health team to develop quarantine protocols for patients. The health system's robust digital health and patient engagement teams re-focused efforts to support protocols for patients who may need to quarantine while the system set up mobile testing sites. Individuals who call in with symptoms of COVID-19 are first evaluated by a triage nurse and then speak to a physician's assistant through a tele-visit. The PA goes through the algorithm developed for suspected cases of COVID-19 and high risk patients are then sent to a drive-thru testing location. When the results come in, a group of about 50 volunteer physicians managed by the innovation staff then connects with patients to review the results and decide on next steps.

"The innovation staff helped develop an app from GetWellNetwork that everyone downloads after they are swabbed. The app asks them about their temperature and then if they test positive, monitors them while they are in self-isolation for at least 14 days," said Dr. Durand. "The individual must then be entirely symptom free for three days before coming out of self-isolation. That was important in the beginning, because in the absence of such tools to enforce strict isolation protocols, patients might have gone on with their daily lives if they were symptom free. Even if individuals test negative, we don't know much about the accuracy of the test, so we make sure they self-quarantined for at least seven days and that they are symptom free for at least 3 days per CDC guidelines."

3. Built a dashboard with COVID-19 analytics. The health system's Analytics Center of Excellence (ACE) developed a Tableau dashboard with new analytics that shows local cases and heat maps important for the system's leaders and providers. Users can see the number of cases in the state, by county and recent diagnoses in a level of granularity that isn't available on national maps. The system also has a virtual health dashboard that shows aggregate data on the thousands of patients who have been triaged, how many patients were in each risk group, how many were tests, percent positive rates by testing site (hospital, drive-through, etc.). The dashboard also tracks how many persons under investigation and confirmed positive COVID-19 cases are in each LifeBridge hospital.

"We can use the dashboards to understand the impact of COVID-19 based on geography as well as which hospitals will need what PPE," said Dr. Durand. "All of these numbers are on the dashboard and every day we think of new things we want to track. I have previous experience with analytics and I know what happens when you have dashboard fatigue, but we are so focused on what everyone wants to see and came up with a dashboard that is getting a ton of use. Everyone has a common sense of what is useful and we were able to create something that wasn't available anywhere else."

4. Expanded telehealth. LifeBridge had developed a sophisticated digital health platform over the past several years, including a digital front door for booking urgent care visits, a virtual hospital for various forms of triage and care coordination, and a burgeoning primary care telehealth program. But the need to expand these projects into other areas has accelerated rapidly over the past few weeks. "During a pandemic, nobody wants to be in the hospital unless there is truly no other option for them," said Dr. Durand. "All of a sudden, this event was a tipping point in telehealth, but our Innovation group really didn't have to facilitate that change, because we have been involved in that for years in helping to build such a strong foundation. We already had operators in place ready to run with their respective platforms and meet the emerging needs in real-time. Our virtual hospital has its own medical director in Dr. Jonathan Thierman; this isn't common for a five-hospital system. He has been an all-star in helping us during this time."

The Innovation team organized the system's ability to enroll more than 2,000 patients in the GetWellLoop digital health platform. They also supported efforts to develop clinical guidelines for specialists to make sure everyone got the right care.

5. Built a PPE factory. The health system realized it would need additional PPE, and with a national shortage of masks, shields and gowns, the system looked inward to develop their own. Dr. Durand and his team converted an empty floor of a LifeBridge outpatient center into a functioning factory within five days by partnering with local architects and Under Armour. Under Armour procured and cut the materials, and then sent them to the factory of LifeBridge volunteers to assemble.

The team was able to quickly develop the needed masks, and moved on to surgical gowns. They also worked with a local printing company to convert their assembly line to make face shields, and assembled dozers of 3D printers donated by local private schools into a "3D printing farm" to produce things like face shields and PAPR respirator parts.

"We jump on these things that are super-fast moving targets," said Dr. Durand. "We are used to operating in areas where we aren't experts and partnering with people who are."


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