Evaluating and Enhancing Health Information Technology for COVID-19 Response Workflow in a Specialized COVID-19 Hospital in a Medically Underserved Community (New York)

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Pandemics are unique in their extraordinary demands on healthcare capacity, but evaluating healthcare organizations’ decision-making and information needs may support responsiveness to more common emergency preparedness events.

Project Details - Ongoing

Summary:

The COVID-19 pandemic has exposed vulnerabilities across the U.S. healthcare system and provided a serious test of hospitals’ resilience. The system has faced formidable challenges associated with all facets of disaster medicine. These challenges relate to prevention, such as containment strategies to prevent spread; preparation, such as ensuring sufficient supplies for testing and personal protective equipment; and response, such as anticipating surge events and ensuring sufficient staffing, space, and supplies.

This research addresses critical barriers to effective responses to a pandemic by: 1) identifying the information and data needs of local hospital decision makers, and 2) characterizing the workflow around decision making tasks. In examining the response at University Hospital of Brooklyn (UHB), a lower-resource, safety net hospital highly impacted by COVID-19, the research team will evaluate UHB’s resilience, decision making approaches, and human factors engineering as it relates to clinical workflows. Columbia University Irving Medical Center (CUIMC), serving the predominantly Latino Northern Manhattan communities of Heights/Inwood, serves as a secondary site and provides a contrast in approach, technological resources, and strategies.

The specific aims of the research are as follows:

  • Analyze past and current pandemic response workflow.
  • Model information workflow, employing cognitive engineering frameworks such as the Systems Engineering Initiative for Patient Safety (SEIPS) and other sociotechnical approaches to technology-mediated work practices.
  • Investigate methods and tools to meet a broad range of known and emerging information needs to support the emergency management response team. 

During the first phase, the research team will interview and observe members of the UHB and CUIMC emergency response teams central to pandemic response. The team will also interview key informants about necessary inputs into the decision-making process and who, such as directors of clinical departments, receive the outputs. During the second phase, the team will investigate how methods and tools support the UHB emergency management response team’s information and workflow needs. A set of prototypes, including dashboards, visualizations, and data integration tools, will be developed. The research team hopes that by introducing novel and more efficient approaches to improve decision making and emergency responses during a pandemic, the quality of patient care, safety, and well-being will be enhanced.