C19 OCHIN Partner QI/Interoperability Challenge

Goals of the Effort: Support staff in documenting at-home COVID test results.

Scope of Effort in Year 1 (What activities are included and which are out of scope):

Stakeholders: OCHIN Collaborative members (i.e., community health centers and all clinical/non-clinical staff)

Workplan (high level: major steps): 

Results Console in Note

• For patient calling in with positive result from an at home COVID antigen testing kit:
  • Access the results console from a smartlink in the note
  • There are two ways to enter home testing results: The Smartlink “. COVIDPOSITIVEENTRYANDTRIAGE” can be used to quickly enter results using the results console. The smartlink “COVID POSITIVE DECISION MAKING” can be used by providers which will pull in the NIH patient prioritization tier as well as show drug interactions with Paxlovid.

1. Onboarding: This was a collaborative wide change put into effect. It was first solicited at our bi-monthly member facing meeting called the Clinical Operations Review Committee (CORC). OCHIN Clinical Informatics used this space to elicit feedback and worked with providers to make sure it is utilized at their health centers.
2. Execution: Changes were rolled out with regular monthly updates and made available to all community health centers in the OCHIN collaborative.
3. Testing and Validation: All new builds go through an internal QA process before going live in OCHIN Epic.
4. Sustainability: Way fewer clicks and puts the information in the note. It also provides Clinical Decision Support (CDS) for providers. This capability has also opened the door for other CDS options. For this reason, we think this approach will be sustainable.

Measures of Success: 

• We are currently measuring success through word of mouth. We have heard that our members are using it heavily across multiple health centers.
• Additionally, this process significantly cuts down the number of clicks the nurse has to do. This allows nurses to have more phone encounters with patients overall.
• Providers reported that they found the CDS that showed the interactions of patient’s current medications and Paxlovid extremely helpful.
• They want to use this same capability for Evusheld.

Challenges Anticipated:

• The main challenge is getting end users to adopt this new workflow.
• The logic behind it was cumbersome and not all inclusive. There are many drugs that interact with Paxlovid.