How NYC Health + Hospitals combined data streams, clinical expertise for 'epidemic intelligence' efforts

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Since March, New York City-based NYC Health + Hospitals has relied on analytics and its incident command strategy as the foundation for its COVID-19 response.

In a June 11 article published in Health Affairs, a team of the health system's physicians and researchers explained how NYC Health + Hospitals used its existing population health analytics infrastructure to spearhead its pandemic response. The infrastructure had been used to support patients with diabetes, hypertension, depression, HIV and other high-risk conditions.

"When COVID-19 arrived, we leveraged that infrastructure to rapidly deploy a suite of dashboards, collating self-report and [Epic] EHR data into one visual schema covering COVID-19 admissions and census, testing, bed capacity and availability, staffing status, and summary overviews of emergency departments and critical care," the co-authors wrote.

To adapt to new COVID-19 workflows, the analytics team worked with hospital epidemiologists, physician councils, chief medical information officers and the IT department to mine, validate and automate real-time data from the EHR. The group developed a dashboard to track hospital capacity across facilities and predict the number of beds needed, while the CMIO, serving as the systemwide "bed czar", led an on-the-ground review of daily baseline hospital capacity data to ensure accuracy.

"We termed these efforts 'epidemic intelligence,' reflecting the convergence of operational visibility, clinical expertise and high-quality data streams," the co-authors wrote.

The health system's incident commander, CMO Machelle Allen, MD, then presented the COVID-19 intelligence report during daily incident command system meetings. ICS is a management approach to provide a common operating plan for all participants across the health system, which comprises 11 hospitals and more than 70 care sites across New York City.

A "Tiger Team" consisting of administrative, operations, logistics, medical and technical personnel then led the daily plans at their respective facilities. Using the dashboard allowed ICS to analyze, for example, which hospitals needed additional personal protective equipment so the Tiger Team leaders could examine the health system's inventory and properly direct PPE.

 

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