Virtual urgent care, remote monitoring: How CHOP's health IT team met the viral surge

The health IT team at Children's Hospital of Philadelphia has been helping manage the recent surge of pediatric respiratory illnesses by shifting to virtual urgent care and boosting remote patient monitoring, CIO Shakeeb Akhter told Becker's.

Like many children's hospitals across the country, CHOP has been inundated with cases of respiratory syncytial virus, influenza and COVID-19 in recent weeks — a phenomenon some public health experts have labeled a "tripledemic."

Becker's interviewed Mr. Akther, who is also a senior vice president, about what his team has been doing to help.

Note: The interview has been condensed and lightly edited for clarity.

Question: How has CHOP's IT department responded to the surge?

Shakeeb Akhter: Over the last few weeks, we have deployed analytics tools to predict and internally share wait times across our emergency departments, quickly brought new beds online, relocated our King of Prussia (Pa.) urgent care to accommodate additional ED patients, and implemented functionality to allow patients to let us know they are on their way to our urgent cares and "save a spot" prior to their arrival. We are also pursuing a telehealth pilot in our urgent care centers to assist with the viral surge.

Q: How does the virtual urgent care program work?

SA: At the peak of the surge, CHOP explored every option to address the high volume of patients presenting to our urgent care and emergency department. For low-acuity patients presenting to urgent care, we designed a program to offer video visits as an alternative to potentially lengthy wait times. We determined eligibility and appropriateness for urgent care video visits using an online pediatric symptom checker.

Additionally, with the viral surge and need for inpatient capacity to accommodate children with severe respiratory illness, we have accelerated our plans to safely discharge appropriate patients with ambulatory monitoring via remote patient monitoring.

Through a combination of EHR-native tools and third-party solutions, we are launching new RPM programs in the next year across a range of use cases, including home-bound NICU patients, malnutrition, concussion management, pediatric epilepsy, newborn anticipatory guidance, post-surgical care, and more.

Lastly, we received a Federal Communications Commission COVID-19 telehealth grant that jump-started our use of connected devices managed and deployed by CHOP Home Care, including connected ventilator and CPAP/BIPAP devices.

Q: What health IT lessons from the COVID-19 pandemic have you used for the recent surge of respiratory illnesses?

SA: Our information services team at CHOP joins a daily enterprise taskforce call that provides situational awareness, giving us the information needed to develop solutions to clinical and operational issues.

The key elements that have allowed us to deliver value are the same as they were during COVID: being embedded within our clinical and operational teams; deploying multidisciplinary IT product teams; utilizing "design thinking" and partnering with our clinical informaticists to develop clinical workflows with the end user in mind; and working in an agile manner to intake new ideas, prioritize and respond quickly.


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