Maura Cash, RN, BSN, CASC, is director of clinical services for HST Pathways, a top-ranked software solutions company for the ambulatory surgery center (ASC) industry.
Across the country, states are taking steps towards normalcy after a prolonged shelter-in-place period due to the rapid spread of coronavirus disease 2019 (COVID-19). This includes assessing which businesses that were formerly shut down due to safety concerns can now be reopened, and what reopening will require to keep both customers and employees safe.
Elective surgeries were among many of the activities that were put on hold. Though most were not life-or-death in nature, the majority of postponed procedures were, at their core, involved patients dealing with conditions that had gotten bad enough to warrant surgery in the first place—be it pain, difficulty with mobility, vision, or other obstacles that prevent these individuals from leading a normal life. With states currently in the process of adjusting guidance on elective procedures, health care systems are determining the best way to adjust business operations to accommodate a backlog of patients, while instituting precautionary measures to prevent another outbreak from occurring.
As health care facilities work to determine how to best implement processes to conform to guidelines from the federal government on reopening including securing sufficient amounts of personal protective equipment (PPE), routinely screening staff and patients, and facilitating social distancing measures onsite, health system leaders must also consider how technology can be utilized to support changes to business operations and patient care. Here are 3 areas where technology can help.
Supply Chain. Federal guidelines for reopening include an emphasis on PPE, disinfecting procedures for equipment and rooms, and processes for ensuring adequate medication and medical supplies, among many other recommendations. Manufacturers globally have diverted normal production of goods to help support the demand for medical equipment needed for essential care of patients impacted by COVID-19, while many others have slowed production due to a lack of demand or lack of workers. Knowing whether your facility has the required supplies in-house needed for all scheduled cases is critical. Using technology to manage supply chains can not only help with maintaining inventory levels, but can also be used to evaluate case costing and identify trends impacting profitability well ahead of time.
Critical Health Screening of Patients. The federal government encourages health facilities to employ maximum use of all telehealth modalities for both the pre-operative registration/admission process and the post-operative visit. However, on the day of the procedure, appropriate health screening and possibly testing will be required. Tests for the virus and/or antibodies are still fairly limited both in their reliability and availability and can take time to process for results. Identifying patients using a health screening questionnaire can be an effective secondary tool to help lower the risk of exposure and rerouting patients that are exhibiting symptoms to the right health care facility. Using an electronic health record (EHR) that includes health risk screening capabilities is essential for tracking responses from individuals, as well as identifying trends over time. For example, HST Pathways recently expanded EHR health risk screening capabilities to include questions specific to COVID-19 at ambulatory surgery centers, such as inquiring about recent travel and symptoms that could be indicative of the virus. These questions can also be updated in real time as federal guidelines are refined and further information is learned about the virus. Health facilities may also want to consider adding information about signs and symptoms for patients to be aware of as part of their preoperative and post-surgical care instructions.
Reduce Risk of Exposure. Health care facilities will need to determine which staff are necessary for procedures and which could continue to work remotely. Technology can enable staff to adjust schedules offsite ensuring that procedures are properly spaced out and staffed, as well as helping schedulers to identify cases where an onsite visit could potentially be replaced with telehealth. While equipment and common areas will need to be sanitized continuously, it is impossible to sanitize paper records. Switching to an EHR can cut the amount of individuals who come in contact with potentially contaminated paper records.
Wiping down the outsides of electronic devices can be accomplished quickly and easily. Additionally, an EHR gives facilities the ability to share data with other health settings in the event that the patient develops symptoms post-operatively that requires admission to another facility. A health center may also need to run reports quickly to determine who cared for that patient and if any other patients or staff were in the facility at the time who were potentially exposed.
Without technology, health systems face a more challenging road ahead in meeting requirements for reopening and ensuring the safety of patients and staff in the process. Fortunately, there are many tools and resources already available with proven records of improving business operations. As we work together to combat the spread of the virus and provide access to patients in need of surgical procedures, health care leaders must take steps to ensure their facilities and business operations are leveraging technology as part of their solution for success and sustainability both now and long into the future.
Maura Cash, RN, is director of Clinical Systems for HST Pathways.