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pandemic protocol
COVID-19 presents communities with unique challenges, unseen for generations. The combination of virulence, extreme contagion, and significant morbidity and mortality data, make it a formidable pathogen. As we have seen in other areas of the world, extreme measures must be taken to control the spread of the virus once it establishes a foothold in communities. The traditional method of concentrated areas of acute treatment- ERs or community assessment centers may not be optimal and in many cases could contribute to the ongoing spread of the virus. We at thinkcatalyst, believe that advances in virtual health and community based mobile testing and assessment tools may provide a better solution to the challenges that we may face. Our protocol, developed by our ER and ICU physicians, may provide a valuable tool in the fight we may be facing in the next few weeks
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- patients undergo a process of "tagging" and attribute allocation based on the above community assessment tool
- these tags are assessed using an algorithm, and the patients are risk stratified
- patients added to the appropriate treatment/testing group accordingly
- the complete assessment takes place without the patient leaving their home
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patients are stratified into 4 groups
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severely ill
high probability
(high risk group)
high probability
(low/med risk group)
low probability of COVID-19
Acutely ill patients are assessed immediately by a dedicated, properly outfitted EMS crew. Patients are brought immediately to a dedicated negative pressure assessment room in the ER or ICU. Patients are not assessed by the traditional triage model in the ER..
All high probablity patients are tested in the community by a properly outfitted mobile testing team. This could be an extension of the community paramedics program. All patients are placed under home quarantine and entered in the COVID-19 watch clinic. They receive regular video-conferences with clinical staff and have a self assessment tool that can be accessed to flag worsening in their condition. They will receive daily tips on the disease and symptoms to watch for automatically, similar to other watch patients. Those with worsening of their condition will be moved to the higher risk category as appropriate.
No immediate action is taken. They are advised to retake the community assessment tool as their symptoms change
COVID-19 watch- working demo
The COVID-19 watch demo is as follows. Any community patients are able to access the "community assessment and monitoring tool" . Here any person in the community can access an assessment tool that automatically registers the patient in the appropriate "COVID-19 watch" virtual clinic. The screening stratifies patients in multiple levels. Firstly, patients are categorized according to health region. Then, they are categorized in terms of severity of COVID-19 symptoms (as above). They are further grouped on exposure risk- both exposure to a known contact and travel risk. Finally, all patients are stratified in terms of co-morbidities and presence of known risk factors for morbidity and mortality (ie. diabetes, hypertension, ACE inhibitor use ... ).
note: if you select "Fraser Health" as your region, you can follow the demo throughout the phases of the clinic.
click to take community assessment tool
After completion, all users of the tool are registered with their health region and stratified as above. They will receive an automatic email with the results of their assessment and a "watch ID". They will also be automatically added to a provincial COVID-ID chart. With this unique ID, they can book video-visits with health care professionals, add messages to their chart, and retake symptom assessments as their condition changes. Specific inputs from the symptom assessment tool will trigger "critical results" which will alert the healthcare in real time and allow for interventions in the community.
The health regions have a list and chart of their COVID-19 watch patients in the community and can support them via video-consult, telephone consult, and automated "nurse bot" responses to triggers as well as a continual automated education program around disease information, procedures around self-quarantine etc. All video-conferences, telephone visits, test results, patient messages ... can thus be securely documented. As well, team members can be added and assigned tasks/orders by other team members, so everyone is on the same page regarding patient care.
view Fraser Health patient pages
